nystatin (Mycostatin, Nilstat, Nyamyc, Nystat Rx, Nystatin Systemic, Nystex, Nystop)

Dosing and uses of Mycostatin, Nilstat (nystatin)

• Adult
• Pediatric

 

Adult dosage forms and strengths

oral powder

• 100,000units/g

oral suspension

• 100,000units/mL

oral tablet

• 500,000units

capsule

• 500,000units
• 1,000,000units

 

Oropharyngeal Candidiasis

Oral suspension: 400,000-600,000 units PO q6hr; swish in mouth several minutes and then swallow

 

Intestinal Candidiasis

Oral tablets: 500,000-1,000,000 units q8hr

Powder: 1/8 to 1/4 teaspoonful in 1/2 cup of water (500,000-1,000,000 units) PO q8hr

 

Invasive Fungal Infections (Orphan)

Liposomal nystatin: Treatment of invasive fungal infections

Orphan indication sponsor

• The University of Texas, M.D. Anderson Cancer Center, Unit 038; Houston, TX 77030

 

Administration

Retain suspension in mouth as long as possible before swallowing

 

Pediatric dosage forms and strengths

oral powder

• 100,000units/g

oral suspension

• 100,000units/mL

oral tablet

• 500,000units

capsule

• 500,000units
• 1,000,000units

 

Oropharyngeal Candidiasis

Premature infants

• 100,000 units PO q6hr; paint suspension into recesses of the mouth

Infants

• 200,000 units PO q6hr (100,000 units in each side of mouth); paint suspension into recesses of the mouth

Children

• Oral suspension: 400,000-600,000 units PO q6hr; swish in mouth several minutes and then swallow

 

Intestinal Candidiasis

Oral tablets: 500,000 units-1,000,000 units q8hr

Powder: 1/8 to 1/4 teaspoonful in 1/2 cup of water (500,000-1,000,000 units) PO q8hr

 

Mycostatin, Nilstat (nystatin) adverse (side) effects

Frequency not defined

Diarrhea

Nausea

Stomach pain

Vomiting

Contact dermatitis

Stevens-Johnson syndrome

Hypersensitivity reactions

 

Warnings

Contraindications

Hypersensitivity

 

Cautions

Not for use in systemic mycoses

Discontinue therapy if irritation or sensitization observed during use

 

Pregnancy and lactation

Pregnancy category: C

Lactation: Not known if excreted in breast milk; use caution

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of Mycostatin, Nilstat (nystatin)

Mechanism of action

Binds sterols in fungal cell membrane, altering permeability and thus causing cellular contents to leak

 

Absorption

Poor PO absorption

Onset: Symptom relief for oral candidiasis 24-72 hr

 

Elimination

Excretion: Feces (as unchanged drug)