Nystatin Smartpractice Europe Gmbh (Nystatin)

• Nystatin is a polyene antifungal indicated for the treatment of superficial fungal infections affecting the skin and mucous membranes.
• Cutaneous candidiasis: Reduces fungal load and promotes healing of skin lesions caused by Candida species.
• Oral thrush (mucosal candidiasis): Controls Candida overgrowth on the oral mucosa, relieving discomfort.
• Intertriginous candidiasis: Treats fungal infection in skin folds, decreasing redness and irritation.
• Diaper rash (Candida): Decreases fungal proliferation in the diaper area, improving skin condition.
• Vaginal candidiasis (topical): Controls Candida infection when applied intravaginally, relieving itching and discharge.

• Nystatin binds to ergosterol, an essential sterol in fungal cell membranes, forming pores that increase membrane permeability. The resulting leakage of intracellular ions and macromolecules leads to cell death, providing a fungicidal effect against susceptible Candida species while having limited absorption in human tissues. Because human cell membranes lack ergosterol, Nystatin exhibits selective toxicity, making it suitable for topical application on skin and mucosal surfaces.

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

Common Side Effects

• Skin irritation: Redness, itching, or burning at the application site.
• Contact dermatitis: Localized allergic skin reaction.
• Nausea (if swallowed inadvertently): Mild gastrointestinal discomfort.
• Stinging sensation: Transient discomfort upon application.
• Dryness: Mild dryness of the treated area.

Serious or Rare Side Effects

• Systemic hypersensitivity: Rare anaphylactic reactions requiring immediate medical attention.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis, extremely rare.
• Liver toxicity: Uncommon, usually associated with extensive absorption.
• Angioedema: Swelling of deeper skin layers, rare.
• Respiratory distress: Very rare, may occur with systemic absorption.

• When using Nystatin, consider the following precautions to ensure safe and effective therapy.
• Application area: Apply only to intact skin or mucosa as directed.
• Allergy assessment: Discontinue use if signs of allergic reaction appear.
• Avoid ingestion: Prevent swallowing of the product; if accidental ingestion occurs, seek medical advice.
• Concurrent antifungals: Consult a healthcare professional before using other topical antifungal agents.
• Pregnancy and lactation: Use only if benefits outweigh potential risks, after professional evaluation.
• Store at room temperature: Keep in the original container, protect from moisture and direct sunlight.

Nystatin can interact with other medications, primarily affecting absorption or increasing the risk of irritation.

Major Interactions (Avoid)

• Systemic antifungals (e.g., amphotericin B): Concurrent use may increase toxicity without added benefit.
• Topical corticosteroids: May reduce antifungal efficacy when applied to the same site.

Moderate Interactions (Monitor Closely)

• Oral antibiotics: May alter normal flora, potentially affecting fungal colonization.
• Skin irritants (e.g., harsh soaps): Can exacerbate local irritation when used together.
• Other topical agents: Apply at different times to minimize interaction.