Pharmacodynamics and pharmacokinetics
Pharmacodynamics
What is nystatin ? This is a polyene antibiotic with antifungal activity. Shows activity against yeast-like fungi Candida . against bacteria . Has a fungistatic effect. Resistance of fungi to the drug develops slowly.
The structure of nystatin contains double bonds, which determine its affinity for the formation of the cell membrane of fungi - the substance molecule is embedded in the membrane and forms channels for the transport of electrolytes into the cell. An increase in osmolarity inside it leads to death. The cell lyses, losing its resistance to external osmotic forces.
Pharmacokinetics
When taken orally, it is almost not absorbed into the gastrointestinal tract. Does not accumulate with repeated doses. Excreted through the intestines.
The active substance of ointments and suppositories when applied externally is not absorbed through the mucous membrane and skin.
Interaction with other drugs, storage method
When taking various drugs simultaneously with Nystatin, you should remember that:
- Tetracycline, Nifuratel, Chymotrypsin and Polymyxin enhance its effectiveness;
- Clotrimazole, representatives of a number of penicillins and tetracyclines somewhat reduce their therapeutic properties;
- oral contraceptives lose effectiveness;
- Maalox and Almagel, indirect anticoagulants, reduce the activity of the natural antibiotic.
While taking retinol and Nystatin drugs, the risk of increased intracranial pressure increases.
In conclusion, we need to dwell on the special requirements for storing the medication. You should know that the activity of Nystatin in all forms of release (except tablets) decreases with prolonged exposure to a warm room. Such conditions do not affect the effectiveness of the pills; they can be stored at temperatures up to plus 20 °C; The main thing is to protect the drug from exposure to direct sunlight.
Indications for use
For vaginal suppositories
- candidiasis of the vulvo-vaginal area ;
- prevention of fungal diseases with local antibiotic .
For tablets
- prevention of fungal diseases in the postoperative period during operations on the gastrointestinal tract ;
- candidiasis of internal organs of the skin and mucous membranes ;
- prevention of gastrointestinal candidiasis during long-term antibiotic therapy .
Indications for use of ointment
Candidiasis of the skin and mucous membranes .
Side effects
This drug is well tolerated by many patients. The annotation for Nystatin states that the composition has side effects. Side effects of Nystatin appear as:
- Disorders of the digestive system.
- Loss of appetite, attacks of nausea and vomiting.
- Allergies, expressed in the form of hives, itching, redness of the skin surface and the appearance of a rash.
If the above symptoms appear, the course of treatment should be stopped completely. In some cases, patients may need symptomatic therapy.
Instructions for use of Nystatin (Method and dosage)
The drug has several forms of release, so we will consider the instructions for use of all dosage forms.
Nystatin tablets, instructions for use
How to take the pills? The tablets are taken orally, regardless of food intake. They are swallowed without chewing. Nystatin tablets are prescribed to adults for candidiasis of internal organs , 500,000 units 6-8 times a day. Duration of treatment is up to 14 days. The average daily dose is 1,500,000 - 3,000,000 units. For generalized candidiasis - up to 6,000,000 units per day, repeated courses are given after 2 weeks.
For children under 1 year of age, the dose is 125,000 units, from 1 to 5 years - 250,000 units, over 13 years - 500,000 units, dosage frequency 3-4 times a day. Duration of treatment is up to 14 days.
Nystatin ointment, instructions for use
Nystatin ointment is intended for external use; it is applied in a thin layer to the skin or mucous membranes 2 times a day for 10 days. Often combined with oral tablets. For stomatitis in a child, apply ointment to the affected areas 3 times a day after meals, treatment continues for at least a week.
If local irritation , skin rash or urticaria , the drug is discontinued.
Nystatin suppositories, instructions for use
Vaginal suppositories Nystatin are inserted deep into the vagina. The dosage regimen is individual. Usually 1 candle in the morning and evening. The duration of treatment is 14 days. During menstruation, treatment is not interrupted. During the treatment period, avoid sexual intercourse. Treatment of the sexual partner is necessary. During pregnancy, suppositories with Nystatin are used as prescribed by a doctor in case of urgent need.
