First-lineNystan
Nystatin
Polyene antifungal (topical)
Topical oral candidiasis in mother and neonate.
Oral suspensionTopical
First-line for
- Neonatal oral candidiasis
- Nipple candidiasis in lactation
- Vulvovaginal candidiasis (alternative)
Mechanism
Binds ergosterol → membrane pores → cell death. Not absorbed orally.
“Mother + baby treat together”
- Treat both for breastfeeding thrush
- 14-day minimum for nipple candida
Dosing
- Oral susp (infant)
- 100,000 U QDS after feeds
- Cream
- BD–QDS for 10–14 d
Contraindications
- AbsoluteHypersensitivity
Side effects
- Mild GI upset
- Local irritation
Fetal & maternal notes
- • Safe in pregnancy and lactation — minimal absorption
Key interactions
None clinically significant
OK—
Clinical pearls
- 💡 Always treat the dyad in breastfeeding candidiasis
- 💡 Combine with topical miconazole for nipples
Content last reviewed: REPLACE_ME (e.g. 2026-07)
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