Polyene antifungal antibiotic
Updated · Methodology
First line
Nipple and milk duct candidiasis. Per ABM Protocol 26 2022 and AEPED 2023, topical cream or suspension to nipples 4 times daily after feeds for 14 days. Simultaneously to the infant – oral suspension 100,000 IU/mL, 1 mL 4 times daily for 14 days. Without simultaneous mother-infant treatment, recurrence is inevitable.
Sources
ICD-10: B37.8 · ICD-11: 1F23.1Y
Binds ergosterol in fungal cell membranes, creates pores, disrupts osmotic balance. Fungicidal against Candida albicans, C. glabrata, C. tropicalis. Not absorbed from the GI tract – no systemic action. Topically also not absorbed.
Safe in pregnancy (topical or oral without systemic absorption).
Fully compatible. Hale L1. Not absorbed from GI tract or skin – no infant systemic exposure. Drug of choice for nipple candidiasis alongside infant treatment.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Verbatim lines from the interaction sections, in the language of the label
«Drug Interactions: Synergism or antagonism between clotrimazole and nystatin, or amphotericin B, or flucytosine against strains of C. albicans has not been reported.»FDA, section 7 · Open on DailyMed
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Nystatin is evaluated for the following indications with varying evidence strength: Nipple candidiasis during lactation (evidence tier B). See the full indication matrix with dosing and citations above on this page.
Common side effects of Nystatin (≥ 1 in 100): Local irritation (rare), Nausea with oral use (rare). See the Safety section for uncommon and serious reactions.
Safe in pregnancy (topical or oral without systemic absorption).
Fully compatible. Hale L1. Not absorbed from GI tract or skin – no infant systemic exposure. Drug of choice for nipple candidiasis alongside infant treatment.
Nystatin is contraindicated in: Hypersensitivity to nystatin. Full list in the Safety section.
Direct links to regulator labels. Open in a new tab.
Probiotics (Lactobacillus spp., Bifidobacterium spp., Saccharomyces boulardii), Saccharomyces boulardii CNCM I-745, Sulfasalazine, Berberine, Diosmectite, Loperamide, Bifidobacterium longum, Curcumin (Curcuma longa extract)