Macmiror Complex 500 (Nystatin, Nifuratel)

Macmiror Complex 500 is used to treat vaginal infections caused by fungi, bacteria or protozoa.

• Vaginal candidiasis: reduces fungal load of Candida species, relieving itching, discharge and irritation.
• Bacterial vaginosis: suppresses overgrowth of anaerobic bacteria, helping restore normal lactobacilli dominance.
• Trichomoniasis: eradicates Trichomonas vaginalis, alleviating malodorous discharge and discomfort.

• Nystatin binds to ergosterol in fungal cell membranes, forming pores that increase permeability and cause cell death. Nifuratel interferes with microbial DNA synthesis and metabolic pathways, exerting antibacterial and antiprotozoal activity against a range of vaginal pathogens. The combination provides simultaneous antifungal, antibacterial and antiprotozoal effects when applied locally to the vaginal mucosa.

Macmiror Complex 500 may cause local or systemic adverse reactions, most of which are mild and reversible.

Common Side Effects

• Vaginal irritation: mild burning, itching or stinging at the site of application.
• Discharge changes: increased volume or altered color/consistency of vaginal discharge.
• Headache: transient mild headache, usually resolving without treatment.

Serious or Rare Side Effects

• Allergic reaction: rash, hives, swelling of face or lips, or difficulty breathing.
• Severe vaginal inflammation: intense redness, swelling, ulceration or pain in the vaginal mucosa.
• Liver enzyme elevation: rare increase in hepatic enzymes, may require monitoring.

Before using Macmiror Complex 500, consider the following precautions to ensure safe and effective therapy.

• Pregnancy: consult a healthcare professional before use, as safety data are limited.
• Breastfeeding: discuss potential risks with a physician, as the drug may be excreted in milk.
• Allergy history: avoid if known hypersensitivity to nystatin, nifuratel or similar agents.
• Concomitant vaginal products: do not use other intravaginal medications simultaneously without medical advice.
• Complete course: use the full prescribed duration even if symptoms improve, to prevent recurrence.
• Store at ambient temperature: keep below 25 °C, in the original packaging, protected from moisture and direct sunlight.

Macmiror Complex 500 may interact with other medicines; awareness of these interactions helps avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Systemic antifungals (e.g., oral fluconazole): concurrent use may increase systemic exposure to nystatin, raising risk of toxicity.
• Immunosuppressants (e.g., cyclosporine): may enhance susceptibility to opportunistic infections if vaginal flora is disturbed.

Moderate Interactions (Monitor Closely)

• Topical antibiotics: may alter vaginal flora and affect the therapeutic balance.
• Hormonal contraceptives: no direct interaction, but vaginal irritation could affect absorption of some forms.
• Probiotic supplements: timing should be staggered to prevent antagonistic effects on the vaginal microbiome.