Nystatin
Mechanism :
Nystatin is both fungistatic and fungicidal in vitro against a wide variety of yeasts and yeast-like fungi. Nystatin acts by binding to sterols in the cell membrane of susceptible fungi with a resultant change in membrane permeability allowing leakage of intracellular components. Nystatin exhibits no activity against bacteria, protozoa, trichomonads, or viruses.
Indication :
- Oropharyngeal candidiasis
- Intestinal candidiasis
- Prophylaxis against oral candidiasis
Contraindications :
Hypersensitivity to nystatin is a contraindication for its use. Some nystatin oral suspension preparations contain sugar and are unsuitable for children with disaccharide intolerance.
Dosing :
Oropharyngeal candidiasis:
Premature infants:
100,000 units, PO, paint suspension in recesses of mouth, every 6 hours.
Infants:
200,000 units, PO, paint suspension in recesses of mouth, every 6 hours (100,000 units in each side)
Children:
400,000-600,000 units PO, swish in mouth several times and then swallow, 4 times a day.
Intestinal candidiasis:
Oral tablets: 500,000-1,000,000 units 3 times a day.
Adverse Effect :
Rarely, oral irritation or sensitization, may occur. Large oral doses produce diarrhea, gastrointestinal distress, nausea and vomiting. Contact dermatitis, Stevens-Johnsons syndrome, hypersensitivity reactions have also been reported.
Interaction :
None known.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Not dialysed. Dose as in normal renal function |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
No dose adjustments are recommended.