Nystatin Powder Dosing and Treatment Regimen
For topical nystatin powder, apply to affected candidal lesions 2-3 times daily until healing is complete, using the powder formulation specifically for very moist lesions. 1
Topical Powder Application
- Apply nystatin topical powder (100,000 units per gram) to affected areas 2-3 times daily until the infection resolves completely 1
- The powder formulation is specifically indicated for very moist lesions where other formulations may be less effective 1
- For candidal foot infections, dust the powder on the feet and inside all footwear to prevent reinfection 1
- Store at controlled room temperature 15-30°C (59-86°F) and avoid excessive heat above 40°C (104°F) 1
Alternative Nystatin Formulations (Non-Powder)
If you're asking about other nystatin formulations rather than specifically powder:
Oral Suspension for Oropharyngeal Candidiasis
- For mild oral thrush, use nystatin suspension 4-6 mL (400,000-600,000 units) four times daily for 7-14 days as first-line therapy per the Infectious Diseases Society of America 2, 3
- Instruct patients to swish the suspension thoroughly in the mouth for at least 2 minutes, ensuring contact with all affected areas, then swallow rather than spit out 2
- Continue treatment for the full 7-14 days even if symptoms improve earlier 2
Nystatin Pastilles
- Alternative dosing is 1-2 pastilles (200,000 units each) four times daily for 7-14 days per the American College of Physicians 3
- Pastilles maintain antifungal activity in the oral cavity for at least 5 hours, compared to rapid elimination with suspension, making them more effective 4
Vaginal Formulation
- For vaginal candidiasis, use nystatin 100,000-unit vaginal tablets once daily for 14 days per the American College of Obstetricians and Gynecologists 3
- Nystatin may be particularly effective for recurrent vulvovaginal candidiasis caused by C. glabrata or fluconazole-resistant Candida species 5
When to Use Alternative Agents
- For moderate to severe oral candidiasis, oral fluconazole 100-200 mg daily for 7-14 days is superior to nystatin and should be used as first-line therapy 2, 3
- Clinical response should be evident within 48-72 hours; if not, consider alternative diagnosis or resistant organisms 3
- Nystatin is generally less effective than fluconazole for moderate-to-severe or systemic infections 3
Special Populations
- For denture-related candidiasis, denture disinfection must accompany nystatin therapy to prevent reinfection 2, 3
- For HIV-infected patients with recurrent infections, antiretroviral therapy is strongly recommended to reduce recurrence rates 2
- For immunocompromised patients with recurrent infections, systemic therapy may be more appropriate than topical nystatin 2