Nystatin Pannonpharma (Nystatin)

Nystatin is a polyol antifungal used to treat superficial Candida infections of mucosal surfaces and skin.

• Oropharyngeal candidiasis (thrush): Reduces fungal load and relieves soreness, white plaques, and discomfort.
• Esophageal candidiasis: Helps clear Candida overgrowth and improves swallowing ability.
• Cutaneous candidiasis: Eliminates skin lesions caused by Candida and promotes healing.
• Diaper dermatitis (Candida diaper rash): Controls fungal growth and soothes irritated skin.

• Nystatin binds to ergosterol, a key component of fungal cell membranes, forming pores that increase membrane permeability. This leads to leakage of intracellular electrolytes and macromolecules, resulting in inhibition of fungal growth and cell death. Because it is poorly absorbed from the gastrointestinal tract, its activity is confined to the site of application, providing targeted antifungal effects without systemic exposure.

Nystatin is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Nausea: Mild stomach upset after oral administration.
• Vomiting: Occasional emesis, especially in children.
• Diarrhea: Loose stools may appear during treatment.
• Abdominal discomfort: Cramping or pain in the gut.
• Altered taste: Temporary metallic or bitter sensation.
• Local irritation: Redness or burning at the site of topical application.

Serious or Rare Side Effects

• Allergic reaction: Rash, itching, swelling, or hives.
• Anaphylaxis: Rare but potentially life‑threatening systemic response.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatic dysfunction: Uncommon elevation of liver enzymes.
• Hematologic changes: Rare neutropenia or eosinophilia.

Before using Nystatin, consider the following safety measures.

• Renal impairment: Use with caution; monitor renal function if prolonged therapy is needed.
• Pregnancy: Only use if the potential benefit justifies the potential risk to the fetus.
• Breastfeeding: Assess infant for possible oral candidiasis; discontinue if adverse effects are observed.
• Hypersensitivity: Discontinue immediately if signs of an allergic reaction appear.
• Concomitant antibiotics: Monitor for reduced efficacy due to altered gut flora.
• Store at ambient temperature: Keep in the original container, protect from moisture and heat.

Nystatin has limited systemic absorption, resulting in few clinically significant drug interactions.

Major Interactions (Avoid)

• Concurrent systemic antifungals (e.g., amphotericin B): May increase risk of additive toxicity.
• High‑dose oral corticosteroids: Potential for enhanced local immunosuppression.

Moderate Interactions (Monitor Closely)

• Broad‑spectrum antibiotics: May disrupt normal flora and affect fungal colonisation.
• Antacids containing aluminum or magnesium: Could alter gastric pH and affect drug dissolution.
• Probiotic supplements: May interfere with intended antifungal activity.