Nystatin oral suspension is used to treat fungal infections in the mouth. It is a widely-used medication considered safe for all ages when used properly. Side effects are very rare beyond mild stomach upset.

The medication is most commonly used to treat oral thrush. It will have little effect on fungal infections in other parts of the body, though the active ingredient nystatin is frequently administered as a topical cream or in tablets for infections in other areas.

Nystatin oral suspension is only effective on certain types of fungus, most notably Candida albicans. For best results the infection should be identified prior to selecting a treatment.

Treatment Overview

Nystatin oral suspension is a cherry-mint flavored liquid. It should not be diluted in other liquids unless instructed to do so by a doctor.

Dosage is largely dependent on age:

• Adults and children old enough to follow instruction should take 4 to 6 mL four times per day.
• Older infants are typically given 2 mL four times per day.
• Premature and very young infants are usually given 1 mL four times per day.

Administration is also somewhat age dependent; infants and other patients who are unable to follow instructions should have the medication applied directly to the affected area using a dropper. Patients who are able to follow instructions should retain the medication in the mouth as long as possible:

• Hold one-half of each dose in one side of the mouth for as long as possible.
• When no longer able to hold the half-dose, it should be swallowed.
• Repeat on the other side of the mouth with the remaining half-dose.
• The medication may also be swished around in the mouth and/or gargled before being swallowed.

There is much more variation when it comes to duration of treatment with nystatin oral suspension. While many patients notice improvements in symptoms just days after starting treatment, it may take several weeks before the infection is cleared up. In general, treatment should continue until:

• 48 hours after all symptoms have stopped; and
• 48 hours after the fungus is no longer detectable in cultures.

There are a number of factors which can impede healing and result in longer treatment:

• Antibiotic use
• Hormonal birth control use
• Steroid inhaler use
• Heavy tobacco use
• Poorly controlled blood sugar
• Poorly fitting dentures
• Severe stress
• Any severe illness

Patients with severe or frequent fungal infections will benefit from regular doctor checkups to ensure nystatin oral suspension is working as intended. Alternative treatments may be preferable if the medication is not producing significant results.

If at any time during treatment with nystatin oral suspension the infection worsens, or swelling of the mouth occurs, a doctor should be consulted at earliest convenience.

Warnings & Adverse Effects

While side effects are typically mild, individuals who have diabetes, HIV, or a history of liver problems are at greater risk of experiencing serious adverse effects. Risks should be discussed with a doctor before starting treatment with nystatin oral suspension.

Other medications, including the non-prescription variety, may significantly reduce the effectiveness of nystatin oral suspension. Consult a doctor or pharmacist if unsure of the consequences of mixing medications.

The most commonly encountered side effects include:

• Nausea
• vomiting
• Mild stomachache
• Diarrhea

Some patients experience irritation in the mouth at the beginning of treatment, which is not cause for concern unless severe. Any swelling of lips, tongue or throat, difficulty breathing, rapid heartbeat, rash, or severe dizziness could be symptoms of an allergic reaction and warrants emergency medical treatment.

The medication's effect on unborn babies is unknown; the medication is sometimes used during pregnancy when it is determined that the benefits outweigh the risks. Parents should discuss the issue with a trusted doctor before starting treatment.