Nystin is an antifungal medication used to treat certain fungal infections—particularly those caused by Candida species. It belongs to a class of drugs known as polyene antifungals, which work by binding to fungal cell membranes, disrupting them and ultimately killing or inhibiting the fungus.
Typically, nystin comes in various forms: oral suspension, topical cream/ointment/powder, and tablets. In this article we focus on nystin tablets—when they are used, how they are dosed, and what factors affect correct dosage.
When Are Nystin Tablets Used?
While nystin suspension is commonly used in oral‑thrush and local infections, the tablet form is most often used for intestinal candidiasis and other gastrointestinal Candida overgrowth, where the drug is intended to act within the gut rather than be systemically absorbed. Because nystin is poorly absorbed into the bloodstream when taken orally, its main effect is local (in the GI tract) instead of systemic.
For example, the adult dosing guideline lists:
“Oral tablets: 500,000‑1,000,000 units q8 hr” for intestinal candidiasis.
Thus, tablets are not always interchangeable with suspension in all indications. It’s vital to follow the proper form for the correct condition.
Correct Dosage for Nystin Tablets
Adult Dosage
According to prescribing information:
- The usual therapeutic dosage of nystin tablets is one to two tablets (500,000 to 1,000,000 units) taken three times daily (TID).
- Some sources list dosing for intestinal candidiasis as 500,000 to 1,000,000 units three times or four times daily.
- One guideline: “500,000‑1,000,000 units q8hr” (which is three times daily).
In simple terms: if each tablet equals 500,000 units (as is typical), you’d often take 1 or 2 tablets every ~8 hours. That could mean 3 doses per day, roughly evenly spaced.
Pediatric Dosage
Tablet use in children is less common compared to suspension forms—especially for oral thrush. For the tablet form for intestinal candidiasis:
- Some data suggest using the same range (500,000‑1,000,000 units three times daily) for children over 5 years.
- For younger children and infants, usually the suspension form is preferred.
Duration of Treatment
- Treatment with nystin tablets generally continues until the infection is resolved. Some sources recommend continuing therapy for at least 48 hours after clinical cure to help prevent relapse.
- For example, in oral thrush using suspension, guidelines say to finish 2 days after symptoms stop.
- For intestinal candidiasis, duration may be longer depending on severity and underlying condition.
Important Considerations: What Affects the Dose?
Strength of the Tablet
- A typical nystin tablet contains 500,000 units of the active drug.
- If prescribed “1‑2 tablets,” it means you might take 500,000 units (1 tablet) or 1,000,000 units (2 tablets) per dose depending on your doctor’s judgement.
Patient Condition
- The severity of infection (e.g., mild vs. extensive intestinal candidiasis) influences prescription decisions.
- Underlying health issues (e.g., immune suppression, GI dysmotility) may affect treatment length and dosing.
- Age: Some forms not recommended for very young children or infants in tablet form. See suspension dosing for those groups.
Form of Administration
- Taking tablets for GI candidiasis ensures drug acts in gut lumen.
- For oral cavity infections (thrush), suspension or lozenges are more common because they allow contact in the mouth and throat. Tablets may not always be appropriate.
Compliance & Timing
- Spacing matters: dosing three times daily usually means ~every 8 hours—e.g., morning, afternoon, evening.
- It’s essential to take doses evenly spaced to maintain effective concentration in gut lumen.
- Take tablets with water; swallow whole (do not chew) unless otherwise instructed.
Sample Dosing Schedule
Here’s a sample adult schedule using tablets (assuming 500,000 unit tablets, 1 tablet per dose):
| Time of day | Dose |
|---|---|
| 08:00 AM | 1 tablet (500,000 units) |
| ~04:00 PM (8h later) | 1 tablet (500,000 units) |
| ~12:00 AM (8h later) | 1 tablet (500,000 units) |
If the doctor prescribes 2 tablets per dose:
- Same timing, but take 2 tablets (1,000,000 units) each time.
