Nystatin

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Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

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Nystatin is one of the most important active ingredients against diseases caused by Candida fungal attack. Since the active ingredient only has a limited local effect, side effects are very rare. Drugs with nystatin are considered the drug of choice even for pregnant and breastfeeding women and may also be used in small children. Here you can read everything you need to know about nystatin.

This is how nystatin works

Nystatin is an antifungal agent from the group of polyenes. It has a fungicidal effect on dormant and dividing yeasts (Candida species).

The human immune system is there, among other things, to protect the body from foreign invaders such as fungi. As soon as a pathogen finds its way into the organism, the body reacts immediately and fights it with various mechanisms.

Usually the person does not notice anything when their immune system is active. However, sometimes the body does not immediately manage to fight the pathogen successfully.

This is especially the case with a weakened immune system, such as with HIV disease, after long antibiotic use or chemotherapy. In this case, pathogens such as fungal cells can attack the body, which leads to serious symptoms of the disease.

The active ingredient nystatin helps the body fight fungi from the Candida group. It attaches to the membrane of the fungal cells, causing pores to form in it and a large number of charged particles (especially potassium ions) to flow out of the cell. This disrupts the metabolism of the fungal cell - it dies.

Uptake, breakdown and excretion

After ingestion by mouth, the active ingredient nystatin is practically not absorbed from the intestine into the blood. Therefore it can be used for the local treatment of a fungal attack in the intestine. It will be excreted in the stool.

Even when applied to the skin, practically no active ingredient is absorbed. Its effect is limited to the place where it was applied.

When is nystatin used?

The areas of application (indications) of nystatin include:

• Fungal attack by Candida fungi on the skin, nails, corners of the mouth, mucous membranes (e.g. vaginal fungus)
• Fungal attack from Candida fungi in the mouth, throat, esophagus and the rest of the gastrointestinal tract (e.g. oral thrush)

This is how nystatin is used

The active ingredient is used in the form of ointments for the skin and mucous membranes, as a vaginal tablet and oral gel, and in the form of suspensions or tablets for oral use. The dosage form with which the fungal disease can be treated most specifically is selected.

In the case of a skin disease, for example, only the affected skin area is treated with a nystatin ointment. If the esophagus or the entire gastrointestinal tract is infected, nystatin tablets or suspensions are best.

If you have fungal infections in the mouth and throat, keep the nystatin suspension in your mouth for as long as possible before swallowing it.

The dosage is very different due to the many different ways of administration. Patients should always follow the dosage given in the package insert or ask their doctor or pharmacist.

It should be noted that the dosage of the active ingredient is not given in milligrams, but in "I.U." (= International units). This makes it possible to dose the active ingredient not via the amount, but according to the individual effect.

In the case of fungal diseases in particular, it is very important that patients adhere to the given dosage and recommended use. If a drug containing nystatin is dosed too low or used irregularly, resistance can develop, as with all other anti-fungal agents (the pathogens become insensitive to the active ingredient).

Therefore, at the end of therapy, it must be ensured that the fungal disease has completely healed in order to avoid a new outbreak. The treatment is therefore usually continued for a few days after the symptoms have subsided.

What are the side effects of nystatin?

Because the effect is mostly local, nystatin side effects are relatively rare. These include hypersensitivity reactions with nystatin ointment (applied to the skin), and gastrointestinal problems with nystatin tablets or nystatin suspension (taken up through the mouth).

What should be considered when taking nystatin?

Contraindications

If there is a known hypersensitivity to nystatin, the active ingredient must not be used. If allergy symptoms (such as redness, itching) occur during use, the drug should be discontinued and the attending physician should be consulted.

Interactions

There are no known interactions with other drugs.

When using a nystatin ointment in the genital or anal area, the tear resistance of latex products (condoms, diaphragms) may decrease, depending on the composition of the ointment. You should therefore read the respective package insert carefully in advance.

Age restriction

The high osmolarity of the active ingredient must be taken into account in the case of drugs that are ingested by mouth. "High osmolarity" means that the active ingredient draws a lot of water from the surrounding cell environment.

This is not a problem in adults, but it can cause severe gastrointestinal damage in premature babies. Therefore, the use of nystatin in newborns and underweight infants is not recommended.

pregnancy and breast feeding period

Due to the very specific and locally limited effect of nystatin, the active ingredient is the agent of choice during pregnancy and breastfeeding. The experience is high and no harmful effects on the child were found.

How to get medication with nystatin

Medicines containing nystatin are available over-the-counter in pharmacies in Germany. In Austria and Switzerland, however, they require a prescription and can only be obtained with a valid prescription.

How long has nystatin been known?

The active ingredient nystatin was discovered in 1948 as the first, highly effective remedy for fungal diseases and has saved countless lives since then. To this day, nystatin is considered to be very effective in superficial fungal diseases and is therefore still widely used.

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