Drug Guide
Ibrexafungerp citrate
Classification
Therapeutic: Antifungal
Pharmacological: Glucan synthase inhibitor
FDA Approved Indications
- Vaginal yeast infections (Vulvovaginal candidiasis)
Mechanism of Action
Ibrexafungerp inhibits 1,3-β-D-glucan synthase, an enzyme essential for fungal cell wall synthesis, leading to cell wall disruption and fungal cell death.
Dosage and Administration
Adult: Check the specific dosing regimen as per FDA approval; typically, a 300 mg dose taken orally once daily for 3 days.
Pediatric: Not currently approved for pediatric use.
Geriatric: Adjust if renal or hepatic impairment present; no specific dose adjustment recommended but monitor closely.
Renal Impairment: No specific adjustment necessary, but monitor for adverse effects.
Hepatic Impairment: Use with caution; no specific dosage adjustments established.
Pharmacokinetics
Absorption: Well absorbed orally.
Distribution: Widely distributed; specifics not fully detailed.
Metabolism: Metabolized minimally, primarily by hepatic pathways.
Excretion: Excreted in feces and urine.
Half Life: Approximately 16 hours.
Contraindications
- Hypersensitivity to Ibrexafungerp or its components.
Precautions
- Use with caution in patients with hepatic impairment; monitor liver function tests.
- Limited data in pregnancy and lactation; use only if potential benefit justifies potential risk.
Adverse Reactions - Common
- Nausea (Common)
- Diarrhea (Common)
- Headache (Common)
Adverse Reactions - Serious
- Liver enzyme elevations (ALT, AST) (Uncommon)
- Allergic reactions including rash, hypersensitivity (Rare)
Drug-Drug Interactions
- Potential interactions with medications affecting CYP enzymes; consult detailed prescribing information.
Drug-Food Interactions
- None specific.
Drug-Herb Interactions
- Avoid concomitant use with herbal products that affect CYP pathways.
Nursing Implications
Assessment: Monitor for signs of hepatic dysfunction and hypersensitivity.
Diagnoses:
- Risk for hepatic injury
- Risk for allergic reaction
Implementation: Administer as prescribed; monitor liver function; assess for adverse effects.
Evaluation: Evaluate patient tolerance, absence of adverse reactions, and successful resolution of infection.
Patient/Family Teaching
- Take medication exactly as prescribed.
- Report any signs of hepatic problems (jaundice, dark urine) or allergic reactions.
- Use in conjunction with other measures for infection control.
Special Considerations
Black Box Warnings:
- None currently issued.
Genetic Factors: No known pharmacogenomic considerations.
Lab Test Interference: May elevate liver function tests; interpret results accordingly.
Overdose Management
Signs/Symptoms: Nausea, vomiting, abdominal pain, possible hepatic dysfunction.
Treatment: Supportive care; no specific antidote; monitor liver function; consider activated charcoal if ingestion is recent.
Storage and Handling
Storage: Store at room temperature, 20-25°C (68-77°F).
Stability: Stable under recommended storage conditions.