Nystatin for thrush

Nystatin is an antifungal drug belonging to the group of polyene antibiotics. Its action is aimed at combating fungal infections caused by various strains of Candida fungi. Here is a brief description of nystatin:

1. Mechanism of action: Nystatin interacts with the fungal cell membrane, forming complexes with ergosterol, which is an important component of the fungal cell membrane. This leads to changes in the permeability of the cell membrane and disruption of its integrity, which ultimately leads to the death of the fungus.
2. Use: Nystatin is widely used to treat fungal infections such as thrush (vaginal candidiasis), stomatitis (inflammation of the oral mucosa), dermatomycosis (fungal skin infections) and others.
3. Dosage forms: Nystatin is available in various forms, including tablets, capsules, syrup, vaginal suppositories, creams and ointments for external use.
4. Use in children: Nystatin is also often used to treat fungal infections in children, including thrush in newborns and young children.
5. Safety and Tolerability: Nystatin is generally well tolerated by most patients and has low systemic absorption when applied topically. However, some people may experience unwanted side effects such as skin or mucous membrane irritation, nausea, or vomiting.
6. Prevention of resistance: It is important to use nystatin as directed by your doctor or as directed on the package to prevent fungi from developing resistance to the drug.

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Indications Nystatin

1. Candidiasis (thrush): Nystatin is often used to treat candidiasis, which often manifests as thrush in women (vaginal candidiasis), as well as oral candidiasis (cracks in the corners of the mouth, white plaque on the oral mucosa).
2. Fungal skin infections: The drug can be used to treat fungal infections of the skin, such as dermatomycoses (fungal infections of the skin and its appendages), including candidiasis of the skin.
3. Fungal infections of the gastrointestinal tract: In some cases, nystatin may be used to treat fungal infections of the gastrointestinal tract caused by Candida.
4. Prevention of candidiasis: Nystatin is sometimes used to prevent candidiasis in patients, especially those with weakened immune systems (such as those with HIV infection or long-term antibiotic use).
5. Respiratory tract infections: Some forms of nystatin may be used to treat fungal infections of the upper respiratory tract.

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Release form

1. Capsules: Like tablets, nystatin may also be available as capsules for oral administration. Capsules typically contain a standard dose of the drug and may be convenient for those who prefer them over tablets.
2. Cream: Nystatin can be used as a cream for external use, for example to treat fungal skin infections. The cream is applied to the affected area of skin and is usually applied several times a day.
3. Tablets: Nystatin may be supplied as tablets for oral administration. Tablets usually contain a standard dose of the active ingredient and may be convenient for use in cases where long-term therapy is needed.

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4. Suppositories: Nystatin may be available as a vaginal suppository for the treatment of vaginal candidiasis in women. The suppositories are inserted into the vagina and dissolve, providing local action of the drug.

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5. Ointment: Nystatin may also be available as an ointment for external use on the skin to treat fungal skin infections.

Pharmacodynamics

1. Antifungal action: Nystatin acts by binding to ergosterol in the fungal cell membrane, causing damage to the membrane and loss of its integrity. This prevents potassium ions and other molecules from entering the cell, which ultimately kills the fungus.
2. Specificity of action: Nystatin acts against yeast-like fungi of the genus Candida, such as Candida albicans, Candida glabrata, Candida tropicalis and others, which often cause candidal infections in humans.
3. Non-steroidal antifungal agent: Nystatin is not a steroidal antibiotic, making it less likely to cause fungal resistance.
4. Primary action in the intestine: When nystatin is taken orally, the drug is mainly active in the gastrointestinal tract, which makes it particularly useful in the treatment of candidiasis of the urogenital tract and intestine.
5. Low systemic absorption: Nystatin is virtually not absorbed from the gastrointestinal tract into the systemic circulation when administered orally, which reduces the risk of systemic side effects.

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Pharmacokinetics

1. Administration: Nystatin is usually taken orally in the form of tablets, capsules, or syrup. There are also topical forms of the drug, such as creams or ointments, intended for external use.
2. Absorption: When taken orally, nystatin is practically not absorbed from the gastrointestinal tract into the systemic bloodstream. This is due to the fact that nystatin is poorly soluble in water and remains in the intestine, where it exerts its antifungal effect. Therefore, systemic side effects with nystatin are rare.
3. Distribution: Nystatin does not have a significant volume of distribution, as it remains predominantly in the intestine. It does not penetrate into the tissues and organs of the body in significant quantities.
4. Metabolism: Nystatin is almost not metabolized in the body. It retains its structure throughout its stay in the gastrointestinal tract.
5. Excretion: Most of nystatin is excreted unchanged through the intestines along with feces. A small amount of the drug may be excreted through the kidneys.
6. Half-life: Nystatin has a short half-life and is rapidly eliminated from the body after discontinuation of administration.

