Which antifungal drug is classified as a polyene on the basis of its chemical structure

Summary

Nystatin is a polyene ionophore antifungal used to treat cutaneous, mucocutaneous, and gastrointestinal mycotic infections, particularly those caused by Candida species.

Brand Names

Flagystatin, Nyaderm, Nyamyc, Nystop, Viaderm Kc

Generic NameNystatinDrugBank Accession NumberDB00646 Background

Nystatin is a polyene antifungal drug that has broad-spectrum fungicidal and fungistatic activity against a number of yeasts and fungi, most notably Candida species.8 It is one of the most effective antifungal agents synthesized by bacteria, in this case a strain of Streptomyces noursei,13 and is closely related to amphotericin B, differing only slightly in structure.2 Nystatin has a greater antifungal activity than amphotericin B - parenterally administered nystatin, however, is associated with significant toxicity and is not available in a formulation appropriate for systemic use.2 As it undergoes very little absorption following oral or topical administration, nystatin's efficacy is limited to the treatment/prevention of cutaneous, mucocutaneous, and gastrointestinal fungal infections.8,9

TypeSmall Molecule GroupsApproved, Vet approvedStructure

WeightAverage: 926.107
Monoisotopic: 925.503499959 Chemical FormulaC47H75NO17Synonyms

• Nistatina
• NYS
• Nystatin
• Nystatine
• Nystatinum

Indication

Nystatin is available in oral formulations for the treatment and/or prevention of oral candidiasis (a.k.a. thrush), intestinal candidiasis, and anal candidiasis.8,9 It is indicated topically for the treatment of vulvovaginal candidiasis and other cutaneous candida infections.9 A combination product containing nystatin alongside neomycin, gramicidin D, and triamcinolone (Viaderm K.C.®) is indicated in the treatment of corticosteroid-responsive dermatoses caused by bacterial or candidal infections and for pruritus ani/vulvae.10 It is also available in combination with metronidazole for the treatment of mixed infections due to Trichomonas vaginalis and Candida albicans.13

Nystatin is also sometimes used off-label for the prevention of invasive candidiasis in low birth weight neonates,4 though it is generally reserved as a second-line option after fluconazole.

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Associated Conditions

• Anal candidiasis
• Candidiasis, Invasive
• Intestinal Candidiasis
• Mixed Vaginal Infections caused by Trichomonas Vaginalis, candida albicans
• Oral Candidiasis
• Pruritus Ani
• Pruritus Vulvae
• Skin candida
• Trichomonas Vaginitis
• Vaginal Candidiasis
• Vulvovaginal Candidiasis
• Corticosteroid-responsive dermatoses
• Cutaneous candidiasis

Contraindications & Blackbox Warnings

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Pharmacodynamics

Nystatin is an antifungal that is both fungistatic and fungicidal in vitro against a wide variety of yeasts and yeast-like fungi. It exerts its antifungal effects via disruption of the fungal cell membrane. Resistance to nystatin is minimal in Candida albicans, but tends to develop in other species of Candida.8 Nystatin carries no significant activity against bacteria, protozoa, or viruses. It carries significant systemic toxicity and is currently unavailable in a formula appropriate for systemic use - its efficacy is currently restricted, therefore, to topical, oral, and gastrointestinal infections.2

Mechanism of action

Nystatin is a channel-forming ionophore, meaning it exerts its therapeutic effect via formation of a membrane-spanning pore in the fungal plasma membrane.5 The formation of this pore results in a change in membrane permeability that allows for leakage of intracellular contents and the subsequent disruption of electrochemical gradients necessary for proper cell function.8,2 Selectivity for fungal cells over mammalian cells is due to nystatin’s greater binding affinity for ergosterol, a key sterol found in fungal cell walls, as opposed to its mammalian counterpart, cholesterol.6

TargetActionsOrganism

AErgosterol	binder	Candida albicans

Absorption

Systemic absorption of nystatin is minimal following oral administration,8 and no detectable plasma concentrations are attained following topical or vaginal administration.12

Volume of distribution

Nystatin is not absorbed into the systemic circulation8 and thus does not undergo distribution.

Protein binding

Nystatin is not absorbed into the systemic circulation8 and is therefore not subject to plasma protein binding.

Metabolism

Because nystatin undergoes little-to-no systemic absorption it is not metabolized to any appreciable extent.8

Route of elimination

The majority of orally administered nystatin is eliminated unchanged in the feces.8

Half-life

Not Available

Clearance

Not Available

Adverse Effects

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Toxicity

The oral LD50 in rats is 10 g/kg.11 There have been no reports of serious toxic effects following overdosage of nystatin - doses in excess of five million units daily have resulted in nausea and gastrointestinal upset with no other associated effects.8

PathwaysNot AvailablePharmacogenomic Effects/ADRs Not AvailableDrug Interactions

This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.

