Recurrent vulvovaginal candidiasis affects a substantial minority of women, and chronic suppressive fluconazole carries resistance and teratogenicity concerns. Vivjoa (oteseconazole) was the first therapy approved specifically for recurrence.
Oteseconazole selectively inhibits fungal CYP51 with minimal activity against human CYP enzymes, and its long half-life supports extended dosing. The oral azole reduces the incidence of recurrent vulvovaginal candidiasis in females with a history of the condition who are not of reproductive potential.
The restriction to patients not of reproductive potential, driven by embryo-fetal toxicity signals and that same long half-life, is the defining commercial limitation on Vivjoa’s addressable population. It remains the only agent approved for recurrence, with no generic competition.