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Dosing and administration

Methods of administration and dosage of Nystatin depend on the form of release:

Tablets or dragees for oral use:

• Adults and children: The recommended dose is usually 500,000 to 1,000,000 IU (international units) 3-4 times daily. The tablets should be swallowed whole with water. For the treatment of intestinal candidiasis, the course may last from 7 to 14 days.

Oral suspension:

• Adults and children: The dosage is 500,000 IU 4 times daily. The suspension should be shaken before use. It can be used to rinse the mouth before swallowing if the treatment is aimed at oral candidiasis.

Vaginal tablets (suppositories):

• Adult women: It is recommended to insert 1 vaginal tablet (100,000 or 500,000 IU) 1-2 times a day for 14 days. Suppositories should be inserted deep into the vagina.

Ointment for external use:

• Adults and children: Apply a thin layer of ointment to the affected areas of the skin 2-3 times a day. The duration of treatment depends on the severity of the infection and the response to treatment.

Important points:

• Before starting treatment with Nystatin, a consultation with a doctor is necessary to confirm the diagnosis and determine the most appropriate form of the drug and dosage.
• Do not stop treatment immediately after symptoms disappear, as this may lead to a relapse of the infection.
• During treatment for vaginal candidiasis, you should avoid sexual intercourse or use condoms to prevent infecting your partner.
• Taking nystatin orally may cause stomach discomfort, so it is recommended to take the drug during or after meals.

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Use Nystatin during pregnancy

Using nystatin during pregnancy is generally considered safe and is often recommended for treating yeast infections in pregnant women. Here are some important points to consider:

1. Safety: Nystatin is considered one of the safest antifungal drugs to use during pregnancy. It is not usually absorbed into the systemic circulation and remains in the intestine, which minimizes the risk to the fetus.
2. Efficacy: Nystatin is effective against Candida fungi, which often cause vaginal yeast infections in pregnant women.
3. Topical use: Nystatin is often used as a vaginal suppository or cream to treat vaginal yeast infections in pregnant women. This topical use helps minimize systemic absorption of the drug.
4. Consult your doctor: It is important to discuss the use of nystatin with your doctor or obstetrician before starting treatment, especially if you have any diseases or conditions that may affect the safety of the drug in your particular case.
5. Dosage and duration of treatment: The dosage and duration of treatment with nystatin may vary depending on the type of infection and your doctor's recommendations.

Contraindications

1. Known hypersensitivity or allergic reaction to nystatin or other components of the drug: People who have previously had allergic reactions to nystatin or any other components of the drug should avoid using it.
2. Systemic fungal infections: Nystatin is generally not effective in treating systemic fungal infections such as candidemia (a fungal infection of the blood). Therefore, its use in these cases is inappropriate and may be contraindicated.
3. Damaged skin or mucous membranes caused by other causes: Nystatin may aggravate the condition of the skin or mucous membranes if they are damaged by other causes, such as injury, burns or other infections.
4. Internal use in the presence of extensive intestinal ulcers or intestinal bleeding: In the presence of such conditions, nystatin may worsen the situation and is contraindicated for internal use.
5. Pregnancy and breastfeeding: In some cases, especially when used orally, the use of nystatin during pregnancy and breastfeeding may require evaluation by a physician and should be used with caution.

Side effects Nystatin

1. Rare allergic reactions: Include skin rash, itching, hives, or angioedema. If an allergic reaction occurs, seek immediate medical attention.
2. Discomfort at the application site: When using topical products, such as vaginal suppositories or creams, some women may experience discomfort or irritation at the application site.
3. Gastrointestinal disorders: May include nausea, vomiting, diarrhea, bloating, and abdominal discomfort. These symptoms are usually temporary and improve after stopping nystatin.
4. Changes in taste: Some patients may notice a change in taste in the mouth while taking nystatin.
5. Rare systemic side effects: Systemic reactions such as dizziness, headache, increased liver enzymes or allergic reactions in case of anaphylactic shock may develop.

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Overdose

Overdose of nystatin is rare when used topically (e.g., creams or ointments), as minimal amounts of the drug are absorbed through the skin or mucous membranes. However, when nystatin is used internally (e.g., as tablets or suspensions for oral administration), there is a potential for overdose.

Symptoms of a nystatin overdose may include:

1. Stomach and intestinal disorders: For example, nausea, vomiting, diarrhea, stomach pain and indigestion.
2. Allergic reactions: Allergic reactions may include hives, itching, swelling of the face, lips or tongue, difficulty breathing and anaphylactic shock.
3. Other possible symptoms: May include dizziness, drowsiness, increased water consumption (polydipsia), thirst (polyuria), hyperkalemia, and others.

