Last updated December 30, 2020 by Lisa Richards, CNC   Reviewed by Zia Sherrell, MPH.

Nystatin For Candida: Uses, Side Effects & Alternatives

Nystatin - antifungal medication for Candida. Uses, side effects, natural alternatives.

Have you found white patches on your tongue, are you suffering from sinus infections, or do you feel tired all the time? The cause of this could be the fungus Candida albicans, a common infection that can affect various parts of the body.

Fungal infections can cause a number of clinical conditions. You can develop candidiasis anywhere on your skin. It could be the cause of your itchy, flakey feet, a condition known as athletes’ foot, or the burning, itchy sensation in your groin due to a vaginal yeast infection, also known as thrush.

Another form of Candida overgrowth is an overgrowth of pathogenic yeast in your intestines. This can lead to a wide range of symptoms, including digestive problems, headaches, recurring yeast infections, and more.

Candida And Your Immune System

Your immune system plays a vital role in fighting disease-causing microorganisms and yeasts. It works in three different ways.

First, your immune system prevents their entry into your body. Second, it attempts to kill the pathogen if it gains access into your body. And finally, it produces memory cells against the responsible pathogens so that it can mount effective immune responses against them if they enter your body in the future.

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There is a group of beneficial microorganisms that reside inside your body and prevent infection by harmful pathogens. Comprised of beneficial bacteria and yeasts, they collectively form your microbiome. When the balance of your microbiome is disrupted by the use of antibiotics, stress, alcohol or poor diet, your body will become vulnerable to infections by harmful pathogens.

Your immune system can be weakened by various factors, ranging from severe health issues like HIV/AIDS, cancer, chemotherapy, or radiotherapy, to more simple reasons like poor nutrition, or the use or misuse of antibiotics that kill the good bacteria in your body. (1)

If you use antibiotics, your normal gut microbiome will be affected leading to a decrease in good bacteria. Studies have shown that even a single course of antibiotics can lead to changes in your microbiome that last for years. This is often followed by the uncontrolled growth of bacterial or fungal infections such as Candida albicans.(2)

Antifungal Medications

One approach for the treatment and remedy of fungal infections is through the use of antifungal drugs.

The choice of medication is based on the type of fungi causing the infection, any other medications that you are taking, the severity of the infection, and your age.

There are different classes of antifungal pharmaceuticals including azoles such as fluconazole, allylamines such as terbinafine, echinocandins such as caspofungin, and polyenes such as amphotericin B and nystatin.

What Does Nystatin Help With?

Nystatin is effective in treating candidiasis of the digestive tract, candidiasis of the skin, oropharyngeal candidiasis which affects your mouth and pharynx, and esophageal candidiasis. (3)

You may experience difficult or painful swallowing, bad breath, swollen glands in your neck, and whitish lesions that scrape off and bleed if you develop oropharyngeal and esophageal candidiasis.

The invasive form of candidiasis is severe, and it can present with fever, chills, and signs of septic shock, like low blood pressure.

After the diagnosis of these conditions, your doctor may administer nystatin to be taken for at least 14 days for complete eradication of the infection.

To avoid the emergence of drug-resistant pathogens, every therapy used should aim to cure the disease or infection completely, and you should always adhere to the treatment schedule as prescribed by your doctor. (4)

Taking your medication correctly will protect you from developing severe and life-threatening forms of the disease which occurs in untreated or poorly treated cases. Nystatin will kill the Candida albicans yeast which is responsible for causing those infections.

How Does Nystatin work?

Fungal cells have a cell membrane. In some ways this cell membrane is like your skin; it keeps the unwanted outside and prevents the cell contents from escaping.

The cell membrane helps to maintain the integrity of the cell by preventing an excessive inflow of liquid which could lead to swelling and bursting. It also prevents the leakage and loss of intracellular contents such as potassium ions, which are an electrolyte required for cellular function.

Nystatin works by binding to a substance called ergosterol which is found in the cell membranes of fungi. Ergosterol is vital to the fungal cell membrane. When the nystatin binds the ergosterol, this leads to increased permeability of the cell membrane. This, in turn, means that the essential contents inside the cell can leak away which leads to the death of the fungal organism.

Humans do not have ergosterol; instead, your body has cholesterol. What this means is that nystatin kills only the fungi and does not destroy human cells.

This is beneficial because a drug that acts against both the cells of the pathogen and your cells could lead to severe adverse reactions and complications. You could be forced to sacrifice your cells so that the drug can act on the pathogen. With nystatin, this is less of an issue. (5)

How Is Nystatin Taken?

Nystatin exists in various forms: oral powder, oral suspension, capsules, and oral tablets.

The route of administration is based on the underlying infection. Oropharyngeal candidiasis is managed using oral suspension by retaining it in the mouth for as long as possible before swallowing. Avoid eating for ten minutes after using the suspension. You may have to use the nystatin four times a day.

Oral tablets are used for esophageal candidiasis.

In addition, nystatin may be applied to the skin in cases of localized fungal skin infections. There are specific doses for children and adults.

It is not absorbed in the gastrointestinal tract and is eliminated in feces which means it’s safe in treating oral and intestinal fungal infections.

Other Names For Nystatin

These are the other names that are used for Nystatin:

  • Mycostatin
  • Nilstat
  • Nystex
  • Nystatin Systemic
  • Nystat Rx
  • Nyamyc

Side Effects of Nystatin

Nystatin does have various side effects. Following its administration, you may experience gastrointestinal upsets such as loose stools, stomach pains, and nausea.

