Nystatin Tablets

Generic name:

Nystatin

Drug class:

Polyene antifungal

Dosage form:

Oral tablets (500,000 units; 1,000,000 units)

Root of administration:

Oral

Dose:

Adults: 500,000–1,000,000 units four times daily for 48 hours after symptom resolution
Pediatrics: 100,000–200,000 units four times daily for 48 hours after symptom resolution
Prophylaxis: 500,000 units two to four times daily (varies by indication; consult label)

Mechanism of action:

Nystatin binds to ergosterol in fungal cell membranes, increasing permeability and causing leakage of intracellular components leading to fungal cell death.

Drug usage cases:

• Oropharyngeal candidiasis (thrush)
• Intestinal candidiasis
• Cutaneous and mucocutaneous candidiasis (adjunctive systemic therapy)
• Prophylaxis in immunocompromised patients
• Off-label: Intertrigo and diaper dermatitis with Candida involvement (adjunctive therapy)

Drug contra indications:

• Hypersensitivity to nystatin or any component of the formulation
• Not indicated for systemic mycoses
• Gastrointestinal obstruction or ileus

Side effects:

• Nausea and vomiting
• Diarrhea
• Abdominal pain and cramps
• Flatulence
• Constipation
• Rash and urticaria
• Pruritus
• Angioedema (rare)
• Contact dermatitis (with topical exposure)

Warnings:

• Not effective for systemic fungal infections due to poor absorption
• Use caution in patients with gastrointestinal disorders or obstruction
• Monitor for signs of hypersensitivity reactions
• Prolonged or repeated use may alter normal gastrointestinal flora
• Use antimicrobial stewardship principles to minimize resistance emergence

Use during pregnancy or breastfeeding:

Nystatin is minimally absorbed systemically when taken orally. Animal reproduction studies have not demonstrated fetal risk at recommended doses. Considered low risk in pregnancy when used topically or orally. Excretion in human milk is not well established; systemic exposure in breastfeeding infants is unlikely but monitor for gastrointestinal disturbance. Use only if clearly needed and benefits outweigh potential risks.