Negative opinion of doctors
The instructions for Nystatin and reviews from doctors warn that this drug should not be used without the prescription of a specialist. Some of them speak about the drug not entirely favorably. They claim that this is an old drug and needs to be taken for a long time, unlike modern medicines. Many people consider this medicine to be quite weak. Doctors note that Nystatin tablets often cause diarrhea and nausea, as well as other negative reactions of the body. They believe that it is better to buy a medicine that is more expensive, but safer and more effective.
Some doctors, at the beginning of their practice, used Nystatin, but then, due to its low effectiveness, were forced to abandon it.
Instructions for use of Nystatin and reviews from doctors describe in detail the contraindications for which this medicine should not be taken. In addition, doctors constantly warn that this drug can only be used as prescribed by a doctor.
Nystatin during pregnancy
Pregnancy is a predisposing factor for the development of vulvovaginitis . The main thing in this situation is the safety of treatment. The instructions include contraindications for the use of nystatin during pregnancy, since there is no information about their safety for the fetus. Nystatin suppositories can be used during pregnancy only in exceptional cases when the benefit to the mother outweighs the risk to the fetus. Reviews from forum visitors confirm that the drug in this form is sometimes prescribed to pregnant women for short courses of treatment.
The use of ointment is contraindicated during pregnancy. However, it has been proven that the active substance is not excreted in milk when used externally, so breastfeeding can be continued during treatment with the ointment. Do not apply the ointment to the area of the mammary gland and nipple.
Nystatin for thrush
Candidiasis of the genital mucosa and oral cavity is called thrush . The main method of treating mild and moderate oral thrush is local treatment in the form of mouth rinses and treatment of the affected areas with a solution of this drug.
Women often experience candidal vulvitis or vulvovaginitis . Vaginal cream or ointment is recommended for the treatment of vulvitis, and tablets and suppositories for vaginitis. For mild vulvovaginitis, local treatment is sufficient - vaginal tablets or suppositories: micogal, clotrimazole, Klion-D. Suppositories with nystatin for thrush have recently been rarely used, since most strains of the Candida fungus have become insensitive to it. The drug has a mycostatic effect, not mycocidal. This provides temporary relief, making you feel better, but leads to relapse. Reviews from forum visitors also speak about this.
If there is no other choice, or the woman has an individual intolerance to the above drugs, then Nystatin is prescribed.
How to take Nystatin suppositories for thrush? They are inserted deep into the vagina 2 times a day. It is very important that the sexual partner also treats with antifungal tablets. If treatment is not carried out, there is a possibility of re-infection of the woman. For mild cases of the disease, drugs for local treatment can be replaced with a single dose of Fluconazole .
For recurrent candidiasis , which tends to exacerbate more than 4 times a year, a combination of local and systemic administration of drugs with one active ingredient is necessary. So, ointment and tablets for thrush are applied topically orally. The following treatment regimen is also possible: a suppository with Nystatin 250,000–500,000 units at night for 14 days, a thin layer of ointment on the mucous membrane of the vulva and vagina 2 times a day for 14-21 days, and tablets of 500,000 units 4 times a day for up to 10 days.
If there is a combined infection (yeast-like fungi and various bacteria), then complex drugs are used, which include nystatin: Macmiror , Terzhinan , Mikozhinaks , Polizhinaks .
Contraindications
Regardless of the form of release, Nystatin is contraindicated in case of intolerance. For internal use, there are restrictions such as functional liver diseases, gastric and/or duodenal ulcers. “Nystatin” for children is used for external use, since this is the safest form, but it is not recommended to use the medicine internally for children under 6 years of age. If the doctor has prescribed it for your child, you should strictly adhere to the dose prescribed by the doctor.
