Yes

Antifungal Agent, Oral Nonabsorbed; Antifungal Agent, Topical; Antifungal Agent, Vaginal

Dental & Medical: Treatment of susceptible cutaneous, mucocutaneous, and oral cavity fungal infections normally caused by the Candida species

B/C (oral)

Hypersensitivity to nystatin or any component

Percentage unknown: Contact dermatitis, Stevens-Johnson syndrome

1% to 10%: Gastrointestinal: Nausea, vomiting, diarrhea, stomach pain

<1%: Hypersensitivity reactions

Symptoms of overdose include nausea, vomiting, diarrhea

Treatment is supportive

No data reported

Keep vaginal inserts in refrigerator; protect from temperature extremes, moisture, and light

Binds to sterols in fungal cell membrane, changing the cell wall permeability allowing for leakage of cellular contents

Onset of symptomatic relief from candidiasis: Within 24-72 hours

Absorption: Not absorbed through mucous membranes or intact skin; poorly absorbed from the GI tract

Elimination: In feces as unchanged drug

Oral candidiasis:

Suspension (swish and swallow orally):

Premature infants: 100,000 units 4 times/day

Infants: 200,000 units 4 times/day or 100,000 units to each side of mouth 4 times/day

Children and Adults: 400,000-600,000 units 4 times/day

Troche: Children and Adults: 200,000-400,000 units 4-5 times/day

Powder for compounding: Children and Adults: 1/8 teaspoon (500,000 units) to equal approximately 1/2 cup of water; give 4 times/day

Mucocutaneous infections: Children and Adults: Topical: Apply 2-3 times/day to affected areas; very moist topical lesions are treated best with powder

Intestinal infections: Adults: Oral tablets: 500,000-1,000,000 units every 8 hours

Vaginal infections: Adults: Vaginal tablets: Insert 1 tablet/day at bedtime for 2 weeks

No data reported

None reported

None reported

No information available to require special precautions

No effects or complications reported

Take as directed. Maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake). Do not allow medication to come in contact with eyes. Report persistent nausea, vomiting, or diarrhea; or if condition being treated worsens or does not improve. Pregnancy precautions: Inform prescriber if you are pregnant.

Oral suspension: Shake well before using. Remove dentures, clean mouth (do not replace dentures until after using medications). Swish suspension in mouth for several minutes before swallowing.

Oral troches: Remove dentures, clean mouth (do not replace dentures until after using medication). Allow troche to dissolve in mouth; do not chew or swallow whole.

Topical: Wash and dry area before applying (do not reuse towels without washing, apply clean clothing after use). Report unresolved burning, redness, or swelling in treated areas.

Vaginal tablets: Wash hands before using. Lie down to insert high into vagina at bedtime.

Administer around-the-clock rather than 4 times/day, 3 times/day, etc, (ie, 12-6-12-6, not 9-1-5-9) to promote less variation in peak and trough serum levels

Cream: 100,000 units/g (15 g, 30 g)

Ointment, topical: 100,000 units/g (15 g, 30 g)

Powder, for preparation of oral suspension: 50 million units, 1 billion units, 2 billion units, 5 billion units

Powder, topical: 100,000 units/g (15 g)

Suspension, oral: 100,000 units/mL (5 mL, 60 mL, 480 mL)

Tablet:

Oral: 500,000 units

Vaginal: 100,000 units (15 and 30/box with applicator)

Troche: 200,000 units

Dismukes WE, Wade JS, Lee JY, et al, "A Randomized, Double-Blind Trial of Nystatin Therapy for the Candidiasis Hypersensitivity Syndrome," N Engl J Med, 1990, 323(25):1717-23.

Epstein JB, Vickars L, Spinelli J, et al, "Efficacy of Chlorhexidine and Nystatin Rinses in Prevention of Oral Complications in Leukemia and Bone Marrow Transplantation," Oral Surg Oral Med Oral Pathol, 1992, 73(6):682-9.

Meunier-Carpentier F, "Symposium on Infectious Complications of Neoplastic Disease (Part II). Chemoprophylaxis of Fungal Infections," Am J Med, 1984, 76(4):652-6.

Poland JM, "Oral Thrush in the Oncologic Patient. Therapy Must Be Tailored," Am J Hosp Care 1987, 4(5):30-2.

Wasilewski C Jr, "Allergic Contact Dermatitis From Nystatin," Arch Dermatol, 1971, 104(4):437.