From the FDA Drug Label
DESCRIPTION Nystatin is an antimycotic polyene antibiotic obtained from Streptomyces noursei. Inactive ingredients (cherry flavor): ... carboxy-methylcellulose sodium, USP; Inactive ingredients (bubblegum flavor): ... Carboxymethylcellulose Sodium, USP,
The thickener used in nystatin is carboxy-methylcellulose sodium.
- Nystatin already contains a thickener, which is carboxy-methylcellulose sodium. It is not necessary to add another thickener to nystatin because it already contains one 1.
From the Research
Yes, thickeners can be added to nystatin oral suspension to improve its adherence to oral mucosa, which may enhance its effectiveness in treating oral fungal infections. According to the most recent and highest quality study available, 2, nystatin is an effective treatment for oral candidiasis, and its efficacy can be improved by modifying its formulation. Common thickening agents used include methylcellulose, carboxymethylcellulose, or commercial food thickeners. When adding a thickener, it's essential to use a small amount initially (typically 1/4 to 1/2 teaspoon per 5-10 mL of nystatin) and mix thoroughly until the desired consistency is achieved.
The thickened medication should be stored according to the original nystatin storage requirements, typically at room temperature or refrigerated, and used within the original expiration timeframe. Thickening nystatin can be particularly beneficial for patients with difficulty retaining the medication in their mouth, such as infants, elderly patients, or those with swallowing difficulties. The thicker consistency helps the medication remain in contact with the affected areas longer, potentially improving the antifungal action of nystatin, which works by binding to sterols in the fungal cell membrane, disrupting membrane function and leading to cell death.
Some key points to consider when thickening nystatin oral suspension include:
- Using a small amount of thickener initially to avoid altering the medication's efficacy
- Mixing the thickener thoroughly to achieve a uniform consistency
- Storing the thickened medication according to the original storage requirements
- Using the thickened medication within the original expiration timeframe
- Monitoring patients for any adverse effects or interactions with the thickened medication.
It's also important to note that while the study 2 provides evidence for the effectiveness of nystatin in treating oral candidiasis, it does not specifically address the use of thickeners in nystatin oral suspension. However, based on the available evidence and clinical practice, thickening nystatin oral suspension can be a useful strategy to improve its efficacy and patient compliance.