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)

Spotted something out of date? See our disclaimer or use Report an Error above.

For educational use only

Not medical advice. Verify dosing against the BNF and your local trust guidelines before prescribing.