Brexafemme Is a Prescription Antifungal Medication Used to Treat and Prevent Vaginal Yeast Infections

Brexafemme (Ibrexafungerp) is the first and only oral triterpenoid antifungal approved by the FDA. It represents a new class of antifungal therapy — one that works differently from the azole-based medications (like Fluconazole) that have been the standard treatment for decades. If you've been prescribed Brexafemme or are curious about it, here's everything you need to know.

What Is Brexafemme?

Brexafemme is the brand name for Ibrexafungerp (also known as Ibrexafungerp citrate, formerly SCY-078). It belongs to a drug class called triterpenoid antifungals, specifically a glucan synthase inhibitor. This makes it fundamentally different from older antifungal medications.

Key facts about Brexafemme:

• Brand name: Brexafemme
• Generic name: Ibrexafungerp
• Drug class: Triterpenoid antifungal (glucan synthase inhibitor)
• Manufacturer: Originally developed by Scynexis, Inc.; now licensed to GSK for commercialization
• FDA approval: Approved for VVC treatment and RVVC prevention
• Controlled substance: No — Brexafemme is not a controlled substance
• Form: 150 mg oral tablet (purple, oval, film-coated)
• Generic available: No generic is available as of 2026

What Is Brexafemme Used For?

Brexafemme has two FDA-approved uses:

1. Treatment of vulvovaginal candidiasis (VVC) — commonly known as a vaginal yeast infection — in adult and postmenarchal pediatric females.
2. Reduction in the incidence of recurrent vulvovaginal candidiasis (RVVC) — for women who get frequent yeast infections (typically defined as 3 or more episodes in a year).

Brexafemme is also being studied in clinical trials for other uses, including invasive candidiasis (serious internal fungal infections) and infections caused by drug-resistant Candida species, including C. auris. However, these are not currently approved uses.

How Is Brexafemme Taken?

One of the biggest advantages of Brexafemme is its simple dosing schedule:

For Treating a Yeast Infection (VVC)

• Take 300 mg (two 150 mg tablets) in the morning
• Take 300 mg (two 150 mg tablets) in the evening, approximately 12 hours later
• That's it — one day of treatment, 4 tablets total (600 mg)

For Preventing Recurrent Yeast Infections (RVVC)

• Take the same one-day dose (300 mg twice, 12 hours apart)
• Repeat this monthly for 6 consecutive months

Important Dosing Notes

• Brexafemme can be taken with or without food
• If you're also taking a strong CYP3A inhibitor (like Ketoconazole or Itraconazole), your dose is reduced to 150 mg twice in one day instead of 300 mg
• Do not take Brexafemme with strong CYP3A inducers (like Rifampin) — see our drug interactions guide

Who Should Not Take Brexafemme?

Brexafemme is not safe for everyone. You should not take it if:

• You are pregnant or might be pregnant. Brexafemme is contraindicated in pregnancy due to evidence of embryo-fetal harm in animal studies. Your doctor must verify you're not pregnant before prescribing it. Women of reproductive age should use effective contraception during treatment and for 4 days after the last dose.
• You have a known allergy to Ibrexafungerp or any of the ingredients in Brexafemme.
• You take strong CYP3A inducers such as Rifampin, Phenytoin, Carbamazepine, or long-acting barbiturates. These drugs reduce Brexafemme's effectiveness.

It's unknown whether Brexafemme passes into breast milk. If you're breastfeeding, discuss the risks and benefits with your doctor.

For a full rundown of potential side effects, see our Brexafemme side effects guide.

How Much Does Brexafemme Cost?

Brexafemme is a brand-name medication with no generic alternative, which means it can be expensive:

• Cash price: $450–$600 for 4 tablets (one treatment course)
• With insurance: Coverage varies. Many commercial plans cover Brexafemme but may require prior authorization or step therapy (trying Fluconazole first). Copays vary by plan.
• Manufacturer copay card: Eligible commercially insured patients may pay as little as $30 per prescription
• Medicare: Medicare Part D plans may cover Brexafemme with varying copays. The $2,000 annual out-of-pocket cap (as of 2025) may help limit costs.
• Patient assistance: Programs may be available for uninsured or underinsured patients through NeedyMeds.org and RxAssist.org

For more ways to reduce cost, see our detailed savings guide for Brexafemme.

Brexafemme Availability in 2026

Brexafemme has had a complicated availability history. A voluntary nationwide recall in 2023 and an FDA clinical hold that lasted about 19 months disrupted supply. GSK is now working to resume commercial distribution, but availability remains limited in early 2026. For the latest updates, see our shortage update.

If you need Brexafemme now, Medfinder can help you find a pharmacy with it in stock. If it's unavailable, your doctor can discuss alternatives including Fluconazole ($4–$15), Miconazole/Monistat ($10–$20 OTC), or Oteseconazole/Vivjoa (~$900 for RVVC prevention).

Final Thoughts

Brexafemme is a groundbreaking medication that offers a new approach to treating and preventing vaginal yeast infections. Its one-day dosing, different mechanism of action, and effectiveness against some resistant strains make it an important option. However, its high cost, current supply limitations, and strict pregnancy contraindication are factors to consider.

Talk to your doctor about whether Brexafemme is right for you, and use Medfinder to help locate it if you get a prescription.