Nystatin is prohibited for pregnant women. It is extremely rarely prescribed during pregnancy in the form of tablets or suppositories, with the dosage reduced. To eliminate the risk, pregnant women are prescribed less dangerous substitutes, for example, Difluzol, Polygynax. During pregnancy, Nystatin is safe only in the form of an ointment, since in this case it will not enter the bloodstream and will not affect the child.
Nystatin analogues
Level 4 ATC code matches:
Ecofucin
Primafungin
Clindacin
Polygynax Virgo
Polygynax
Analogs of the polyene series: Levoy , Natamycin ; imidazoles: Ketoconazole , Miconazole , Clotrimazole ; triazoles: Fluconazole , Intraconazole .
Reviews about Nystatin
Nystatin tablets, what are they for? This is an antifungal drug used to treat candidiasis , a fungal disease that can occur with damage to the skin, nail plates, mucous membranes and internal organs ( generalized candidiasis ). Candidiasis of the genital mucosa and oral cavity is called thrush. The main method of treating mild to moderate oral thrush is local treatment. Adults can dissolve the tablet after meals 3-4 times a day or lubricate the affected areas of the oral mucosa with ointment. For newborns, a tablet of nystatin 250,000 units is crushed and dissolved in a small amount of water. Drops of the resulting solution are applied to a gauze swab and the areas are treated 3-4 times a day. Children from 2 years of age can be given the drug orally, 1/4 tablet three times a day, and the oral mucosa can be treated with the drug “ Candide ”.
Reviews of Nystatin suppositories for thrush are associated with side effects: increased urination, irritation, burning sensation in the vagina. Women often stopped treatment immediately after the symptoms disappeared, while the pathogen was not eliminated and the symptoms returned after a while. According to many women, these suppositories are not very effective; they believe that the drug is “outdated” and prefer modern antimycotic drugs. There are also reviews that these suppositories were prescribed during pregnancy to treat thrush.
Reviews of Nystatin tablets are most often associated with its prescription for the prevention of dysbacteriosis during long-term use of antibiotics. From the first days of antibiotic treatment, many patients were prescribed 250,000 units 4 times a day. It is effective only for the prevention of intestinal candidiasis, since its systemic absorption is 3–5% and it does not affect fungi outside the intestine. When taking the tablets, side effects were observed in the form of nausea and stool upset. In order to prevent candidiasis infections, this drug is immediately introduced into tablets containing an antibiotic. Thus, Tetracycline with nystatin are used for bronchitis , tonsillitis , furunculosis , tracheitis , cholecystitis , purulent skin infections and acne .
Nystatin ointment was used to treat superficial candidomycosis of the skin and in cases of mild disease, good results were noted. For severe fungal skin infections, local application of ointment alone was not enough and systemic antimycotics ( Fluconazole ) were prescribed.
Nystatin price, where to buy
You can buy nystatin preparations for thrush at any pharmacy, they are available for free sale and you do not need a prescription in Latin, written out by a doctor. Their cost is reasonable. Thus, the price of Nystatin in suppositories ranges from 84-92 rubles, the price of Nystatin in tablets No. 20, 500,000 units. is 20-28 rubles, and the price of Nystatin ointment 30 g is 49-75 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Nystatin vaginal suppositories 250 thousand.
unit 10 pcs PAO Biosintez 89 rub. order - Nystatin rectal suppositories 500 thousand. unit 10pcs PAO Biosintez
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- Nystatin sup. vaginal 500 thousand units 10 pcs. PJSC Biosintez
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- Nystatin ointment 100000 units 30g tube PAO Biosintez
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Pharmacy Dialogue
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- Nystatin suppositories (sup. vag. 500TE No. 10) Biosynthesis OJSC
RUB 161 order
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Pharmacy24
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18 UAH. order - Nystatin 500000 OD No. 10 rectal suppositories PAT Monfarm, Ukraine
59 UAH order
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23 UAH order
PaniPharmacy
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21 UAH order
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50 UAH order
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42 UAH order
- Nystatin tablets Nystatin tablets. p/o 500000ED No. 20 Ukraine, Health LLC
20 UAH order
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