Nystatin

Nystatin
Clinical data
Trade names	Mycostatin, others
AHFS/Drugs.com	Monograph
MedlinePlus	a682758
License data	US DailyMed: Nystatin;
Routes of; administration	Topical, vaginal, by mouth
Drug class	Polyene antifungal medication
ATC code	A07AA02 (WHO) D01AA01 (WHO), G01AA01 (WHO), J01RA19 (WHO);
Legal status
Legal status	In general: ℞ (Prescription only);
Pharmacokinetic data
Bioavailability	0% on oral ingestion
Metabolism	None (not extensively absorbed)
Elimination half-life	Dependent upon GI transit time
Excretion	Fecal (100%)
Identifiers
	IUPAC name (1S,3R,4R,7R,9R,11R,15S,16R,17R,18S,19E,21E, 25E,27E,29E,31E,33R,35S,36R,37S)-33-[(3-amino-3,6-dideoxy-β-L-mannopyranosyl)oxy]-1, 3,4,7,9,11,17,37-octahydroxy-15,16,18-trimethyl-13-oxo-14, 39-dioxabicyclo[33.3.1]nonatriaconta-19,21,25,27,29,31-hexaene-36-carboxylic acid;
CAS Number	1400-61-9 ;
PubChem CID	14960;
DrugBank	DB00646 ;
ChemSpider	23078586 ;
UNII	BDF1O1C72E;
KEGG	D00202 ;
ChEBI	CHEBI:473992 ;
ChEMBL	ChEMBL229383 ;
NIAID ChemDB	004993;
CompTox Dashboard (EPA)	DTXSID4040688 ;
ECHA InfoCard	100.014.317
Chemical and physical data
Formula	C47H75NO17
Molar mass	926.107 g·mol−1
3D model (JSmol)	Interactive image;
Melting point	44–46 °C (111–115 °F)
	SMILES CC1C=CC=CCCC=CC=CC=CC=CC(CC2C(C(CC(O2)(CC(C(CCC(CC(CC(CC(=O)OC(C(C1O)C)C)O)O)O)O)O)O)O)C(=O)O)OC3C(C(C(C(O3)C)O)N)O;
	InChI InChI=1S/C47H75NO17/c1-27-17-15-13-11-9-7-5-6-8-10-12-14-16-18-34(64-46-44(58)41(48)43(57)30(4)63-46)24-38-40(45(59)60)37(54)26-47(61,65-38)25-36(53)35(52)20-19-31(49)21-32(50)22-33(51)23-39(55)62-29(3)28(2)42(27)56/h5-6,8,10-18,27-38,40-44,46,49-54,56-58,61H,7,9,19-26,48H2,1-4H3,(H,59,60)/b6-5+,10-8+,13-11+,14-12+,17-15+,18-16+/t27-,28-,29-,30+,31+,32+,33+,34-,35+,36+,37-,38-,40+,41-,42+,43+,44-,46-,47+/m0/s1 ; Key:VQOXZBDYSJBXMA-NQTDYLQESA-N ;
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Nystatin, sold under the brand name Mycostatin among others, is an antifungal medication.^[1] It is used to treat Candida infections of the skin including diaper rash, thrush, esophageal candidiasis, and vaginal yeast infections.^[1] It may also be used to prevent candidiasis in those who are at high risk.^[1] Nystatin may be used by mouth, in the vagina, or applied to the skin.^[1]

Common side effects when applied to the skin include burning, itching, and a rash.^[1] Common side effects when taken by mouth include vomiting and diarrhea.^[1] During pregnancy use in the vagina is safe while other formulations have not been studied in this group.^[1] It works by disrupting the cell membrane of the fungal cells.^[1]

Nystatin was discovered in 1950 by Rachel Fuller Brown and Elizabeth Lee Hazen.^[2] It was the first polyene macrolide antifungal.^[3] It is on the World Health Organization's List of Essential Medicines.^[4] It is available as a generic medication.^[1] It is made from the bacterium Streptomyces noursei.^[2] In 2023, it was the 233rd most commonly prescribed medication in the United States, with more than 1 million prescriptions.^[5]^[6]

^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k "Nystatin". American Society of Health-System Pharmacists. Archived from the original on 3 February 2016. Retrieved 27 January 2016.
^ ^a ^b Espinel-Ingroff AV (2013). Medical Mycology in the United States a Historical Analysis (1894-1996). Dordrecht: Springer Netherlands. p. 62. ISBN 9789401703116. Archived from the original on 2 February 2016.
^ Gupte M, Kulkarni P, Ganguli BN (January 2002). "Antifungal antibiotics". Applied Microbiology and Biotechnology. 58 (1): 46–57. doi:10.1007/s002530100822. PMID 11831475. S2CID 8015426.
^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
^ "The Top 300 of 2023". ClinCalc. Archived from the original on 12 August 2025. Retrieved 12 August 2025.
^ "Nystatin Drug Usage Statistics, United States, 2013 - 2023". ClinCalc. Retrieved 20 August 2025.

[AHFS2016-1] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k "Nystatin". American Society of Health-System Pharmacists. Archived from the original on 3 February 2016. Retrieved 27 January 2016.

[Es2013-2] Espinel-Ingroff AV (2013). Medical Mycology in the United States a Historical Analysis (1894-1996). Dordrecht: Springer Netherlands. p. 62. ISBN 9789401703116. Archived from the original on 2 February 2016.

[3] Gupte M, Kulkarni P, Ganguli BN (January 2002). "Antifungal antibiotics". Applied Microbiology and Biotechnology. 58 (1): 46–57. doi:10.1007/s002530100822. PMID 11831475. S2CID 8015426.

[WHO23rd-4] World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.

[5] "The Top 300 of 2023". ClinCalc. Archived from the original on 12 August 2025. Retrieved 12 August 2025.

[6] "Nystatin Drug Usage Statistics, United States, 2013 - 2023". ClinCalc. Retrieved 20 August 2025.

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