Nystatine Rph (Nystatin)

Nystatin is used to manage fungal infections caused by Candida species across several body sites.

• Oropharyngeal candidiasis: reduces yeast colonisation and relieves symptoms of oral thrush.
• Esophageal candidiasis: helps clear fungal infection and improve swallowing.
• Cutaneous candidiasis: treats skin infections such as diaper rash and intertrigo.
• Gastrointestinal candidiasis: controls overgrowth of Candida in the GI tract.
• Vaginal candidiasis: alleviates itching and discharge caused by yeast infection.

• Nystatin binds to ergosterol, a key sterol in fungal cell membranes, forming pores that increase membrane permeability. This leads to leakage of intracellular electrolytes and macromolecules, ultimately causing fungal cell death without significant absorption into the systemic circulation.

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

Common Side Effects

• Nausea: mild stomach upset after oral administration.
• Vomiting: occasional emesis following dose.
• Diarrhoea: loose stools may occur.
• Abdominal pain: cramping or discomfort.
• Skin irritation: redness or itching at the site of topical application.
• Taste alteration: temporary change in taste perception.

Serious or Rare Side Effects

• Severe allergic reaction: rash, swelling, or difficulty breathing.
• Hepatic dysfunction: rare liver enzyme elevations.
• Neutropenia: uncommon reduction in white blood cells.
• Stevens‑Johnson syndrome: extremely rare severe skin reaction.
• Anaphylaxis: life‑threatening hypersensitivity (very rare).

Before using Nystatin, consider the following safety measures.

• Assess hypersensitivity: confirm no known allergy to polyene antifungals.
• Monitor renal function: use caution in patients with impaired kidney function.
• Observe for allergic reactions: discontinue if rash, swelling, or breathing difficulty occurs.
• Use in immunocompromised patients: ensure close clinical supervision.
• Limit duration: avoid prolonged use without medical review.
• Store at room temperature: keep in the original packaging, protect from moisture and direct sunlight.

Nystatin has limited systemic absorption, but certain co‑administered agents may affect its safety or efficacy.

Major Interactions (Avoid)

• Concurrent systemic antifungals (e.g., amphotericin B): increased risk of additive toxicity.
• Nephrotoxic drugs (e.g., aminoglycosides): may exacerbate renal side effects.

Moderate Interactions (Monitor Closely)

• Antacids: may reduce absorption of oral suspension.
• Broad‑spectrum antibiotics: can alter normal flora, affecting fungal balance.
• Oral contraceptives: no clinically significant interaction, but monitor efficacy.
• Probiotics: may diminish antifungal effect when taken simultaneously.
• Other topical agents: assess for skin irritation when layered.