Antifungal Agent: Nystatin Pessary 1 Lac IU (100,000 International Units) is a medication formulated as a pessary, or vaginal insert, for local treatment.1
Composition: Each pessary contains 100,000 IU of nystatin, a polyene antifungal antibiotic produced by the bacterium Streptomyces noursei.2
Topical Action: The pessary is designed for intravaginal administration, where it exerts its antifungal effect locally with minimal systemic absorption.3
Non-Absorbable: Nystatin is virtually non-toxic and non-absorbable from the vaginal mucosa, which means it works directly at the site of infection without causing significant systemic side effects.4
Advantages
Targeted Treatment: Provides a highly effective and targeted treatment for localized fungal infections of the vagina, concentrating the active ingredient directly at the site of the infection.
Broad Spectrum Against Yeasts: Nystatin is both fungistatic and fungicidal against a wide variety of yeasts and yeast-like fungi, with high activity against Candida species.
Well-Tolerated: The drug is generally well-tolerated, even with prolonged use, with rare instances of local irritation or sensitization.5
Safety Profile: Due to its minimal absorption, it has a good safety profile and is considered a safe option, including for use in pregnant women under a doctor’s supervision.
Uses
Vulvovaginal Candidiasis: The primary indication is for the local treatment of fungal infections of the vagina and vulva caused by Candida species, commonly known as a yeast infection or moniliasis.6
Confirmed Diagnosis: This medication is used after a diagnosis of vulvovaginal candidiasis has been confirmed by appropriate microbiological studies, such as a KOH smear or culture, to rule out other pathogens.
Intercurrent Conditions: It can also be used as a prophylactic measure to prevent candidal infections during prolonged courses of antibiotic therapy, in patients with weakened immune systems, or in other susceptible individuals.
Maintenance Therapy: In some cases, it may be used as maintenance therapy for patients who experience recurrent vaginal yeast infections.
Nature
Polyene Antifungal Class: Nystatin belongs to the polyene class of antifungal drugs, which are characterized by their mechanism of action involving binding to fungal cell membranes.7
Mechanism of Action: It acts by binding to ergosterol, a key sterol present in the cell membrane of sensitive fungi. This binding creates pores in the membrane, leading to an increased permeability and leakage of intracellular components, which ultimately causes the death of the fungal cell.8
No Bacterial/Viral Activity: Nystatin is not active against bacteria, protozoa, or viruses, making it a specific treatment for fungal infections and not effective for mixed or non-fungal vaginitis.9
Minimal Resistance: Resistance to nystatin is minimal in Candida albicans, the most common cause of vaginal yeast infections, making it a reliable first-line treatment.10
Storage
Temperature: Store Nystatin Pessary at controlled room temperature, typically below 1130∘C (1286∘F), in a cool and dry place.13
Protection: The pessaries must be kept in their original packaging, protected from light and moisture, to maintain their stability and effectiveness.
Patient Instructions: Patients should be advised to store the medication properly and to follow the instructions for use, including the correct insertion technique, often with the use of a provided applicator.
Expiry Date: Always check the expiry date on the packaging and discard any unused or outdated medication, as the potency of the active ingredient may decrease over time.
