Classifications: antifungal agent; Therapeutic: antifungal
Prototype: Amphotericin B
Pregnancy Category: C
Mechanism of action simulates that of amphotericin B and nystatin by binding to sterols in the fungal cell membrane resulting
in cell death of fungi.
Effective against many yeasts and filamentous fungi including Candida, Aspergillus, Cephalosporium, Fusarium, and Penicillium. Limited activity in vivo against Trichomonas vaginalis.
Blepharitis, conjunctivitis, and keratitis caused by susceptible fungi. Drug of choice for Fusarium solani keratitis.
Oral, cutaneous, and vaginal candidiasis; intranasal treatment of pulmonary aspergillosis.
Concomitant administration of a corticosteroid.
Pregnancy (category C) or lactation. Safety and efficacy in children are not established.
Route & Dosage
Adult: Ophthalmic 1 drop in conjunctival sac of infected eye q12h for 34 d, then decrease to 1 drop q68h, then gradually
decrease to 1 drop q47d
- Wash hands thoroughly before and after treatment. Infection is easily transferred from infected to noninfected eye and to
- Shake well before using.
- Store at 2°24° C (36°75° F).
Adverse Effects (≥1%)Special Senses:
Blurred vision, photophobia, eye pain. Uneven adherence of suspension to epithelial ulcerations or in fornices.
No clinically significant interactions established.
Drug adheres to ulcerated surface of the cornea and is retained in conjunctival fornices. Does not appear to be systemically
Assessment & Drug Effects
- Inspect eye for response and tolerance at least twice weekly.
- Note: Lack of improvement in keratitis within 710 d suggests that causative organisms may not be susceptible to natamycin.
Reevaluation is indicated and possibly a change in therapy.
Patient & Family Education
- Learn appropriate technique for application of eye drops.
- Expect temporary light sensitivity. Be prepared to wear sunglasses outdoors after drug administration and perhaps for a
few hours indoors.
- Return to ophthalmologist for reevaluation of eye problem if you experience symptoms of conjunctivitis: pain, discharge,
itching, scratching "foreign body sensation," changes in vision.
- Do not share facecloths and hand towels; this will help prevent transmission of the fungal infection.