Always finish the full course even if symptoms improve, to lower risk of relapse.
Effectiveness & Data
- Nystin’s minimal systemic absorption makes it well‑suited to treat localized fungal overgrowth in the gut.
- While specific large‑scale randomized trials for tablet dosing are limited, prescribing monographs reflect decades of use.
- One source quotes the adult tablet dose of 500,000‑1,000,000 units TID with good tolerability.
- Because the drug acts locally, blood level monitoring is not typical; effectiveness is judged by symptomatic improvement and resolution of infection.
Safety, Side‑Effects & What to Watch
Safety Profile
- Because absorption is minimal, systemic side‑effects tend to be rare.
- One prescribing information sheet noted: overdoses (e.g., >5 million units daily) caused nausea/GI upset; no serious toxic effects reported.
Common Side‑Effects
- Gastrointestinal upset: nausea, vomiting, diarrhea.
- Local irritation if used in mouth or throat (for suspension/lozenge form rather than tablets).
- Allergic reactions (rare): rash, itching, swelling.
Warnings
- Hypersensitivity to nystin: do not use.
- Although absorption is minimal, nystin tablets are not intended to treat systemic fungal infections. Using them for such can be ineffective.
- For infants and children under certain ages, the tablet form may not be suitable—use suspension.
Key Takeaways: What You Should Remember
- Correct tablet dose: Usually 500,000 units (1 tablet) to 1,000,000 units (2 tablets) taken three times daily (every ~8 hours) for most adult GI candidiasis cases.
- Duration: Continue until infection clears and often for at least two additional days (or as advised by your doctor) to reduce relapse risk.
- Form matters: Tablets are best for intestinal candidiasis; suspension or lozenge is preferred for mouth/throat infections.
- Spacing & consistency: Keeping doses evenly spaced matters for effectiveness.
- Safety profile is good: Minimal absorption means fewer systemic side‑effects, but always monitor for GI upset or allergic signs.
- Follow your doctor’s guidance: The doctor may adjust dosing based on your condition, age, or other medical factors.
Common Questions (FAQ)
Q: Can I take nystin tablets for oral thrush?
A: Not typically. For oral cavity infections, nystin suspension or lozenge is often preferred because it allows contact with the affected mucosa. Tablets are designed for gut lumen use.
Q: What happens if I miss a dose?
A: Take it as soon as you remember unless the next scheduled dose is close. Don’t double‑up. The goal is regular spacing to maintain effective exposure in the gut.
Q: Can I stop early if I feel better?
A: It’s best to complete the full course (and follow your doctor’s instructions). Stopping early may lead to relapse or incomplete fungal eradication.
Q: Does food affect absorption?
A: Nystin has minimal absorption, so food does not significantly affect systemic levels. However, for the tablet to act effectively in the gut, regular intake is important.
Q: Are there age or pregnancy concerns?
A: For young children (especially under 5 years) and infants, the tablet form is often not used; suspension is preferred. Pregnant or breastfeeding people should consult their doctor; while nystin is considered relatively safe, always weigh risks vs benefits.
Final Thoughts
Choosing and maintaining the correct dosage of nystin tablets is a key part of successful treatment of intestinal candidiasis. With typical adult dosing of 500,000 to 1,000,000 units three times a day, and a focus on completing the full treatment course, patients can often expect good outcomes. The medication’s safety profile is favorable due to low systemic absorption, but compliance with timing, spacing, and full‑course completion matters.
If you’ve been prescribed nystin tablets—or believe you may need them—use this information as a guide but rely on your healthcare professional’s directions. Make sure to ask about your specific dose, how long you should take it, and what signs to watch for. By staying informed, you’ll be better prepared to get the most from your treatment and support your recovery.
Note: This article does not replace medical advice. Always consult your doctor or pharmacist for dosing tailored to your condition.
