From the Guidelines
Nystatin is recommended at a dose of 100,000 U/mL, with a dosage of 4–6 mL 4 times daily, or 1–2 nystatin pastilles (200,000 U each) administered 4 times daily for 7–14 days.
Recommended Dosage and Frequency
- The dosage of nystatin suspension is 100,000 U/mL, with a recommended dosage of 4–6 mL 4 times daily 1.
- Alternatively, 1–2 nystatin pastilles (200,000 U each) can be administered 4 times daily for 7–14 days 1.
Key Considerations
- Nystatin is recommended for mild disease, while other antifungals like fluconazole are recommended for moderate to severe disease 1.
- The recommended treatment duration is 7–14 days 1.
- Chronic suppressive therapy is usually unnecessary, but if required, fluconazole is recommended instead of nystatin 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Infants: 2 mL (200,000 units) four times daily (in infants and young children, use dropper to place one-half of dose in each side of mouth and avoid feeding for 5 to 10 minutes). NOTE: Limited clinical studies in premature and low birth weight infants indicate that 1 mL four times daily is effective. Children and Adults: 4 to 6 mL (400,000 to 600,000 units) four times daily (one-half of dose in each side of mouth). The recommended dose and frequency of Nystatin are:
- Infants: 2 mL (200,000 units) four times daily
- Premature and low birth weight infants: 1 mL (100,000 units) four times daily
- Children and Adults: 4 to 6 mL (400,000 to 600,000 units) four times daily 2
From the Research
Recommended Dose and Frequency of Nystatin
The recommended dose and frequency of Nystatin vary depending on the specific condition being treated and the population.
- For oral candidiasis, a dose of 400,000 IU of nystatin pastilles resulted in a significantly higher mycological cure rate than a dose of 200,000 IU 3.
- Treatment with nystatin pastilles for 4 weeks seemed to have better clinical efficacy than treatment for 2 weeks 3.
- In a study of older, chronically ill, institutionalized adults, a topical antifungal regimen consisting of an antifungal denture soaking solution (10,000 IU nystatin/mL) and a nystatin vaginal lozenge (100,000 IU/g) was used three times daily for seven days 4.
- For infants with oral candidiasis, nystatin oral suspension was administered four times a day for 10 days, but fluconazole was shown to be superior to nystatin suspension in this population 5.
- In HIV-positive patients, nystatin was found to be less effective than other antifungal drugs, such as fluconazole, ketoconazole, and miconazole, in increasing mycological cure rates 6.
- For prevention of fungal peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD), nystatin tablets (500,000 units) were given orally four times per day during antibiotic therapy 7.