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Oteseconazole is an orally bioavailable, selective azole antifungal indicated for the reduction of recurrent vulvovaginal candidiasis (RVVC) in females who are not of reproductive potential. It acts as a metalloenzyme inhibitor targeting fungal lanosterol 14α-demethylase (CYP51), an enzyme essential for ergosterol biosynthesis and fungal cell membrane integrity. By inhibiting CYP51, oteseconazole disrupts ergosterol production, leading to increased membrane permeability and fungal cell death. The drug demonstrates potent activity against multiple Candida species and is distinguished by its tetrazole metal-binding group, which confers high selectivity for fungal over human CYP51 isoenzymes. Oteseconazole was developed by Mycovia Pharmaceuticals and approved by the FDA in April 2022[3][5][6][8].
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