• Approved
• Vet approved
• Nutraceutical
• Illicit
• Withdrawn
• Investigational
• Experimental
• All Drugs

DrugInteraction

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interactions in your software

Ambrisentan	The excretion of Ambrisentan can be decreased when combined with Nystatin.
Asunaprevir	The excretion of Asunaprevir can be decreased when combined with Nystatin.
Atogepant	The serum concentration of Atogepant can be increased when it is combined with Nystatin.
Atorvastatin	The excretion of Atorvastatin can be decreased when combined with Nystatin.
Axitinib	The excretion of Axitinib can be decreased when combined with Nystatin.
Belantamab mafodotin	The excretion of Belantamab mafodotin can be decreased when combined with Nystatin.
Bempedoic acid	The excretion of Bempedoic acid can be decreased when combined with Nystatin.
Benzylpenicillin	The excretion of Benzylpenicillin can be decreased when combined with Nystatin.
Bosentan	The excretion of Bosentan can be decreased when combined with Nystatin.
Brincidofovir	The serum concentration of Brincidofovir can be increased when it is combined with Nystatin.

Food InteractionsNo interactions found.

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Product Ingredients IngredientUNIICASInChI Key

Nystatin dihydrate	Not Available	Not Available	VXWFKTGGEJLHPP-WFCLXGQZSA-N

Product ImagesInternational/Other BrandsAdiclair (Ardeypharm) / Afunginal (Euro Generics) / Biofanal (Pfleger) / Candacide (Be-Tabs Pharmaceuticals) / Candermil (LKM) / Candex (Square) / Candidias (Fabra) / Candistat (Ambalal Sarabhai Enterprises) / Candistin (Pharos) / Canstat (Aspen Pharmacare) / Cazetin (Ifars) / Diaper NZ (Cheminter) / Dipni (Omega) / Enystin (Kalbe) / Fukangning (Deyer) / Fungatin (Ferron) / Fungicidin Leciva (Zentiva) / Fungistin (Beximco) / Fungostatin (Nobel) / Funistatin (Nobel) / Gynostatin (Iqfarma) / Kandistatin (Metiska) / Kenalon (Ta Fong) / Lederlind (Riemser) / Ledernyst (Riemser) / Lystin (Biolab) / Nilstat (Glenmark) / Nyaderm (Taro) / Nystan (Bristol Myers Squibb)Brand Name Prescription Products NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage

Mestatin	Cream	25000 unit / g	Vaginal	Medic Laboratory LtÉe	1980-12-31	1996-09-09
Mycostatin Oral Suspension 100000iu	Liquid	100000 unit / mL	Oral	Squibb Canada Inc., Division Of Bristol Myers Squibb Canada Inc.	1972-12-31	2003-07-28
Mycostatin Oral Tab 500000iu	Tablet	500000 unit	Oral	Squibb Canada Inc., Division Of Bristol Myers Squibb Canada Inc.	1955-12-31	2002-07-30
Mycostatin Vaginal Crm 25000unit	Cream	25000 unit / g	Vaginal	Squibb Canada Inc., Division Of Bristol Myers Squibb Canada Inc.	1973-12-31	2005-08-01
Nadostine Sus 100000iu/ml	Suspension	100000 unit / mL	Oral	Lab Nadeau LtÉe, Division Of Technilab Inc.	1974-12-31	2004-08-03
Nadostine Tab 100000unit	Tablet	100000 unit	Vaginal	Lab Nadeau LtÉe, Division Of Technilab Inc.	1973-12-31	2004-08-03
Nadostine Tab 500000unit	Tablet	500000 unit / tab	Oral	Lab Nadeau LtÉe, Division Of Technilab Inc.	1973-12-31	1999-09-28
Nilstat 25000units/g	Cream	25000 unit / g	Vaginal	Technilab Pharma Inc.	1974-12-31	2004-08-03
Nilstat Oral Dps 100000iu/ml	Solution / drops	100000 unit / mL	Oral	Lederle Cyanamid Canada Inc.	1970-12-31	1997-01-29
Nilstat Orl Tab 500000unit	Tablet	500000 unit / tab	Oral	Lederle Cyanamid Canada Inc.	1970-12-31	1997-01-29

Generic Prescription Products NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage

