Nystatin
MYCOSTATIN
Pronunciation: nye-STAT-in
“Not a statin”
Polyene antifungal, not a HMG-CoA reductase inhibitor like simvastatin
What it isPolyene that forms pores in fungal ergosterol membranes; oral, cutaneous, and vaginal candidiasis.
Why this oneLack of systemic absorption allows mucosal and cutaneous treatment with essentially no systemic interactions.
What limits itThat same nonabsorption makes it useless for invasive disease; poor contact time often defeats the oral suspension.
FDA-approved for
- candidiasis (~1954)
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Intestinal candidiasis | Adult | 500,000–1,000,000 units (1–2 tablets) TID | 500,000–1,000,000 units TID |
Renal Undefined
Hepatic Undefined
Instructions
- Continue treatment for at least 48 hours after clinical cure to prevent relapse
Available strengths
- tab 500000 units
- powder 100000 units/g
- susp 100000 units/mL
- cream 100000 units/g
- ointment 100000 units/g
Cautions
- Oral irritation and sensitization reported
- Discontinue if hypersensitivity (rash, urticaria; rarely Stevens-Johnson syndrome)
Adverse reactions
- Diarrhea, nausea, vomiting, GI upset
- Rash/urticaria (rare)
Pregnancy Category C; use only if clearly needed. No animal reproduction data.
Lactation Undefined
Cost
| Strength | #/mo | generic $ | CostPlus | |
|---|---|---|---|---|
| 500000 units | tab | 90 TID | not offered | |
| 100000 units/mL | susp | per unit | not offered | |
| 100000 units/g | cream | per unit | not offered | |
| 100000 units/g | ointment | per unit | not offered | |
| 100000 units/g | powder | per unit | not offered |
Generic entry1982
NO BOXED WARNINGS
Principal riskLittle; not absorbed
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityLocal irritation or hypersensitivity; systemic toxicity is minimal with correct local use.
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