If you’re concerned about side effects, you might find that natural antifungals are a less aggressive treatment. Some antifungal herbs have been shown to be just as effective as prescription antifungals like Nystatin and Diflucan.

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Allergic reactions may also occur in patients who cannot tolerate the drug. They include hypersensitivity reactions and contact dermatitis.

In rare cases, Stevens-Johnson syndrome can occur. In this serious condition, there could be a rash, itchiness, irritation, swelling of the whole body especially of your face, and difficulty in breathing. This is a life-threatening condition that warrants urgent medical attention and supportive management might be indicated such as oxygen administration to manage any breathing difficulties. It is likely that your doctor will decide to discontinue nystatin and your medication to another antifungal. (6)

A risk versus benefit analysis will be done in these circumstances, but generally, if you have had a hypersensitivity reaction, this is a contraindication to its use, and you should perhaps consider a natural alternative. Nystatin will be less effective once you have become hypersensitive to it, which means that you would need a risky and higher dose to kill the fungus. (7)

Who Should Take Nystatin?

You should only take nystatin when prescribed by your doctor. Taking medicines without a medical reason can lead to what is known as sensitization whereby you will require a higher dose to treat the same infection.

Nystatin is classified as a Category C in pregnancy, meaning that animal studies show that there is a risk, but there are no available human studies. It is used cautiously when the benefits outweigh the risks to treat fungal infections in pregnancy. (8)

Nystatin Drug Interaction

Nystatin does not react with most commonly used drugs. However, as a precaution you should discuss your current medications with your doctor. This discussion should include prescription or herbal medications, any other medicine that you have used recently, and allergies that you have. This will ensure that you are using the best drug combination for your problem.

Natural Alternatives

If you are suffering from a fungal infection and Nystatin does not seem like a suitable treatment for you, there are various natural remedies available that you can use to treat Candida. These include garlic, undecylenic acid, berberine, and caprylic acid.


Garlic can be used to treat topical candidiasis by crushing it into a paste and applying it over the site of infection.

Vaginal candidiasis can be treated by soaking a gauze in garlic and placing it on the area for up to 30 minutes. Any longer than this might cause unwanted effects such as allergic reactions, irritation, swelling, and redness. You should rinse the paste away immediately using running water when such reactions occur.

You can also benefit your condition by taking garlic supplements, but please consult your doctor before doing so as it may interact with other medications that you are taking.

Undecylenic acid

Undecylenic acid is an unsaturated fatty acid that is derived from castor oil, but it also can be found in human sweat! It is often the active ingredient in antifungal creams for athletes’ foot and ringworm.

It is active against both Candida and tinea species. You can use it to manage fungal infections of the skin, where it can benefit you by reducing itchiness, irritation, and burning that the Candida can cause. (9)

You can also take undecylenic acid internally in the form of a supplement. It usually comes in the form of calcium undecylenate.

Undecylenic acid prevents yeast from growing or morphing into the hyphal form, which is the form yeast takes during an active infection. It inhibits the lipid metabolism which is vital for the survival, growth, and development of the fungi or yeast.


Berberine, found in Oregon grapes and barberry, also has antifungal properties which boost your immune system and increase your ability to fight fungal infections. It can prevent the growth of fungal organisms and can be used together with fluconazole for increased antifungal activity.

The available forms include liquid extracts and capsules. The liquid extracts are diluted with water and taken 1-3 times per day. Note that excessive doses may lead to irritation of the liver.

Caprylic acid

Caprylic acid is extracted from coconut oil. It is beneficial in the treatment of fungal infections, high cholesterol, and against bacterial infections. It can also prevent the development of antibiotic resistance when used alongside other medications.

The mechanism of action lies in the destruction of yeasts and reducing the growth of fungi and Candida. It can be applied directly to the infected skin, or it can be taken orally.

Old fashioned soap and water

Poor hygiene enables Candida on the skin to grow and spread easily. Soapy water should be used to prevent the spread of fungal skin infections from one site to another.

Wash three times in a day and dry your skin thoroughly, as fungi prefer wet skin. Ensure that you use a gentle soap to avoid drying out the skin. If you apply a moisturizing agent such as coconut oil after washing the skin, this will further help the issue. Coconut oil contains caprylic acid and so has some antifungal properties too.

The benefits of natural treatments

With a natural approach to treating your Candida, you are less likely to experience side effects. Generally, these therapies are very effective against the various types of Candida overgrowth. Some natural treatments can be made at home, and they are relatively inexpensive.

Unlike synthetic pharmaceuticals, these natural alternatives do not have chemical preservatives. Some preservatives can lead to serious conditions and adverse events. It is essential to weigh up the benefits of any treatments versus the possible risks.

Natural remedies are low risk, and these alternatives could have a helpful role to play in the fight against fungal infections like Candida overgrowth.

Prevention of Candida overgrowth

Fungal infections are common, and prevention is better than cure, so you should avoid unnecessary use of antibiotics which lead to an imbalance of the gut microbiome and allow Candida to flourish.

Carefully consider your diet and consider using a probiotic to support your intestinal health, especially if you need to use antibiotics.

Nystatin is an effective treatment for Candidiasis, although it does come with side effects. If you’re concerned about these side effects, consider using a natural antifungal like caprylic acid or undecylenic acid. These are effective against Candida and generally have far fewer side effects.

Whichever antifungal treatment you choose, be sure to combine it with healthy lifestyle choices like regular exercise and a low-sugar, anti-Candida diet. These can increase the effectiveness of your antifungals and prevent the Candida infection from coming back.

Filed under: Antifungals
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