Nystatin

Definition
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Polyene antimycotic from Streptomyces noursei.

Pharmacodynamics (Effect)
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Complex formation with the cytoplasmic membrane of yeast fungi and the resulting change in permeability.

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Dermatology

Antimycotics

Medicinal products which have either a fungistatic or fungicidal action. See Table 1 for the classification.

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Indication
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Candida infections.

Dosage and method of use
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Systemic: 3 times/day 1 million IU p.o. for at least 2 weeks. Prophylaxis: 3 times/day 500.000 IU p.o.
Topical: ointments/pastes/creams: apply 2-3 times/day in case of candidiasis of the skin and mucous membranes and in case of candida paronychia (see special features of topical application).
Oral thrush: 4 times/day 2-6 ml suspension (at 0.1 million IU/ml) drop into the mouth and rinse for 10 minutes. Infants and toddlers: 1 ml 4 times/day.
Intestinal candidosis: 3 times/day 0,5-1,5 million IU p.o. Infants: 3 times/day 0,15-0,3 million IU.

Standard concentration
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100 000 IU/g in ointments, pastes and creams.

Undesirable effects
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Paragroup allergy to liquid preparations, vomiting, diarrhoea.

Interactions
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External use of Clotrimazole leads to a mutual reduction in efficacy.

Recipe(s)
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Nystatin dequalinium chloride cream

Nystatin Paste

Preparations
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Candio-Hermal, Candio Hernal Plus (combination with fluprednides), Mykundex, Multilind healing ointment with nystatin

Note(s)
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For external use the usual dosage of 100,000 IU/g applies. As the activity of the dried substance varies, it is more appropriate to indicate the dosage in international units (IU) rather than grams. Nystatin is sensitive to light, oxygen, heat and extreme pH values. In aqueous suspension it is particularly unstable and often has a shelf life of only 1 week at refrigerator temperature!