What is the dose of oral nystatin (antifungal medication) drops?

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From the Guidelines

The recommended dose of oral nystatin drops for treating oral candidiasis is 100,000 U/mL, with 4–6 mL administered 4 times daily, for 7–14 days 1. This dosage is based on the clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America, which provides a strong recommendation with moderate-quality evidence for the use of nystatin suspension as an alternative for mild disease 1. Some key points to consider when administering oral nystatin drops include:

  • The suspension should be held in the mouth as long as possible before swallowing to maximize contact time with the affected tissues.
  • Patients should avoid eating or drinking for 30 minutes after administration.
  • Treatment should continue for at least 48 hours after symptoms resolve, typically for a total of 7-14 days.
  • For infants, the dose can be applied with a clean finger or cotton swab to coat the affected areas, using half the dose (0.5 mL) on each side of the mouth. It is essential to note that nystatin works as a topical antifungal by binding to ergosterol in the fungal cell membrane, creating pores that lead to cell death, and is not significantly absorbed systemically, making it very safe with minimal side effects 1. If symptoms persist beyond two weeks of treatment, patients should seek further medical evaluation.

From the FDA Drug Label

Nystatin Oral Suspension, USP, 100,000 Nystatin Units per mL, NDC 66689-008-02: 2 fl. oz. bottle (60 mL): supplied in individual carton with calibrated dropper.

The dose of oral nystatin drops is 100,000 units per mL.

  • The calibrated dropper is supplied with the 2 fl. oz. bottle (60 mL) for accurate dosing 2.

From the Research

Oral Nystatin Drops Dose

  • The provided studies do not specify the exact dose of oral nystatin drops 3, 4, 5, 6, 7.
  • However, study 6 mentions that nystatin is effective against Candida species, with a low resistance rate of 4%, making it a suitable choice for oral candidiasis.
  • Study 7 reviews the efficacy and safety of antifungal prophylaxis, including nystatin, in the neonatal intensive care population, but does not provide specific dosage information.
  • It is essential to consult a healthcare professional or a reliable medical source for the recommended dose of oral nystatin drops, as the dosage may vary depending on the specific condition being treated and the patient's age and health status.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The significance of itraconazole for treatment of fungal infections of skin, nails and mucous membranes.

Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2009

Research

A brief review of antifungal therapy for deep fungal infection.

Oncology (Williston Park, N.Y.), 2001

Research

A review of Candida prophylaxis in the neonatal intensive care population.

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2011

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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