Dom-nystatin Suspension	Suspension	100000 unit / mL	Oral	Dominion Pharmacal	1998-08-05	Not applicable
Ftp-nystatin	Solution / drops	100000 unit / mL	Oral	Ftp Pharmacal Inc.	1998-10-09	2004-08-03
Jamp-nystatin Oral Suspension USP	Suspension	100000 unit / mL	Oral	Jamp Pharma Corporation	2015-01-09	Not applicable
Mycostatin	Powder	100000 [USP'U]/1g	Topical	E.R. Squibb & Sons, L.L.C.	2009-06-01	2010-03-31
Mycostatin	Cream	100000 [USP'U]/1g	Topical	E.R. Squibb & Sons, L.L.C.	2007-01-01	2007-06-30
Nyamyc	Powder	100000 [USP'U]/1g	Topical	Upsher-Smith Laboratories, LLC	2005-05-03	Not applicable
Nyata	Kit	100000 U/1g	Topical	Crown Laboratories	2015-12-17	2016-10-03
Nyata Nystatin Powder	Kit	100000 U/1g	Topical	Crown Laboratories	2016-12-08	2017-01-02
Nystatin	Tablet, film coated	500000 [USP'U]/1	Oral	Aidarex Pharmaceuticals LLC	1988-12-22	Not applicable
Nystatin	Suspension	100000 [USP'U]/1mL	Oral	Lohxa	2019-01-03	Not applicable

Over the Counter Products NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage

Candistatin Topical Powder - 100000 Unit/g	Powder	100000 unit / g	Topical	Bristol Myers Squibb	1996-12-31	2008-04-25
Mycostatin Crm 100000unit/gm	Cream	100000 unit / g	Topical	Squibb Canada Inc., Division Of Bristol Myers Squibb Canada Inc.	1970-12-31	2006-09-06
Mycostatin Ont 100000iu/gm	Ointment	100000 unit / g	Topical	Squibb Canada Inc., Division Of Bristol Myers Squibb Canada Inc.	1955-12-31	2002-07-30
Mycostatin Topical Pwr 100,000units/gm	Powder	100000 unit / g	Topical	Convatec, Division Of Bristol Myers Squibb Canada Co.	1994-12-31	2008-11-12
Nadostine Crm 100000iu/gm	Cream	100000 unit / g	Topical	Lab Nadeau LtÉe, Division Of Technilab Inc.	1974-12-31	2004-08-03
Nadostine Ont 100000iu/gm	Ointment	100000 unit / g	Topical	Lab Nadeau LtÉe, Division Of Technilab Inc.	1974-12-31	2004-08-03
Nilstat Top Crm 100000unit/gm	Cream	100000 unit / g	Topical	Lederle Cyanamid Canada Inc.	1979-12-31	1997-01-29
Nilstat Top Ont 100000unit/gm	Ointment	100000 unit / g	Topical	Lederle Cyanamid Canada Inc.	1979-12-31	1997-01-29
Nyaderm	Cream	100000 unit / g	Topical	Taro Pharmaceuticals, Inc.	1979-12-31	Not applicable
Nyaderm Ont 100000unit/gm	Ointment	100000 unit / g	Topical	Taro Pharmaceuticals, Inc.	1979-12-31	2022-02-04

Mixture Products NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage

APOLIND WUNDBAL M NYSTATIN	Nystatin (70000 IU/g) + Zinc oxide (492 mg/g)	Suspension	Oral		2006-07-01	Not applicable
APOLIND WUNDBAL M NYSTATIN	Nystatin (70000 IU/g) + Zinc oxide (492 mg/g)	Suspension	Oral		2006-07-01	Not applicable
BABYLIND MEDICADA® CREMA TÓPICA.	Nystatin (100 %) + Zinc oxide (20 g)	Cream	Topical	LABORATORIOS DEMAC LTDA.	2020-12-16	Not applicable
BABYSKIN® N CREMA	Nystatin (2.2727 g) + Zinc oxide (40 g)	Cream	Topical	ALTEA FARMACEUTICA S.A.	2009-06-24	Not applicable
DECADRON®OVULOS	Nystatin (100000 IU) + Dexamethasone acetate (0.25 mg)	Insert	Vaginal	TECNOFAR TQ S.A.S	2007-01-29	Not applicable
DEMTRIS® CREMA	Nystatin (10 million IU) + Neomycin (250 mg) + Triamcinolone acetonide (100 mg)	Cream	Topical	FAES FARMA COLOMBIA S.A.	2016-10-04	Not applicable
DEMTRIS® UNGUENTO	Nystatin (100000 IU) + Neomycin (2.5 mg) + Triamcinolone acetonide (1 mg)	Ointment	Topical	FAES FARMA COLOMBIA S.A.S.	2016-10-04	Not applicable
Flagystatin	Nystatin (100000 unit / sup) + Metronidazole (500 mg / sup)	Suppository	Vaginal	Aventis Pharma Ltd.	1972-12-31	2004-07-30
Flagystatin	Nystatin (100000 unit) + Metronidazole (500 mg)	Insert	Vaginal	Sanofi Aventis	1979-12-31	Not applicable
Flagystatin	Nystatin (100000 unit / 4.5 g) + Metronidazole (500 mg / 4.5 g)	Cream	Vaginal	Sanofi Aventis	1976-12-31	2017-08-24

