Nystatin Actavis (Nystatin)

Nystatin Actavis is used to treat fungal infections of the Candida species affecting the oral cavity, esophagus and gastrointestinal tract.

• Oral candidiasis (thrush): reduces fungal load and relieves symptoms such as soreness and white plaques in the mouth.
• Esophageal candidiasis: eradicates Candida infection of the esophageal mucosa, improving dysphagia and pain.
• Intestinal candidiasis: clears Candida overgrowth in the gastrointestinal tract, alleviating abdominal discomfort and diarrhea.

• Nystatin binds selectively to ergosterol, a key sterol component of fungal cell membranes. This binding creates pores that increase membrane permeability, leading to leakage of intracellular electrolytes and macromolecules, ultimately causing fungal cell death while sparing human cells that lack ergosterol.

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

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Vomiting: occasional emesis after oral administration.
• Abdominal pain: cramping or discomfort in the stomach area.
• Diarrhea: loose stools that may be transient.
• Taste alteration: temporary metallic or bitter taste.
• Mild skin rash: localized erythema or itching.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction with breathing difficulty.
• Hepatic dysfunction: elevated liver enzymes or jaundice.
• Neutropenia: marked reduction in white blood cell count.
• Stevens‑Johnson syndrome: severe skin blistering and mucosal involvement.
• Severe gastrointestinal bleeding: uncommon but potentially life‑threatening.

When prescribing Nystatin Actavis, clinicians should consider several precautionary measures to ensure safe use.

• Renal function: assess baseline kidney function, especially in patients with pre‑existing renal disease.
• Hepatic function: monitor liver enzymes in patients with known liver impairment.
• Immunocompromised patients: use with caution, as systemic spread of infection may occur.
• Concomitant antibiotics: be aware of possible overgrowth of resistant organisms.
• Allergic history: verify no prior hypersensitivity to polyene antifungals.
• Store below 25°C: keep in the original pack, protect from moisture.

Nystatin Actavis can interact with other medicines, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Systemic azole antifungals: may antagonize Nystatin's local action.
• Nephrotoxic agents (e.g., aminoglycosides): combined use can increase renal risk.
• Live vaccines: concurrent administration may reduce vaccine efficacy.

Moderate Interactions (Monitor Closely)

• Antacids containing aluminum or magnesium: may affect oral absorption.
• Broad‑spectrum antibiotics: can alter normal flora and affect Candida colonisation patterns.
• Oral contraceptives: monitor for rare reports of reduced effectiveness.