Nystatin 100,000 units/mL Oral Suspension

How it works

It binds to ergosterol in the fungal cell membrane, creating pores that cause leakage of cell contents and fungal cell death; it acts locally within the mouth and gut.

Prescribing in practice

• It is essentially not absorbed from the gut, so systemic effects are minimal and it acts only on contact — adequate mouth exposure is essential for efficacy.
• Hold the suspension in the mouth, in contact with the affected areas, before swallowing, and use after food.
• Continue treatment for the full course, typically for a period after lesions clear, to prevent relapse.

Monitoring

Routine laboratory monitoring is not required; review clinically for resolution of lesions and consider an alternative or underlying-cause review if there is no response.

Counselling the patient

• Keep the liquid in your mouth and swish it around the affected areas for as long as you can before swallowing.
• Use it after food and avoid eating or drinking for a short time afterwards so it stays in contact.
• Finish the whole course even once the white patches have cleared.

Evidence & guidelines

A long-established topical treatment for oral candidiasis recommended in UK primary-care guidance, with good local efficacy and minimal systemic exposure.