Nystatin: Overview of Oral and Topical Treatments - Verywell Health

Nystatin is a prescription medication used to treat fungal (or yeast) infections that affect the skin, mouth, and intestinal tract. It is part of the polyene group of antifungal drugs. It is primarily prescribed for candidiasis, yeast infection caused by an overgrowth of Candida fungus that lives naturally in and on the human body.

Oral nystatin is used to treat oral thrush. Topical nystatin is used to treat fungal infections of the skin. Nystatin kills fungus to get rid of an infection or prevents it from growing in the first place. In addition to generic nystatin, you may also find it available under the brand names Mycostatin, Nystop, Nyamyc, or Pediaderm AF.

Oral Nystatin

Uses

Oral nystatin, which is taken by mouth, is approved to treat yeast infections in the mouth, throat, and stomach. Sometimes, these infections are referred to as thrush. Direct contact with nystatin is needed to fight the fungus in these parts of the body.

Nystatin works by stopping the growth of the fungus. It does that by making holes in the cell walls of the fungus, which disrupts the fungus and causes its essential contents to leak out. This kills the fungi and treats the infection. If nystatin is being used to prevent infection, its presence destroys the fungus as soon as it starts to overgrow.

While anyone can develop candidiasis (or thrush), it's a common infection for people with weaker immune systems, like babies, older adults, and people living with HIV.

Dosage

The oral version of nystatin comes in liquid or tablet form. The exact dosage will depend on the patient and the severity of the infection, but generally, treatment is recommended for seven to 14 days:

• For fungal infections of the stomach, nystatin tablets are usually taken three to four times per day.
• For fungal infections of the mouth or throat (also referred to as oral thrush), nystatin liquid is usually used four times a day.
• To prevent a fungal infection, nystatin may be taken once or twice a day.

Liquid nystatin is meant to be swished or held in the mouth for 30 seconds before swallowing, and it's usually advised not to eat or drink for 30 minutes after taking it.

Some people report that nystatin has a bitter taste, but your pharmacist may be able to add some flavoring to make it easier to tolerate. For newborns and infants, liquid nystatin can be applied to the yeast patches with a dropper or cotton swab.

It's important to follow all dosage instructions provided by your healthcare provider or pharmacist, as these will be specific to you and your particular case.

Keep taking nystatin for the full recommended duration, even if you start to feel better or your symptoms go away. If you stop using nystatin too soon or skip a dose, the infection may not be fully treated, and resistant yeast will multiply.

Nystatin works directly in the area of the infection. Because oral nystatin isn't absorbed into the bloodstream, it can't be used to treat systemic candidiasis, a fungal infection that affects the blood, heart, brain, eyes, or other parts of the body.

Topical Nystatin

Uses

Nystatin is available by prescription in topical form, which means it comes as a cream, ointment, or powder that's applied directly to the affected area. Topical nystatin is approved to treat fungal infections on the skin. It can also sometimes be used to treat vaginal yeast infection if available in a capsule suppository form, though this will depend on your healthcare provider's preference.

Like oral nystatin, the topical version works when it comes into contact with the fungus, attacking and killing off the fungal cells. Specifically, it targets the protective walls of the fungal cells, causing them to empty and die off.

Dosage

Topical nystatin should only be applied to the external skin. The exact dosage prescribed will vary depending on the patient and the severity of the fungal infection, though typical treatment lasts for seven to 14 days:

• For skin candidiasis, a thin layer of the cream or ointment nystatin should be applied to the affected area twice a day.
• For fungal infections on the feet, nystatin powder should be applied to the area twice daily. The only difference from the cream version is that powder nystatin should be dusted on the feet in addition to socks, shoes, and other footwear used.

Wash your hands before and after using topical nystatin. You may cover the affected area loosely with a sterile bandage, but try not to use an airtight or plastic-covered bandage so that the nystatin has room to work.

If you get topical nystatin in your eyes or mouth, rinse with water immediately. Continue to use the full course of nystatin, even if the infection seems to be getting better.

Whether you're using liquid or cream nystatin, talk to your healthcare provider if you don't notice any improvement in your fungal infection after several days.

Warnings or Interactions

Nystatin has a few common side effects associated with its oral and topical use. If using oral nystatin, you may experience:

• Gastrointestinal symptoms such as upset stomach, nausea, vomiting, or diarrhea
• Oral irritation, rash

If these common side effects worsen or become too bothersome, check with your healthcare provider or pharmacist about whether you should continue taking nystatin. They may be able to recommend a different type of antifungal for your infection.

Rare reactions include Stevens-Johnson syndrome, fast heartbeat, broncho-spasm, swelling, and non-specific muscle aches.

If using topical nystatin, you may experience:

• Skin irritation
• Mild itching

Contact your healthcare provider if this irritation turns into a rash or becomes painful. Allergic reactions also have the potential to occur.

Seek immediate medical care if you experience difficulty breathing, hives, or swelling of the face, lips, tongue, or throat.

It's important to share your medical history and current medications with your healthcare provider before using any form of nystatin. This is especially critical if you have HIV/AIDS, diabetes, or kidney disease, as these conditions may require different medications.

Your healthcare provider should also know if you're pregnant, planning to become pregnant, or breastfeeding, as the effects of nystatin on unborn or nursing babies aren't clearly known.

Nystatin doesn't have a high reported risk of interacting with other drugs, but you should still inform your healthcare provider about all medications you're currently taking, including vitamins and supplements.

A Word From Verywell

While nystatin is often an effective option for eligible patients, your healthcare provider will likely consider your overall health and the severity of the fungal infection before prescribing it. But if your fungal infection is recurring or doesn't respond well to nystatin, know that there are other antifungal drugs that can be used as a second line treatment, like diflucan.

For a more severe infection that has a risk of becoming systemic, your healthcare provider may also consider a different class of antifungal drugs that can be administered intravenously, or through an IV.