Oteseconazole is an azole metalloenzyme inhibitor that targets fungal CYP51.[L41635] CYP51, also known as 14α demethylase, participates in the formation of ergosterol, a compound that plays a vital role in the integrity of cell membranes.[L41635,A247020] By binding and inhibiting CYP51, oteseconazole is active against most microorganisms associated with recurrent vulvovaginal candidiasis (RVVC).[L41635] Oteseconazole has demonstrated activity against _Candida albicans_, _Candida glabrata_, _Candida krusei_, _Candida parapsilosis_, _Candida tropicalis_, _Candida lusitaniae_ and _Candida dubliniensis_.[L41635] Unlike previous-generation azole antifungals, oteseconazole has a high selectivity for CYP51 and little interaction with human cytochrome P450s.[A247035] This is possible thanks to the tetrazole moiety in oteseconazole that increases target selectivity.[A247035] In contrast with oteseconazole, other antifungals with imidazole or triazole moieties, such as [ketoconazole] or [fluconazole], have a high number of drug-drug interactions due to their interaction with human CYPs.[A247050] The use of oteseconazole is contraindicated in females of reproductive potential due to its embryo-fetal toxicity risks.[L41635] This drug was approved by the FDA on April 26, 2022.[L41645]
Oteseconazole is an azole antifungal indicated to reduce the incidence of recurrent vulvovaginal candidiasis (RVVC) in females with a history of RVVC who are not of reproductive potential.[L41635]
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