Class: Polyene Antifungal
Dosage Forms. Topical Cream: 100,000 units/g; Topical Ointment: 100,000 units/g
Common FDA Label Indication, Dosing, and Titration.
1. Candidiasis of skin: Apply liberally to affected areas bid until healing complete
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 Topical
Medication Safety Issues: Nystatin Topical
Drug Interactions: Nystatin Topical. None known
Adverse Reactions: Nystatin Topical
Efficacy Monitoring Parameters. Resolution of clinical symptoms.
Toxicity Monitoring Parameters. Severe skin irritation or rash.
Key Patient Counseling Points. Apply to affected area of skin. Skin should be intact. Do not get it in eyes, nose, or mouth. Avoid occlusive dressings, tight-fitting diapers, and plastic pants if using on diaper area of children.
Clinical Pearls. As effective as clotrimazole in treating topical Candida infections. Vaginal tablet for vaginal Candida infections is still available but infrequently used. Miconazole and terconazole are both more effective than nystatin and are available OTC.