Suppositories with nystatin in pregnancy

Suppositories with nystatin in pregnancy used to be quite widespread, but taking into account progress in medicine and the pharmaceutical industry, the views on the use of any medications during pregnancy have changed quite a lot. At the moment there is no unambiguous evidence that would indicate the benefits or harm of nystatin in pregnancy, so the opinions on the treatment of nystatin in pregnant women are very diverse. There is an opinion that it is possible to use this drug without harm to the child, but also it should not be forgotten that any medicine can affect the fetus. Therefore, it is necessary to understand the pharmacological properties of the drug and find out all the pros and cons regarding this drug.

[1], [2], [3], [4]

Main pharmacological properties of suppositories with nystatin

Suppositories with nystatin is a drug that has an antifungal effect, which is especially pronounced with respect to yeast-like fungi. The drug from the group of polyene preparations, which has a pronounced effect on fungi and does not affect the bacterial and viral flora. In moderate therapeutic doses, the effect of the drug is to temporarily block the reproduction of fungi, that is, it has a fungistatic effect. With increasing doses up to large, the drug may also have a fungicidal effect, that is, it kills fungi.

The mechanism of action of suppositories with nystatin is the destruction of the cell membrane of the fungus. This is due to the fact that the molecule of nystatin has many substances that are similar to the ball of substances in the membrane of the fungus, and nystatin is built into its membrane, thus disrupting the work of the cellular pumps. Due to these processes, the normal ion storage of cellular and extracellular structures is violated, which facilitates the penetration of sodium ions into the cell, and then of water. In this case, the cell breaks its work and lysis of the cellular structures occurs, and then the fungus dies, which stops the reproduction of the fungus.

Pharmacokinetic features of the drug

Nystatin has special properties, which are its very low bioavailability, which reaches no more than three to five percent. Due to this property, the drug in its oral intake is not absorbed into the intestinal mucosa and does not affect the systemic circulation, it is also taken regardless of the intake of food. The drug has only a local effect on the fungus, is excreted unchanged with feces. As for local forms, the ointment when used is not absorbed into the vessels of the subcutaneous tissue.

Suppositories with nystatin have only a pronounced local effect, are not absorbed into the systemic circulation. This allows us to assume that suppositories with nystatin may be used in pregnancy.

Features of application of suppositories with nystatin

Suppositories with nystatin are used vaginally or rectally. Before taking the toilet, you must hold the genitals. Apply one candle two times a day - in the morning and in the evening, while injecting suppositories deep into the vagina. Duration of treatment at least ten to fourteen days.

Overdosage with the use of suppositories with nystatin is rare, which is due to the fact that the drug is not absorbed. There may be a slight local manifestation.

Interaction with other drugs is to reduce their effectiveness when used concurrently with other antifungal or hormonal drugs. Also, the drug is incompatible with other acids, hydrogen peroxide, potassium permanganate.

The storage conditions for suppositories are as follows: shelf life of two years. Store at a relative temperature of no higher than 28 degrees, avoiding direct action of high and low temperatures, and also to exclude high humidity.

Suppositories with nystatin from thrush during pregnancy have a high potential for use, which is due to their local action and high fungistatic effect. Pharmacokinetic features of the drug allow using it in connection with the fact that it is not absorbed into the systemic bloodstream and acts only on fungi. The issue of harm to the child remains not fully understood, because the drug is not recommended in the first trimester of pregnancy, when the process of organogenesis and differentiation of the fetal tissues is intensive.

Suppositories with nystatin in pregnancy are used in candidiasis, which is a direct indication for the purpose of this drug. Given the low bioavailability of the drug, its low toxicity and a slight effect on the systemic blood flow, we can talk about taking the drug during pregnancy. But each case is individual and the question of the correct prescription of the drug during pregnancy should be decided by the doctor, taking into account all the nuances and features. In any case, the negative influence of suppositories with nystatin on fetal development is not ruled out. It is necessary to be attentive to your health and the health of your unborn child.

[7]

Basic principles of nystatin in pregnancy

Pregnancy is a period in a woman's life, when all internal organs adapt to the development of the fetus and to its vital activity. Development of the fetus occurs gradually and passes through various stages - first there is an organogenesis process that begins in the first trimester, and then the growth and differentiation of the child's tissues continues. But this is not all, because normal functioning in the mother's body requires normal blood flow and nutrition, which is due to the functioning of the placenta. All these components have a continuous connection with the mother's body, and many processes in the body of a woman do not proceed as usual. Fetus is an agent alien to the body of a woman, in fact 50% of the information it contains from the pope. The immune system of a woman perceives it as an antibody to some extent, so until the formation of its placenta with an individual barrier and blood flow, a state of relative immunosuppression develops. Such a state promotes the development and reproduction of the conditionally pathogenic flora.

The intestines and vagina are a place that has its own biocenosis and functions normally due to opportunistic microflora. When a woman's general immunity decreases, local defenses also decrease, which helps to reduce the activity of beneficial microorganisms with the multiplication of pathogens. This is how one of the frequent diseases develops, which worries pregnant women - fungal vaginitis or else it is called thrush. This pathology, which is characterized by the multiplication of fungal flora of the vagina with the development of appropriate clinical manifestations. This occurs against the background of the fact that the number of lactobacilli of the vagina and Dodderlein sticks decreases, which normally in the vagina during the splitting of glucose form lactic acid and thus contribute to the maintenance of a weakly acidic environment of the vagina. This is one of the main local mechanisms for protecting the vagina, which is disrupted in pregnant women with candidiasis or fungal vaginitis.

The drug nystatin in the form of suppositories used to be the "gold standard" for treatment of candidiasis, but over time standards were revised in connection with the formation of resistance of fungi to this drug. To date, it is returned to him because the microorganisms have "forgotten" this drug a little and it has high efficiency. As for pregnant women, here the issue of use is very controversial, since special attention is paid to the benefits or possible harm to the fetus. Unequivocally answer the question of the use of suppositories with nystatin in pregnancy is very difficult, which is due to the complicated pharmacodynamics of the drug, but this drug is used.

Indications for the use of suppositories with nystatin in pregnancy are limited because of high risk, but the main indication is the candidiasis of the vagina with identification of yeast fungi. In this case, the suppository with nystatin is most indicated due to direct action directly on fungi.

Nystatin, as a pharmacological drug is available in various forms - in tablets, in ointments, in suppositories, and also is a part of combined preparations. Suppositories, that is, suppositories, distinguish between vaginal and rectal, which are used respectively to treat candidiasis of the vagina and intestine. Tablets, ointment and suppository have a similar trade name - "Nystatin", as well as the drug is a part of combined suppositories for the treatment of candidiasis with the name of the drug " Polizhinaks ". There are other names of suppositories with nystatin - Nistafungin, Antikandin, Moronal, Fungicidin, Mikostatin, Stamyin, Fungistatin.

[5], [6]

Contraindications to use and side effects

The drug is contraindicated for use, especially during pregnancy, in the presence of allergic reactions in the history or in case of allergies to additional composite components of the drug. Some pharmacological studies indicate that the drug is contraindicated in pregnancy and lactation, but this issue is very controversial and individual, so you can not say that it is absolutely contraindicated.

Adverse events occur very rarely precisely because of the peculiarities of pharmacodynamics, since the drug is not absorbed and does not affect the system organs. If the dose is exceeded, dyspepsia can occur in the form of abdominal pain, nausea, malaise, vomiting. There may be local manifestations when applying suppositories with nystatin in the form of itching, discomfort in the vagina, burning sensation.