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Pharmacy and Medications

Nystatine Systemic or Local Effect?

05/24/2011

Question:

Dear Pharmacist, I wonder if Nystatine is a systemic medication or a topical medication (I mean it is not absorbed into the blood stream even we swallow the oral tablet). I have read from 2 different books and one of the either says it is systemic the other says it is not absorbed at all. Which source is most reliable? I also notice that oral version of this medicine is used for sucking and it cures the susceptible yeast infection of the mouth and intestine. Another oral version of the medicine is for swallowing and it can cure yeast infection of the genitalia area as well. So this means that it is absorbed into the blood stream. Why is it like this?

Answer:

Nystatin is polyene antibiotic used to treat certain types of fungal infections. It is available in products that are creams, ointments, vaginal tablets, oral tablets, oral dissolving tablets and solution. It has very, very, very little absorption if taken orally so the levels in the blood stream would not be measurable.

The instances that nystatin is used orally is to usually prevent against fungal type infections with patients who need to prevent a fungal infection or may need to have the antifungal applied to an oral area due to a fungal infection such as thrush. The tablets that are available are in the forms of dissolving tablets and are intended to be held on the tongue until dissolved, oral tablets used to prevent fungal infection prior to a procedure or vaginal tablets which are applied into the vagina to treat a fungal infection. These forms allow the drug to be applied topically similar to how a cream is applied on the skin, but using a cream in the mouth or gut in not an option.

Fungal infections that require a medication to reach the blood stream would require another medication other than nystatin. In the future, a good reference that you can use to provide information is MedLine Plus that is sponsored by the National Library of Medicine and the National Institute of Health. http://www.nlm.nih.gov/medlineplus/druginformation.html.  

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Response by:

Sarah Hudson-DiSalle, PharmD, RPh
Specialty Practice Pharmacist of Outpatient Pharmacy
College of Medicine
The Ohio State University