Brexafemme Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Brexafemme Tablet (generic name: ibrexafungerp) is a prescription triterpenoid antifungal used to treat and help prevent vaginal yeast infections in adult and teenage females who have started their periods. It works differently from older antifungal drugs by disrupting the fungal cell wall. It is taken as two tablets by mouth, with a dose repeated 12 hours later, and carries a boxed warning against use during pregnancy.

What is Brexafemme Tablet

Brexafemme is a prescription antifungal tablet used to treat and help prevent vaginal yeast infections in adult and teenage females who have started their periods. It is a triterpenoid antifungal, a type of medicine that works differently from older antifungal drugs.

Brexafemme Tablet uses

• Treatment of vulvovaginal candidiasis (VVC), also called a vaginal yeast infection
• Reduction in the incidence of recurrent vulvovaginal candidiasis (RVVC) in women who get frequent yeast infections

Benefits of Brexafemme Tablet

• Treats vaginal yeast infections.
• Helps relieve itching caused by yeast infections.
• Helps reduce vaginal irritation and discomfort.
• Offers an oral treatment option.
• Helps reduce recurrent vaginal yeast infections when prescribed monthly.

How Brexafemme Tablet works

Brexafemme works by blocking an enzyme called glucan synthase, which fungi need to build their outer cell wall. Without this enzyme working properly, the fungus cell wall falls apart and the yeast dies. It continues to work even in the normal acidic environment of the vagina.

Brexafemme Tablet dosage

Brexafemme can be taken with or without food. Each treatment dose is two tablets taken by mouth. For treating a yeast infection, the two doses are taken about 12 hours apart on the same day, such as one in the morning and one in the evening. If the first dose is taken in the morning, take the second dose that evening; if the first dose is taken in the afternoon or evening, take the second dose the next morning.

For preventing repeat yeast infections, this same one-day, two-dose treatment is repeated once a month for six months. If you are also taking certain strong medicines that affect liver enzymes, your doctor may lower your dose. Brexafemme is not established as safe and effective in girls who have not yet started their periods.

If you miss a dose, take it as soon as you remember; if it is almost time for the next dose, skip the missed one and take the next dose as scheduled. Do not double up.

Available forms and strengths

Brexafemme is available as a tablet.

Side effects of Brexafemme Tablet

Common

• Diarrhea or loose stools
• Nausea
• Abdominal pain or stomach pain
• Dizziness
• Vomiting
• Headache
• Painful menstrual periods
• Gas (flatulence)
• Back pain
• Elevated liver enzyme levels (elevated transaminases)
• Vaginal bleeding
• Rash or hypersensitivity reaction
• Urinary tract infection
• Tiredness (fatigue)

Serious

• Hives
• Difficulty breathing
• Swelling of the face, lips, tongue, or throat
• Sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights
• Fast, irregular, or pounding heartbeats, fluttering in the chest, shortness of breath, sudden dizziness, lightheadedness, or fainting
• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady
• Very stiff muscles, high fever, profuse sweating, and tremors

Warnings and precautions

• Brexafemme has a boxed warning (the FDA's strongest warning) about the risk of harm to an unborn baby. 
• It should not be used during pregnancy. Doctors should confirm a patient is not pregnant before starting treatment, and women who can become pregnant should use effective birth control during treatment and for 4 days after the last dose.
• It is not known if Brexafemme passes into breast milk or how it might affect a nursing baby. Talk with your doctor about whether to take Brexafemme or breastfeed.
• No dose change is needed for people with mild or moderate liver problems. Use in people with severe liver impairment has not been studied.
• It isn't known if alcohol affects Brexafemme, but heavy drinking can weaken the immune system and make it harder for the body to fight infections.
• Do not take Brexafemme if you are allergic to ibrexafungerp or any of its ingredients.
• Taking Brexafemme with certain other medicines, such as some antifungals used for other infections or drugs for seizures, tuberculosis, or HIV, can change how well it works or increase side effects. Avoid combining it with strong inducers of a liver enzyme called CYP3A, and tell your doctor about all medicines and supplements you take.
• Do not give this medicine to anyone else, even if they have the same symptoms, since it may harm them.

Storage

• Store Brexafemme at room temperature between 68°F and 77°F (20°C and 25°C)
• Brief exposure to temperatures between 59°F and 86°F (15°C to 30°C) is permitted, such as during transport
• Brexafemme is supplied in child-resistant packaging
• Keep Brexafemme and all medicines out of reach of children

When to see a doctor

• Get medical help right away if you have signs of a serious allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Seek medical care immediately for serious eye symptoms like sudden vision loss, blurred or tunnel vision, eye pain or swelling, or seeing halos around lights.
• Get help right away for serious heart symptoms such as a fast, irregular, or pounding heartbeat, fluttering in the chest, shortness of breath, sudden dizziness, lightheadedness, or fainting.
• Seek emergency care for severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, heavy sweating, or tremors.
• If you think you have taken too much Brexafemme, get medical help right away or contact a poison control center.

Alternatives

• Terconazole
• Clotrimazole
• Fluconazole