Mycostatine (Nystatin)

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

• Oral candidiasis (thrush): reduces fungal load and resolves oral lesions.
• Esophageal candidiasis (when administered orally): clears infection and improves swallowing.
• Prophylaxis in high‑risk patients: helps prevent Candida overgrowth during antibiotic or corticosteroid therapy.

• Nystatin binds selectively to ergosterol, a key sterol in fungal cell membranes, forming pores that increase membrane permeability. This disruption leads to leakage of intracellular contents and ultimately fungal cell death, while having minimal effect on human cells that lack ergosterol.

Adverse reactions may occur with oral nystatin therapy.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Vomiting: occasional episodes after dosing.
• Diarrhea: loose stools during treatment.
• Abdominal pain: cramping or discomfort.
• Taste alteration: temporary change in taste perception.
• Mild rash: localized skin irritation.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction with difficulty breathing.
• Stevens‑Johnson syndrome: rare severe skin reaction.
• Hepatotoxicity: liver enzyme elevations in rare cases.
• Severe hypersensitivity: swelling of face, lips, or tongue.
• Persistent vomiting: leading to dehydration.
• Rare systemic infection: secondary bacterial infection.

Before prescribing Mycostatine, consider the following safety measures.

• Assess renal function: adjust use in patients with severe kidney impairment.
• Monitor for allergic reactions: discontinue if signs of hypersensitivity appear.
• Use with caution in infants: dosage must be determined by a pediatric specialist.
• Avoid in patients with known hypersensitivity to nystatin or other polyenes.
• Review concomitant medications: consider potential interactions with other antifungals.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Nystatin may interact with other medications; awareness of these interactions helps ensure safe use.

Major Interactions (Avoid)

• Concomitant use with cholestyramine: binding may reduce local antifungal activity.
• Simultaneous administration of systemic azoles (e.g., fluconazole): may diminish nystatin efficacy.

Moderate Interactions (Monitor Closely)

• Use with broad‑spectrum antibiotics: increased risk of fungal overgrowth.
• Co‑administration with antacids: may alter gastric pH and affect drug dissolution.
• Interaction with immunosuppressants: monitor for enhanced immunosuppression.
• Use with other topical antifungals: assess for cumulative irritation.
• Combination with probiotics: evaluate for potential gastrointestinal effects.