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Nystatin
Nystatin (Mycostatin, Nilstat)
Nystatin
(nye-STAT-in)
Pregnancy Category: C (A for vaginal use) Tablets: Mycostatin Nilstat. Oral Suspension: Mycostatin Nadostine Nilstat Nystex PMS Nystatin. Troches: Mycostatin Pastilles. Vaginal Tablets: Mycostatin Nadostine Topical: Mycostatin Nadostine Nilstat Nyaderm Nystex Nystop Topical Powder: Candistatin Nystop (Rx)

Classification: Antibiotic, antifungal

See Also: See also Anti-Infectives.

Action/Kinetics: Derived from Streptomyces noursei; is both fungistatic and fungicidal against all species of Candida. Binds to fungal cell membranes (sterols), resulting in altered cellular permeability and leakage of potassium and other essential intracellular components. Poorly absorbed from the GI tract; unabsorbed nystatin is excreted in the feces.

Uses: Candida infections of the skin, mucous membranes, GI tract, vagina, and mouth (thrush). The drug is too toxic for systemic infections although it can be given PO for intestinal moniliasis infections, as it is not absorbed from the GI tract.

Contraindications: Use for systemic mycoses. Use of topical products in or around the eyes.

Special Concerns: Do not use occlusive dressings when treating candidiasis. Do not use lozenges in children less than 5 years of age.

Side Effects: Nystatin has few toxic effects. GI: Epigastric distress, N&V;, diarrhea. Other: Rarely, irritation.

How Supplied: Capsule: 500,000 U, 1 million U; Cream: 100,000 U/gm; Lozenge/troche: 200,000 U; Ointment: 100,000 U/gm; Powder: 100,000 U/gm; Suspension: 100,000 U/mL; Tablet: 100,000 U, 500,000 U

Dosage
•Capsule, Lozenge, Oral Suspension, Tablets Intestinal candidiasis.
Tablets, 500,000-1,000,000 units t.i.d.; continue treatment for 48 hr after cure to prevent relapse.
Oral candidiasis.
Oral Suspension, adults and children: 400,000-600,000 units q.i.d. (1/2 dose in each side of mouth, held as long as possible before swallowing); infants: 200,000 units q.i.d. (same procedure as with adults); premature or low birth weight infants: 100,000 units q.i.d. Lozenge, adults and children: 200,000-400,000 units 4-5 times/day, up to 14 days. NOTE: Lozengesshould not be chewed or swal-lowed.
•Vaginal Tablets
100,000 units (1 tablet) inserted in vagina once each day for 2 weeks.
•Topical Cream, Ointment, Powder (100,000 units/g each)
Apply to affected areas b.i.d.-t.i.d., or as indicated, until healing is complete.

 
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