Moronal (Nystatin)

Moronal is a polyene antifungal used to treat fungal infections of the oral and upper gastrointestinal tract.

• Oral candidiasis (thrush): reduces fungal load and relieves symptoms such as soreness and white plaques.
• Esophageal candidiasis: eradicates Candida infection of the esophagus and improves swallowing.
• Mouth and throat fungal infections: clears infection and prevents spread to adjacent tissues.

• Nystatin binds to ergosterol, a key sterol component of fungal cell membranes, forming pores that increase membrane permeability. This disruption leads to leakage of intracellular ions and macromolecules, ultimately causing fungal cell death without significant effects on human cells lacking ergosterol.

Adverse reactions may occur with oral nystatin therapy.

Common Side Effects

• Nausea: mild stomach upset after ingestion.
• Vomiting: occasional expulsion of stomach contents.
• Abdominal discomfort: cramping or pain in the stomach area.
• Diarrhea: loose stools during treatment.
• Altered taste: temporary metallic or bitter sensation.
• Mild skin rash: localized itching or redness.

Serious or Rare Side Effects

• Severe allergic reaction (anaphylaxis): difficulty breathing, swelling, or hives.
• Hepatic dysfunction: elevated liver enzymes or jaundice.
• Neutropenia: marked reduction in white blood cells.
• Stevens‑Johnson syndrome: severe skin blistering and detachment.
• Renal impairment: decreased kidney function.
• Systemic fungal infection: rare dissemination of Candida.

Before initiating therapy, consider the following precautions.

• Assess renal function: adjust use in patients with severe renal impairment.
• Monitor hepatic function: watch for signs of liver enzyme elevation.
• Avoid in known hypersensitivity: discontinue if allergic reactions occur.
• Use caution in immunocompromised patients: increased risk of systemic infection.
• Store at room temperature: keep in the original container, protect from moisture and light.

Nystatin may interact with other medications; review patient medication lists.

Major Interactions (Avoid)

• Concomitant use with nephrotoxic agents: may increase risk of kidney injury.
• Co‑administration with systemic azole antifungals: potential antagonistic effect reducing overall antifungal efficacy.

Moderate Interactions (Monitor Closely)

• Concurrent antibiotics: may alter gut flora and increase gastrointestinal side effects.
• Antacids containing magnesium or aluminum: may reduce nystatin absorption.
• Oral corticosteroids: may increase risk of systemic fungal infection.