• For Nystatin to be effective, it must remain in direct contact with the oral mucosa for as long as possible. It is not absorbed significantly into the systemic circulation through the digestive tract.

  • Preparation: Shake the bottle vigorously before each administration to ensure the active ingredient is evenly suspended.

  • Application: Use the provided graduated dropper to measure the prescribed dose

  • Technique: Apply the suspension to the affected areas of the mouth. Retain the liquid in the oral cavity, swishing it around the tongue and cheeks, for several minutes before swallowing.

  • Timing: Administer the dose after meals. To maximise efficacy, avoid eating, drinking, or rinsing the mouth for at least 30 minutes post-application.

  • Duration: Treatment should be continued for at least 48 hours after the clinical symptoms have completely resolved to ensure the eradication of the fungal colonies and prevent relapse.

• • Active Substance: Nystatin (100,000 units per 1mL).

  • Excipients: Common inactive ingredients include purified water, ethanol, and flavouring agents (such as cherry or peppermint).

  • Important Note: Most formulations contain sucrose or glycerol. Patients with diabetes or rare hereditary fructose intolerance should exercise caution and maintain strict oral hygiene to prevent dental caries.

Nystatin is generally well-tolerated due to its minimal systemic absorption. However, the following may occur:

• Gastrointestinal: High doses may occasionally cause nausea, vomiting, or diarrhea upon swallowing.

• Local Irritation: Transient oral irritation or a burning sensation may be felt on the tongue or mucosa.

• Hypersensitivity: Although rare, allergic reactions including rash or urticaria can occur. Serious reactions (Stevens-Johnson syndrome) are extremely rare but require immediate medical intervention.

Clinical Cautions and Contraindications

• Medical History: Patients with a known hypersensitivity to nystatin or any of the excipients should avoid this medication.

• Pregnancy and Lactation: While systemic absorption is negligible, Nystatin should only be used during pregnancy or breastfeeding if the clinical benefit outweighs the potential risk. Consult a healthcare professional before use.

• Denture Care: Patients who wear dentures must ensure they are thoroughly cleaned and soaked in an antifungal solution daily, as the prosthesis can serve as a reservoir for Candida spores.

• Inhaler Protocol: If the infection was triggered by corticosteroid inhaler use, patients should be advised to rinse their mouth with water or brush their teeth immediately after each inhaler puff to prevent recurrence.