Class: Polyene Antifungal
Dosage Forms. Suspension: 100,000 units/mL; Tablet: 500,000 units; Capsule: 500,000 units, 1,000,000 units
Common FDA Label Indication, Dosing, and Titration.
1. Gastrointestinal candidiasis, nonesophageal: 500,000-1,000,000 units po tid
2. Oropharyngeal candidiasis: 400,000-600,000 units po qid (retained in mouth as long as possible prior to spitting)
Off-Label Uses. None
MOA. Nystatin binds to the sterols in fungal cell walls, damaging the fungal cell wall membrane and altering its permeability.
Drug Characteristics: Nystatin Systemic
Medication Safety Issues: Nystatin Systemic
Drug Interactions: Nystatin Systemic. None known
Adverse Reactions: Nystatin Systemic
Efficacy Monitoring Parameters. Resolution of clinical symptoms.
Toxicity Monitoring Parameters. Seek medical attention if severe skin irritation or rash occurs.
Key Patient Counseling Points. Store the oral liquid or tablets at room temperature. Shake suspension well before using.
Clinical Pearls. As effective as clotrimazole in treating topical Candida infections. Nystatin is not absorbed and will not treat systemic infections.