Your Patients Need Brexafemme Kit — Here's How to Help Them Find It

As a prescriber, you've likely fielded calls from patients unable to fill their Brexafemme Kit (Ibrexafungerp) prescriptions. The drug's temporary unavailability has created a gap in your treatment toolkit — particularly for patients with recurrent vulvovaginal candidiasis (RVVC) or azole-resistant infections who had finally found an effective therapy.

This guide provides actionable steps your practice can take to support patients: from tracking down remaining stock to transitioning patients to effective alternatives and streamlining the process when Brexafemme Kit returns to market.

Current Availability Status

As of March 2026, Brexafemme Kit (Ibrexafungerp 150 mg tablets) is temporarily unavailable from the manufacturer:

• Scynexis listed the medication as temporarily unavailable with no estimated return date
• The NDA has been transferred to GSK (completed November 2025)
• The FDA clinical hold was lifted in May 2025
• Standard pharmaceutical wholesalers do not have stock
• No generic version of Ibrexafungerp exists

For the complete shortage timeline, see: Brexafemme Kit Shortage: What Providers Need to Know.

Why Patients Can't Find Brexafemme Kit

Understanding the root cause helps you counsel patients effectively:

1. Manufacturing pause: The FDA clinical hold and subsequent NDA transfer have interrupted production and distribution
2. No generic backup: Without a generic Ibrexafungerp product, there's no alternative manufacturer to maintain supply
3. Pharmacy inventory depleted: As a specialty medication with a relatively small patient population, pharmacies didn't maintain deep stock
4. Transition period: GSK now holds the NDA but hasn't resumed commercial distribution

What Providers Can Do: 5 Practical Steps

Step 1: Use Medfinder for Providers to Track Availability

Medfinder for Providers is a free tool designed to help clinical teams locate hard-to-find medications. Your staff can:

• Search for Brexafemme Kit availability by location
• Identify pharmacies that may have remaining inventory
• Share the tool with patients so they can search independently
• Monitor for restocking when GSK resumes distribution

Integrate Medfinder into your practice workflow so staff can quickly check availability when a patient needs a hard-to-find medication.

Step 2: Pre-Authorize Alternative Prescriptions

Don't wait for patients to call back frustrated. When prescribing Brexafemme Kit, proactively:

• Discuss the current shortage and set realistic expectations
• Write a backup prescription for an alternative (e.g., Fluconazole maintenance for RVVC)
• Document the clinical rationale for Brexafemme in the chart — this will streamline future prior authorization when the drug returns

Step 3: Contact Specialty Pharmacies

Specialty pharmacies may have different sourcing capabilities than chain pharmacies. Consider:

• Establishing relationships with specialty pharmacies that focus on women's health or infectious disease medications
• Asking specialty pharmacies to notify your practice when Brexafemme Kit becomes available through their channels
• Exploring whether compounding pharmacies can prepare alternative antifungal formulations for resistant cases

Step 4: Prepare Prior Authorization Documentation

When Brexafemme Kit returns to market, many insurers will likely continue to require prior authorization and step therapy. Prepare now by:

• Documenting Fluconazole treatment failure or contraindication in patient charts
• Recording specific Candida species and susceptibility testing when available
• Noting the patient's history of recurrent infections and prior treatment attempts
• Having PA templates ready for rapid submission

Step 5: Educate Patients and Manage Expectations

Provide patients with written resources they can reference:

• Brexafemme Kit Shortage Update for Patients
• Alternatives to Brexafemme Kit
• How to Find Brexafemme Kit in Stock

Clear communication reduces patient anxiety and helps maintain the therapeutic relationship during this disruption.

Alternative Treatment Options

For your clinical decision-making, here's a concise comparison of available alternatives:

For Acute VVC

• Fluconazole 150 mg (generic): Single oral dose, first-line, $3–$15. Effective for most uncomplicated VVC but limited against resistant strains
• Miconazole (Monistat): OTC topical, 1–7 day regimens, $10–$20. Appropriate for uncomplicated VVC; patient preference may vary
• Clotrimazole: OTC topical, various regimens, $8–$15

For RVVC Prevention

• Oteseconazole (Vivjoa): FDA-approved for RVVC in patients not of reproductive potential. Oral dosing with induction and maintenance phases
• Fluconazole maintenance: 150 mg weekly for 6 months (off-label). Well-established efficacy data; recurrence rates increase after discontinuation

For Azole-Resistant Infections

• Intravaginal Boric acid 600 mg daily for 14–21 days
• Compounded topical Amphotericin B
• Compounded topical Flucytosine
• Consider infectious disease consultation for complex or refractory cases

Workflow Tips for Your Practice

• Add a shortage flag: Flag Brexafemme Kit in your EHR or prescribing system so staff are aware of the unavailability before writing prescriptions
• Create a patient handout: Summarize the shortage status and alternative options in a one-page handout for distribution
• Set a calendar reminder: Check availability quarterly via Medfinder for Providers or the ASHP drug shortage database
• Coordinate with your pharmacy partners: Ask your preferred pharmacies to alert your practice when Brexafemme Kit returns to their inventory

Final Thoughts

The Brexafemme Kit shortage is one of many medication availability challenges facing clinicians in 2026, but its impact is outsized because of the limited alternatives for azole-resistant VVC and the unique RVVC prevention indication. By using tools like Medfinder for Providers, proactively managing alternative prescriptions, and staying informed about the GSK transition, you can continue to provide excellent care for your patients during this disruption.

For cost-related guidance to share with patients, see: How to Help Patients Save Money on Brexafemme Kit.