Mycostatin, Nadostine , Nilstat, Nyaderm , Nystex, O-V Statin
Classifications: antifungal antibiotic; Therapeutic: antifungal antibiotic
Prototype: Amphotericin B
Pregnancy Category: C
500,000 unit tablets; 100,000 units/mL oral suspension; 200,000 troches; 100,000 units vaginal tablets; 100,000 units/g cream, ointment, powder.
Nontoxic, nonsensitizing antifungal antibiotic produced by Streptomyces noursei. Binds to sterols in fungal cell membrane, thereby changing membrane potential and allowing leakage of intracellular components
that leads to fungi cell death.
Fungistatic and fungicidal activity against a variety of yeasts and fungi; not appreciably active against bacteria, viruses,
Local infections of skin and mucous membranes caused by Candida sp. including Candida albicans (e.g., paronychia; cutaneous, oropharyngeal, vulvovaginal, and intestinal candidiasis).
Use of vaginal tablets during pregnancy (category C); vaginal infections caused by Gardnerella vaginalis or Trichomonas sp.
Lactation (PO form); diabetes mellitus.
Route & Dosage
| Candida Infections
Adult: PO 500,0001,000,000 U t.i.d.; 14 troches 45 times/d; Suspension: 400,000600,000 U q.i.d. Intravaginal 12 tablets daily for 2 wk
Child: PO Suspension: 400,000600,000 U q.i.d.
Infant: PO 100,000200,000 U q.i.d.
- Give reconstituted powder for oral suspension immediately after mixing.
- Rinse mouth with 12 tsp using oral suspension. Keep in mouth (swish) as long as possible (at least 2 min), then spit
it out. (If you cannot keep the liquid in your mouth or cannot spit, or if you have been told to "swish and swallow,"
you may swallow the drug.) For children, infants: Apply drug with swab to each side of mouth. Avoid food or drink for 30
min after treatment.
- Store vaginal tablets in refrigerator below 15° C (59° F).
Adverse Effects (≥1%)GI:
Nausea, vomiting, epigastric distress, diarrhea
(especially with high oral doses).
Poorly absorbed from GI tract. Elimination:
Assessment & Drug Effects
- Monitor oral cavity, especially the tongue, for signs of improvement.
- Avoid occlusive dressings or applications of ointment preparation to moist, dark areas of body because they favor growth
Patient & Family Education
- This drug may cause contact dermatitis. Stop using the drug and report to physician if redness, swelling, or irritation
- Take for oral candidiasis (thrush) treatment after meals and at bedtime.
- Dissolve troche in mouth (about 30 min). Do not chew or swallow. Avoid food and drink during period of dissolving and for
30 min after treatment.
- Care of dentures: Remove dentures before each rinse with oral suspension and before use of troche. Remove dentures at night
(infection occurs more frequently in person who wears dentures 24 h a day).
- Dust shoes and stockings, as well as feet, with nystatin dusting powder.
- Gently clean infected areas with tepid water before each application of topical preparation.
- Continue medication for vulvovaginal candidiasis during menstruation.
- Use vaginal tablets up to 6 wk before term to prevent thrush in the newborn.