What is the dosage and treatment duration for Nystatin (antifungal)/Triamcinolone Acetonide (corticosteroid) 100,000U-1MG/1GM ointment for a chronic rash in the inframammary area?

Dosage for Nystatin/Triamcinolone Acetonide Ointment for Chronic Inframammary Rash

Apply a thin film of nystatin/triamcinolone acetonide 100,000U-1mg/1gm ointment to the affected inframammary area 2-3 times daily, using approximately 15-30 grams per 2-week period for this body region. 1, 2

Application Frequency and Duration

• Standard dosing is 2-3 times daily application to the affected area, as recommended by the FDA for topical corticosteroid formulations 2
• For chronic rashes in intertriginous areas like the inframammary fold, apply sparingly due to increased risk of skin atrophy in these sensitive skin fold regions 1, 3
• The nystatin component should be applied 2-3 times daily based on standard antifungal dosing 4

Quantity Guidelines

• For the inframammary area (similar to "groins and genitalia" body region), use approximately 15-30 grams per 2-week period for single daily application 5
• Since this medication is dosed 2-3 times daily, expect to use 30-90 grams per 2-week period depending on the extent of involvement 5
• The 15-gram tube provided will last approximately 5-15 days with twice-daily application to a localized inframammary area 5

Treatment Duration Considerations

• Initial treatment should continue for 2-3 weeks to assess response, as topical steroids are typically applied short-term in combination formulations 5
• After clinical improvement, gradually reduce application frequency rather than abruptly stopping to prevent rebound flares 1, 3
• For maintenance after initial control, consider reducing to once daily or twice weekly application to minimize adverse effects while maintaining disease control 1, 3

Critical Precautions for Inframammary Application

• Monitor closely for skin atrophy, striae, and telangiectasia as intertriginous areas are particularly susceptible to corticosteroid-induced adverse effects 1, 3
• The combination product should not be used long-term due to the medium-potency corticosteroid component (triamcinolone 0.1% is Class IV-V potency) 1
• If no improvement occurs within 2-3 weeks, reassess the diagnosis as the condition may not be fungal or may require alternative therapy 5

When to Modify or Discontinue

• If signs of secondary bacterial infection develop, discontinue occlusive effects from the intertriginous location and add appropriate antimicrobial therapy 2
• Consider transitioning to nystatin alone or a lower-potency steroid once inflammation is controlled to reduce long-term steroid exposure 1
• For chronic management beyond 3-4 weeks, consider steroid-sparing alternatives such as topical calcineurin inhibitors to avoid cumulative corticosteroid effects 1