Nystatin

Nystatin is an antifungal medication. It is used to treat Candida (yeast) infections of the skin, including diaper rash, thrush, esophageal candidiasis, and vaginal yeast infections. It can also be used to prevent fungal infections. Nystatin can be used by mouth, in the vagina, or on the skin.

Pharmacodynamics

Nystatin is a channel-forming ionophore, meaning that it exerts its therapeutic effect via the formation of a membrane-spanning pore in the plasma membrane of the fungus. Formation of this pore results in a change in membrane permeability that allows leakage of intracellular contents and subsequent disruption of the electrochemical gradient, which are necessary for proper cell function. The selectivity for fungal cells over mammalian cells is due to the greater binding affinity of nystatin for ergosterol, a molecule found only in fungal cells.

Pharmacokinetics

Systemic absorption of nystatin is minimal after oral administration, and no detectable plasma concentrations are achieved after topical or vaginal administration. Nystatin is not absorbed into the systemic circulation; therefore, there are no data on the pharmacokinetic properties of this drug.

Side effects

• Bitter taste and nausea are common adverse reactions.
  
  

The oral suspension form may cause a number of adverse effects:

Common

• Diarrhea
• Abdominal pain

Rarely

• Tachycardia
• Bronchospasm
• Facial swelling
• Muscle pain

Both the oral suspension and the topical form may cause

• hypersensitivity reactions, including Stevens-Johnson syndrome
• Rash
• Itching
• Burning and acute generalized exanthematous pustulosis.

Toxicological Data

LD50 (rat, oral): 10,000 mg-kg-1