Nystatin
Indications
Nystatin is used for:
Fungal infections, Oropharyngeal candidiasis, Intestinal candidiasis, Vaginal candidiasis
Adult Dose
Oral
Oral candidiasis
Adult: As oral susp or drop : 100,000-600,000 U (1-6 ml drop) into the mouth 4 times daily. Keep in contact w/ affected area as long as possible.
Continue for 48 hr after clinical cure to prevent relapse.
Intestinal candidiasis
Adult: As tab or oral susp/drop: 500,000 or 1,000,000 U 3-4 times daily.
Prophylaxis: 1,000,000 U daily.
Vaginal
Vulvovaginal candidiasis
Adult: insert 1 vaginal tablet into vagina daily at bedtime for 14 days or longer.
Child Dose
As oral susp or drop
Infants: PO: 2 mL/dose, children 4–6 mL/dose, to coat oral mucosa q6h
As tab
Child: PO: 3–6 tabs/day tid
For prophylaxis of oral candidiasis in the newborn the suggested dose is
1 ml (100,000 U) once daily. Administration should be continued for 48 hours after clinical cure to prevent relapse.
Renal Dose
Administration
May be taken with or without food.
Contra Indications
Hypersensitivity.
Precautions
Immunocompromised patients. Childn. Pregnancy and lactation. Patient Counselling May damage latex contraceptives (vag).
Lactation: Not known if excreted in breast milk; use caution
Pregnancy-Lactation
Pregnancy category: C, ROUTE(S) : Mouth/Throat / PO
Pregnancy Category: A, ROUTE(S) : Vaginal
Interactions
Adverse Effects
Side effects of Nystatin :
Nausea, vomiting, diarrhoea, GI upset, oral irritation and sensitisation. Rarely, rash, urticaria, Stevens-Johnson syndrome, tachycardia, bronchospasm, facial swelling, nonspecific myalgia
Vaginal tablet: May damage latex contraceptives (e.g. diaphragms, condoms), additional contraceptive measures should be taken. Localized sensitization.
Mechanism of Action
Nystatin, a polyene antifungal, binds to ergosterol in the fungal cell membrane. This binding affects the cell wall permeability allowing leakage of cellular contents.