nystatin (Mycostatin, Nilstat, Nyamyc, Nystat Rx, Nystatin Systemic, Nystex, Nystop)
Classes: Antifungals, Other; Antifungals, Systemic
Dosing and uses of Mycostatin, Nilstat (nystatin)
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)