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Interactions with other drugs

1. Antimicrobials: Using nystatin with antibiotics such as tetracyclines or amphotericin B may decrease the effectiveness of nystatin due to their antimicrobial action.
2. Drugs that suppress gastrointestinal function: Drugs that suppress gastric acidity, such as proton inhibitors and antacids, may decrease the effectiveness of nystatin by changing the pH of the environment, which may lead to a decrease in its antimicrobial effect.
3. Immunosuppressants: Use of nystatin with immunosuppressants such as glucocorticosteroids or cytotoxic drugs may increase the risk of developing fungal infections.
4. Antiretroviral drugs: The combination of nystatin with antiretroviral drugs such as protease inhibitors or nucleoside reverse transcriptase inhibitors may require careful monitoring of the patient due to possible increased toxicity of one of the drugs.

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Storage conditions

Storage conditions for nystatin may vary depending on the form of the drug and the manufacturer's recommendations. However, in general, the following is recommended:

1. Temperature: Nystatin should generally be stored at room temperature, not exceeding 25 degrees Celsius.
2. Storage conditions: The drug should be stored in a place protected from light to avoid exposure to direct sunlight.
3. Humidity: Store nystatin in a dry place, away from moisture and humidity.
4. Storage conditions after opening the package: If the drug is available as tablets, capsules or syrup, it is usually recommended to store it in a dark and cool place, but often no special conditions are required after opening the package. However, always follow the instructions on the drug label.
5. Expiry date: It is also important to monitor the expiration date of the drug and not use it after this date.

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Special instructions

Special instructions for the use of nystatin may include the following aspects:

1. Confirming the diagnosis: Before starting treatment with nystatin, it is important to confirm the diagnosis of a fungal infection. This may require laboratory testing of a sample taken from the affected area to determine the type of fungus and its sensitivity to nystatin.
2. Taking the medicine: Follow your doctor's instructions or the directions on the medicine package regarding dosage, frequency, and duration of use. Do not stop taking nystatin before the prescribed time, even if symptoms disappear, to avoid recurrence of the infection.
3. Use in Children: There may be specific dosages and forms of the drug for children, so it is important to follow your doctor's recommendations regarding the use of nystatin in children.
4. Topical application: When using topical forms of nystatin (eg, creams, ointments, suppositories), strict hygiene and application techniques should be followed to prevent infection or reinfection.
5. Precautions for use: If allergic reactions, severe skin irritation or other side effects occur, stop using nystatin and consult a doctor.
6. Prevention of resistance: It is important to use nystatin only when necessary and strictly as prescribed by your doctor to prevent fungi from developing resistance to the drug.

Nystatin for thrush in children

Nystatin is widely used to treat thrush (vaginal candidiasis) in children. Thrush in children can occur due to various reasons, such as vaginal flora disorders, decreased immunity or the use of antibiotics. Nystatin acts against Candida fungi, which usually cause thrush.

To treat thrush in children, nystatin is usually given as a vaginal suppository or cream that is applied to the area around the vagina. For infants and young children, nystatin may also be given as drops or syrup to take by mouth.

It is important to consult a pediatrician before starting treatment with nystatin in a child so that he or she can assess the child's condition, make a correct diagnosis, and recommend the optimal dosage and duration of treatment. The doctor will also help determine which form of nystatin will be most suitable for a particular case and how to use it correctly.

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Nystatin for thrush in newborns

Nystatin is often used to treat thrush (candidiasis) in newborns. Thrush in newborns often appears as a whitish, caseous coating on the tongue, lips, and inner cheeks. This condition is caused by a fungal infection, usually Candida albicans. Here's how nystatin is typically used to treat thrush in newborns:

1. Topical use: Nystatin is available as an oral suspension that can be applied directly to the affected areas inside the newborn's mouth. The usual dose is 0.5 ml of the suspension four times daily, which the newborn can hold in the mouth for as long as possible before swallowing.
2. Duration of treatment: Treatment for thrush in newborns is usually carried out for 7-14 days. It is important to continue treatment for the entire period, even if symptoms begin to improve, to prevent relapses.
3. Monitoring symptoms: Once treatment has begun, it is important to monitor your child closely for changes in his or her condition and symptoms of thrush. If the condition worsens or does not improve after a few days of treatment, you should consult your doctor for evaluation and adjustment of treatment.

In most cases, nystatin is well tolerated by newborns and effectively treats thrush. However, as with any medication, side effects or reactions may occur, so it is important to strictly follow your doctor's instructions and avoid self-medication.

Nystatin for thrush in men

Nystatin is not usually used to treat vaginal yeast infections (vaginal candidiasis) in men, as the condition is most often associated with a yeast infection of the vagina, which occurs predominantly in women. However, men can also develop a yeast infection in the genital area, which usually manifests as male candidiasis (candidal balanoposthitis).

Other antifungal medications, such as creams, ointments, or suppositories containing antifungals such as ketoconazole or miconazole, are usually used to treat yeast infections in men.

If a man suspects he has a candidal infection in the genital area, it is important to see a doctor to get a proper diagnosis and appropriate treatment. Self-medication can lead to a worsening of the problem or insufficient effect of therapy.

Shelf life

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