Ibrexafungerp, also known as SCY-078 or MK-3118, or as the brand name Brexafemme, is a triterpene antifungal indicated in the treatment of vulvovaginal candidiasis and prevention of recurrent vulvovaginal candidiasis in post-menarchal patients. It is a derivative of enfumafungin and was developed out of a need to treat fungal infections that may have become resistant to echinocandins or azole antifungals. Ibrexafungerp is orally bioavailable compared to the echinocandins caspofungin, micafungin, and anidulafungin; which can only be administered parenterally. Similarly to echinocandin antifungals, Ibrexafungerp inhibits β-1,3-glucan synthase. While echinocandins bind to the FKS1 domain of β-1,3-glucan synthase, enfumafungin and its derivatives bind at an alternate site which allows them to maintain their activity against fungal infections that are resistant to echinocandins. The inhibition of β-1,3-glucan synthase prevents the synthesis of 1,3-β-D-glucan, an essential component of the fungal cell wall, which ultimately leads to osmotic instability and cell death.

Ibrexafungerp Pathway References