Names and pronunciation
(nye-stat′in) Nystop, Nyaderm
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Drug reference
(nye-stat′in) Nystop, Nyaderm
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Func. class.: Antifungal
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Chem. class.: Amphoteric polyene
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ACTION: Interferes with fungal DNA replication; binds sterols in fungal cell membrane, which increases permeabil- ity, leaking of cell nutrients
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USES: Candida species causing oral, intestinal infections
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CONTRAINDICATIONS: Hyper- sensitivity Precautions: Pregnancy, breastfeeding, systemic infection
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SIDE EFFECTS GI: Nausea, vomiting, anorexia, diarrhea, cramps
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DOSAGE AND ROUTES Oral infection • Adult/adolescent/child: SUSP 400,000- 600,000 units qid; use ½ dose in each side of mouth; swish and swallow; use for at least 48 hr after symptoms resolved • Infant: SUSP 200,000 units qid (100,000 units in each side of mouth) • Newborn and premature infant: SUSP 100,000 units qid • Adult/child: TROCHES 200,000- 400,000 units qid × ≤2 wk GI infection • Adult: PO 500,000-1,000,000 units tid Cutaneous candidiasis • Adult/child: Top cream/ointment apply to affected area bid; powder apply to affected area bid-tid
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Available forms: Tabs 500,000 units; suspension 100,000 mg/mL
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Administer: Store at room temperature for oral susp; tabs in tight, light-resistant containers at room temperature PO route • Oral susp dose by placing ½ in each cheek, then swallow; do not mix with food • Topical dose after cleansing area; mouth may be swabbed; very moist le- sions best treated with topical powder
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Assess: • Allergic reaction: rash, urticaria, irri- tated oral mucous membranes; product may have to be discontinued • Obtain culture, histologic tests to con- firm organism • Predisposing factors: antibiotic ther- apy, pregnancy, diabetes mellitus, sexual partner infection (vaginal infections) • Pregnancy/breastfeeding: use only if clearly needed; may breastfeed
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Evaluate: • Therapeutic response: culture negative N for Candida
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • That long-term therapy may be needed to clear infection; to complete entire course of medication • To avoid commercial mouthwashes for mouth infection • To shake susp before measuring each dose, to swish and swallow • To notify prescriber of irritation; prod- uct may have to be discontinued See Appendix B
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PHARMACOKINETICS PO: Little absorption, excreted in feces
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• Adult/adolescent/child: SUSP 400,000- 600,000 units qid; use ½ dose in each side of mouth; swish and swallow; use for at least 48 hr after symptoms resolved
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• Adult/child: TROCHES 200,000- 400,000 units qid × ≤2 wk GI infection
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• Adult: PO 500,000-1,000,000 units tid Cutaneous candidiasis
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• Adult/child: Top cream/ointment apply to affected area bid; powder apply to affected area bid-tid
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