Nilstat (Nystatin)

Nystatin is used to treat fungal infections of the gastrointestinal and oral mucosa.

• Gastrointestinal candidiasis: reduces fungal load and relieves symptoms in the GI tract.
• Oral candidiasis (thrush): clears yeast overgrowth and improves oral comfort.
• Infant candidiasis: helps eradicate Candida infections in newborns and young children.

• Nystatin binds to ergosterol, a key sterol component of fungal cell membranes, forming pores that increase membrane permeability. This leads to leakage of intracellular ions and molecules, disrupting cellular homeostasis and ultimately causing fungal cell death without significant interaction with human cell membranes.

Nystatin may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Nausea: mild stomach upset after oral administration.
• Vomiting: occasional expulsion of the suspension.
• Abdominal discomfort: cramps 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

• Anaphylactic reaction: severe allergic response requiring immediate medical attention.
• Hepatic dysfunction: signs of liver injury such as jaundice.
• Neutropenia: marked reduction in white blood cells.
• Stevens‑Johnson syndrome: severe skin blistering and detachment.
• Renal impairment: decreased kidney function.
• Eosinophilia: elevated eosinophil count indicating hypersensitivity.

Before prescribing Nilstat, clinicians should consider several safety aspects.

• Assess renal function: adjust use in patients with severe renal impairment.
• Monitor hepatic function: rare liver toxicity has been reported.
• Avoid in patients with known hypersensitivity to nystatin or other polyene antifungals.
• Use with caution in immunocompromised individuals: risk of systemic infection.
• Store at below 25°C: keep in the original container, protect from moisture and light.

Nystatin may interact with other medicines; some combinations require avoidance while others need monitoring.

Major Interactions (Avoid)

• Concurrent use of nephrotoxic drugs: may increase risk of renal toxicity.
• Co‑administration with systemic azoles: may alter fungal flora and reduce efficacy.
• Use with cholestyramine: can bind nystatin and reduce absorption.

Moderate Interactions (Monitor Closely)

• Antacids containing aluminum or magnesium: may affect oral suspension pH.
• Probiotic supplements: may interfere with colonization of Candida.
• High‑fat meals: may delay gastric emptying and affect drug contact time.