Nystatin is an antifungal medication that works by inhibiting the growth and spread of Candida albicans fungus. This fungus can cause infections on the skin or mucous membrane, like thrush or yeast infections.

This medication is available in pharmacies and drugstores in the form of an oral suspension, vaginal cream or ointment, and should be used as prescribed.

Nystatin can be found in combination with metronidazole in the form of vaginal ovules. These can be prescribed for the treatment of yeast infections or bacterial vaginal infections caused by Trichomonas or Gardnerella vaginalis.

What it's for

Nystatin is indicated for the treatment of infections caused by the Candida albicans fungus, such as vaginal candidiasis or candidiasis in the mouth, esophagus or intestines, thrush or diaper rash in babies or children, or ringworm between the fingers, armpits or breasts.

How to use

Nystatin use will vary depending on the form that is prescribed:

1. Nystatin oral suspension

Nystatin oral suspension should be used after brushing your teeth or dentures.

Use the measuring device that comes with the bottle of nystatin oral suspension. Dosing will depend on age, and includes:

Premature babies or underweight children: 1 mL of oral suspension, 4 times a day (one dose taken every 6 hours)
Breastfeeding babies: 1 to 2 mL of the oral suspension, 4 times a day (one dose taken every 6 hours). Avoid breastfeeding the for at least 5 minutes after the nystatin dose
Children and adults: the dose is 1 to 6 mL of oral suspension, 4 times a day.

Nystatin oral suspension should be gargled and kept inside the mouth for as long as possible before swallowing. In infants and toddlers, half the dose should be applied to each side of the mouth.

It is important to shake the bottle of nystatin suspension before using it to ensure its components are well-mixed.

Nystatin use should be continue for an additional 2 days after symptoms resolve to prevent recurrence.

2. Nystatin vaginal cream

Nystatin vaginal cream should be applied once a day, preferably at night, for 14 days. It should be applied deeply into the vaginal canal, using the applicator provided in the packaging. If you forget to apply a dose at night, you should apply it the next morning and then continue the treatment at the correct time. If your symptoms do not resolve within 14 days, you should see your doctor for follow-up.

To use nystatin vaginal cream, wash your hands well before and after use. Pull the applicator plunger all the way down, remove the cap from the cream tube and screw the applicator to the tip of the tube. Squeeze the cream into the applicator until full and unscrew the applicator from it. Either in a squatting position or lying down, apply the applicator into the vagina, and push the plunger all the way in. Remove the applicator and discard.

Continue to apply nystatin vaginal cream during menstruation. Avoid using tampons, vaginal douches or spermicides during treatment.

3. Nystatin ointment

Nystatin dermatological ointment is typically combined with zinc oxide, which works as a skin protector.

Recommended doses of nystatin dermatological ointment include:

Diaper rash in babies and children: use at every diaper change if the baby has a severe diaper rash. To prevent diaper rash, it can be applied twice a day. It is important that the baby's skin is clean and dry before application;
Skin irritations or ringworm between the fingers, armpits or breasts: apply the cream, twice a day, to the affected areas.

The treatment time with nystatin dermatological ointment may vary, and should be advised by your doctor.

4. Nystatin vaginal ovules

Nystatin vaginal ovules usually also contain metronidazole, which is an antimicrobial indicated for the treatment of yeast infections or vaginal infections caused by Trichomonas or Gardnerella vaginalis.

These ovules are similar to suppositories, but are inserted vaginally. They will start to melt at 37ºC in the vagina or with vaginal discharge.

Before inserting, wash your hands thoroughly. These ovules can inserted manually or with an applicator. In a slightly squatting position or while lying down, insert the egg deep into the vagina once a day (preferably at night) for 7 days or as prescribed. After inserting, wash your hands well with soap and water.

Treatment with nystatin ovules should not be interrupted during periods, however you should avoid using tampons, vaginal douches or spermicides. Furthermore, it is important to avoid prolonged contact of the egg with your hands, as it can dissolve and make application more difficult.

Possible side effects

Side effects of nystatin vary depending on the form being used. Oral suspensions can cause vomiting, nausea, diarrhea or abdominal pain may occur. Vaginal ovules or cream can cause itching, local irritation or a burning sensation.

It is recommended to stop treatment and seek medical help if you experience allergies or irritation after using this medication.

Contraindications for use

Nystatin should not be used during pregnancy or breastfeeding unless prescribed, nor by people who are allergic to nystatin.