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Nystatin (Topical)

Pronunciation

Pronunciation

(nye STAT in)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Cream, External:

Generic: 100,000 units/g (15 g, 30 g)

Kit, External:

Nyata: 100,000 units/g [DSC]

Pediaderm AF Complete: 100,000 units/g [DSC] [contains methylparaben, propylene glycol, propylparaben]

Ointment, External:

Generic: 100,000 units/g (15 g, 30 g)

Powder, External:

Nyamyc: 100,000 units/g (15 g, 30 g, 60 g)

Nystop: 100,000 units/g (15 g, 30 g, 60 g)

Pedi-Dri: 100,000 units/g (56.7 g [DSC])

Generic: 100,000 units/g (15 g, 30 g, 60 g)

Brand Names: U.S.

  • Nyamyc
  • Nyata [DSC]
  • Nystop
  • Pedi-Dri [DSC]
  • Pediaderm AF Complete [DSC]

Pharmacologic Category

  • Antifungal Agent, Topical

Pharmacology

Binds to sterols in fungal cell membrane, changing the cell wall permeability allowing for leakage of cellular contents

Absorption

None through mucous membranes or intact skin

Onset of Action

Symptomatic relief from candidiasis: 24 to 72 hours

Use: Labeled Indications

Fungal infections (cutaneous and mucocutaneous): Treatment of cutaneous and mucocutaneous fungal infections caused by Candida albicans and other susceptible Candida species.

Contraindications

Hypersensitivity to nystatin or any component of the formulation

Dosing: Adult

Fungal infections (cutaneous and mucocutaneous): Topical: Note: Cream is usually preferred to ointment for intertriginous areas; very moist lesions are best treated with topical powder

Cream, ointment: Apply to the affected areas twice daily or as indicated until healing is complete

Powder: Apply to the affected areas 2 to 3 times daily until healing is complete

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Fungal infections (cutaneous and mucocutaneous): Infants, Children, and Adolescents: Topical: Refer to adult dosing.

Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption

Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption

Administration

For topical external use only; not for systemic, oral, intravaginal, or ophthalmic use. Apply liberally to clean/dry skin. For fungal infection of the feet, the powder should be dusted in all footwear (in addition to application to the feet).

Storage

Cream, ointment: Store at room temperature.

Topical powder: Store between 15°C to 30°C (59°F to 86°F). Avoid excessive heat (40°C [104°F]).

Drug Interactions

Progesterone: Antifungal Agents (Vaginal) may diminish the therapeutic effect of Progesterone. Avoid combination

Adverse Reactions

Frequency not defined: Dermatologic: Contact dermatitis, Stevens-Johnson syndrome

<1% (Limited to important or life-threatening): Hypersensitivity reactions

Warnings/Precautions

Concerns related to adverse effects:

• Hypersensitivity: May occur; immediately discontinue if signs of a hypersensitivity reaction occur.

• Irritation: Discontinue if irritation occurs.

Other warnings/precautions:

• Appropriate use: For topical external use only; not for systemic, oral, intravaginal, or ophthalmic use.

Pregnancy Risk Factor

C

Pregnancy Considerations

Animal reproduction studies have not been conducted. Absorption following oral use is poor and nystatin is not absorbed following application to mucous membranes or intact skin.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Have patient report immediately to prescriber severe skin irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

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