Nystatin Suspension Can Be Swallowed for Oral Candidiasis Treatment
Yes, nystatin suspension can and should be swallowed for effective treatment of oral and esophageal candidiasis. 1, 2
Administration Guidelines
- Nystatin suspension is designed to be swallowed after being held in the mouth to treat both oropharyngeal and gastrointestinal candidiasis 1
- For adults, the recommended dosage is 4-6 mL (400,000-600,000 units) four times daily 2
- Treatment should continue for 7-14 days and at least 48 hours after symptoms resolve 2
- For oropharyngeal candidiasis (thrush), the patient should:
Mechanism of Action
- Nystatin is a polyene antifungal that works by binding to ergosterol in fungal cell membranes, creating pores that lead to cell death 3
- It is not systemically absorbed when taken orally, making it safe for treating localized candidiasis 4
- The medication works topically on contact with infected surfaces in the mouth and throughout the digestive tract 1, 4
Clinical Applications
- Nystatin suspension is effective for:
- For denture-related oral candidiasis, patients should remove dentures when using nystatin to ensure contact with affected tissues 1
Efficacy Considerations
- Nystatin pastilles may have higher mycological cure rates than suspension alone for oral candidiasis 5
- A combination of nystatin suspension and pastilles for 2 weeks may achieve higher clinical and mycological cure rates than using suspension alone 5
- For refractory cases of oropharyngeal candidiasis, fluconazole or itraconazole solution may be more effective alternatives 1
Common Side Effects and Precautions
- Poor taste is a common complaint with nystatin suspension 5
- Gastrointestinal adverse reactions may occur but are generally mild 5
- Cutaneous hypersensitivity reactions are rare 2
- The suspension contains small amounts of alcohol (0.5-1% v/v) and sucrose (50% w/v) 3
Special Populations
- In neonates, nystatin suspension (1 mL of 100,000 U/mL every 8 hours) is used to prevent invasive candidiasis 1
- For immunocompromised patients with recurrent infections, longer treatment courses or suppressive therapy may be needed 1
Remember that nystatin suspension is specifically designed to be swallowed after coating the oral mucosa, as this provides treatment to both the oral cavity and the gastrointestinal tract for comprehensive management of candidiasis.