Nystatin — NZ Medication Guide

What is Nystatin?

Nystatin is a polyene antifungal used topically and orally (non-absorbed) to treat Candida infections of the mouth, throat, and gastrointestinal tract. This medication is funded by Pharmac for oropharyngeal and gastrointestinal candidiasis.

What is Nystatin Used For?

Nystatin is used for oropharyngeal candidiasis (oral thrush), intestinal candidiasis, and skin/mucous membrane candidal infections. It is not absorbed systemically from the gut, so it is only effective for local infections.

How Does Nystatin Work?

Nystatin binds to ergosterol in the fungal cell membrane, creating pores that disrupt membrane integrity and cause leakage of intracellular contents — killing the fungal cells. It is fungicidal at high concentrations.

How to Take Nystatin

For oral thrush: nystatin oral suspension (100,000 units/mL) — hold 1–2 mL in the mouth as long as possible (5 minutes), then swallow, four times daily for 7–14 days. Pastilles (lozenges) can be slowly dissolved in the mouth. Continue for 2 days after symptoms resolve.

Common Side Effects of Nystatin

  • Nausea (mild — uncommon)
  • Diarrhoea (uncommon)
  • Oral irritation (mild)

Serious Side Effects — Seek Medical Attention

Contact your doctor or call 111 immediately if you experience any of the following:

  • Systemic side effects are essentially absent — nystatin is not absorbed from the gastrointestinal tract
  • Rarely: contact dermatitis with topical use

Drug Interactions

Nystatin may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:

  • No significant systemic drug interactions (not absorbed orally)

New Zealand Prescribing Information

Nystatin oral suspension (100,000 units/mL, 30 mL and 60 mL) and pastilles are funded by Pharmac. It is particularly useful for oral thrush prevention in patients on inhaled corticosteroids, chemotherapy, or immunosuppressive therapy. For denture wearers, dentures should also be soaked in nystatin solution or antifungal cleaning solution to prevent reinfection.

Frequently Asked Questions

Will nystatin work for vaginal thrush?

Oral nystatin is not absorbed and will not treat vaginal thrush. For vaginal candidiasis, topical clotrimazole pessaries or cream, or oral fluconazole 150 mg, are the appropriate treatments.

How should I take nystatin suspension to get the best effect?

Hold the suspension in your mouth and swish it around for at least 5 minutes before swallowing. This ensures maximum contact time between the medicine and the infected mucous membranes. Avoid eating or drinking for 30 minutes after use.

Reviewed by a Registered Pharmacist NZ

References & Further Information

The following New Zealand and international resources were used to inform this page:

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