Ibrexafungerp — Complete Research Guide (2026)

Last updated 2026-06-30

What is Ibrexafungerp?

Ibrexafungerp (brand name Brexafemme, formerly SCY-078) is a first-in-class oral triterpenoid antifungal and the first non-azole approved for vulvovaginal candidiasis.

It received FDA approval in 2021 for the treatment of acute vulvovaginal candidiasis and for reducing the incidence of recurrent vulvovaginal candidiasis in adult and post-menarchal paediatric females.

Evidence level is high for this indication, supported by the phase 3 VANISH randomised placebo-controlled trials in humans; broader uses such as invasive fungal infections remain investigational.

How does Ibrexafungerp work?

Ibrexafungerp is a glucan synthase inhibitor that, like echinocandins, blocks synthesis of beta-1,3-glucan in the fungal cell wall, but it is a structurally distinct triterpenoid rather than a lipopeptide.

Its distinct chemistry allows oral administration and retains activity against some azole- and echinocandin-resistant strains.

What does the research say about Ibrexafungerp?

• In the phase 3 VANISH-303 trial, oral ibrexafungerp was superior to placebo for clinical cure of acute vulvovaginal candidiasis. ^[1]
• Superiority over placebo was confirmed in the global phase 3 VANISH-306 trial. ^[2]
• In a phase 3 trial, monthly oral ibrexafungerp reduced the incidence of recurrent vulvovaginal candidiasis versus placebo. ^[4]

Clinical research & studies

The references below are the primary sources cited throughout this guide. Each links directly to PubMed or the regulator. Where evidence is preclinical (animal or in-vitro), that is stated rather than implied.

• [1] Ibrexafungerp Versus Placebo for Vulvovaginal Candidiasis Treatment: A Phase 3, Randomized, Controlled Superiority Trial (VANISH 303) — Schwebke JR et al., Clinical Infectious Diseases 2022. (Randomized controlled trial (phase 3))
• [2] Efficacy and safety of oral ibrexafungerp for the treatment of acute vulvovaginal candidiasis: a global phase 3, randomised, placebo-controlled superiority study (VANISH 306) — Sobel R et al., BJOG 2022. (Randomized controlled trial (phase 3))
• [3] Oral Ibrexafungerp for Vulvovaginal Candidiasis Treatment: An Analysis of VANISH 303 and VANISH 306 — Goje O et al., Journal of Women's Health 2023. (Pooled analysis of phase 3 RCTs)
• [4] A phase 3, multicenter, randomized, placebo-controlled trial of monthly oral ibrexafungerp to reduce the incidence of recurrent vulvovaginal candidiasis — Goje O et al., American Journal of Obstetrics and Gynecology 2025. (Randomized controlled trial (phase 3))
• [5] Ibrexafungerp: First Approval — Lee A et al., Drugs 2021. (Review)

Dosing context

For acute vulvovaginal candidiasis it was studied as a short same-day oral regimen of two doses, while recurrence prevention was studied as a once-monthly oral course.

This is context only and not a dosing recommendation; the prescriber determines the appropriate regimen and confirms it is safe for the individual.

Side effects & safety profile

Ibrexafungerp is teratogenic and is contraindicated in pregnancy; a negative pregnancy test before treatment and effective contraception during treatment are required for people who can become pregnant.

The most common adverse effects reported in trials were gastrointestinal, including diarrhoea, nausea and abdominal pain, along with dizziness; it is generally otherwise well tolerated as a short oral course.

This is educational information only; ibrexafungerp is a prescription medicine that must be prescribed and monitored by a clinician, with particular attention to pregnancy status.

Stacking & combinations

Ibrexafungerp is a prescription-only oral antifungal, not a supplement or peptide, and because of its teratogenicity it must never be combined or self-administered outside medical supervision.

Finding Ibrexafungerp vendors

User reviews

Frequently asked questions

References

1. [1] Ibrexafungerp Versus Placebo for Vulvovaginal Candidiasis Treatment: A Phase 3, Randomized, Controlled Superiority Trial (VANISH 303) — Schwebke JR et al., Clinical Infectious Diseases 2022. PMID: 34467969. View sourceStudy: Randomized controlled trial (phase 3)Oral ibrexafungerp was superior to placebo for clinical cure of acute vulvovaginal candidiasis.
2. [2] Efficacy and safety of oral ibrexafungerp for the treatment of acute vulvovaginal candidiasis: a global phase 3, randomised, placebo-controlled superiority study (VANISH 306) — Sobel R et al., BJOG 2022. PMID: 34676663. View sourceStudy: Randomized controlled trial (phase 3)Ibrexafungerp demonstrated superiority over placebo for acute vulvovaginal candidiasis.
3. [3] Oral Ibrexafungerp for Vulvovaginal Candidiasis Treatment: An Analysis of VANISH 303 and VANISH 306 — Goje O et al., Journal of Women's Health 2023. PMID: 36255448. View sourceStudy: Pooled analysis of phase 3 RCTsPooled VANISH-303 and VANISH-306 data confirmed consistent efficacy and tolerability.
4. [4] A phase 3, multicenter, randomized, placebo-controlled trial of monthly oral ibrexafungerp to reduce the incidence of recurrent vulvovaginal candidiasis — Goje O et al., American Journal of Obstetrics and Gynecology 2025. PMID: 40752754. View sourceStudy: Randomized controlled trial (phase 3)Monthly ibrexafungerp reduced recurrence of vulvovaginal candidiasis versus placebo.
5. [5] Ibrexafungerp: First Approval — Lee A et al., Drugs 2021. PMID: 34313977. View sourceStudy: ReviewSummarises the first FDA approval, mechanism and development status of ibrexafungerp.