Unapproved/Other Products NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage

FIRST BXN Mouthwash	Nystatin (6.75 mg/1mL) + Diphenhydramine hydrochloride (0.84 mg/1mL) + Lidocaine hydrochloride (6.75 mg/1mL)	Kit	Oral	CutisPharma, Inc	2009-09-08	Not applicable
FIRST Dukes Mouthwash Compounding	Nystatin (0.6 g/0.6g) + Diphenhydramine hydrochloride (0.525 g/0.525g) + Hydrocortisone (0.06 g/0.06g)	Kit	Oral	CutisPharma, Inc.	2010-12-15	Not applicable
FIRST Marys Mouthwash Compounding	Nystatin (1.2 g/1.2g) + Diphenhydramine hydrochloride (0.45 g/0.45g) + Hydrocortisone (0.06 g/0.06g) + Tetracycline hydrochloride (1.5 g/1.5g)	Kit	Oral	CutisPharma, Inc.	2010-12-15	Not applicable
MIKOSTATIN 100.000 I.U./ML ORAL SÜSPANSİYON 48 ML	Nystatin (100000 i.u./ml)		Oral	Deva Holding A.S.	2020-08-14	Not applicable

ATC CodesD01AA01 — Nystatin

• D01AA — Antibiotics
• D01A — ANTIFUNGALS FOR TOPICAL USE
• D01 — ANTIFUNGALS FOR DERMATOLOGICAL USE
• D — DERMATOLOGICALS

G01AA01 — Nystatin

• G01AA — Antibiotics
• G01A — ANTIINFECTIVES AND ANTISEPTICS, EXCL. COMBINATIONS WITH CORTICOSTEROIDS
• G01 — GYNECOLOGICAL ANTIINFECTIVES AND ANTISEPTICS
• G — GENITO URINARY SYSTEM AND SEX HORMONES

A07AA02 — Nystatin

• A07AA — Antibiotics
• A07A — INTESTINAL ANTIINFECTIVES
• A07 — ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS
• A — ALIMENTARY TRACT AND METABOLISM

G01AA51 — Nystatin, combinations

• G01AA — Antibiotics
• G01A — ANTIINFECTIVES AND ANTISEPTICS, EXCL. COMBINATIONS WITH CORTICOSTEROIDS
• G01 — GYNECOLOGICAL ANTIINFECTIVES AND ANTISEPTICS
• G — GENITO URINARY SYSTEM AND SEX HORMONES

Drug Categories

• Alimentary Tract and Metabolism
• Anti-Infective Agents
• Antidiarrheals, Intestinal Antiinflammatory/antiinfective Agents
• Antifungal Agents
• Antifungal Agents (Vaginal)
• Antifungals for Dermatological Use
• Antifungals for Topical Use
• Compounds used in a research, industrial, or household setting
• Dermatologicals
• Genito Urinary System and Sex Hormones
• Gynecological Antiinfectives and Antiseptics
• Intestinal Antiinfectives
• Ionophores
• Lactones
• Membrane Transport Modulators
• OATP1B1/SLCO1B1 Inhibitors
• OATP1B3 inhibitors
• Polyene Antifungal
• Polyenes
• Polyketides

ClassificationNot classifiedAffected organisms

• Fungi

UNIIW1LX4T91WICAS number1400-61-9InChI KeyVQOXZBDYSJBXMA-NQTDYLQESA-NInChI

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

IUPAC Name

(1S,3R,4R,7R,9R,11R,15S,16R,17R,18S,19E,21E,25E,27E,29E,31E,33R,35S,36R,37S)-33-{[(2R,3S,4S,5S,6R)-4-amino-3,5-dihydroxy-6-methyloxan-2-yl]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

SMILES

[H][C@]12C[C@@H](O[C@@H]3O[C@H](C)[C@@H](O)[C@H](N)[C@@H]3O)\C=C\C=C\C=C\C=C\CC\C=C\C=C\[C@H](C)[C@@H](O)[C@@H](C)[C@H](C)OC(=O)C[C@H](O)C[C@H](O)C[C@H](O)CC[C@@H](O)[C@H](O)C[C@](O)(C[C@H](O)[C@H]1C(O)=O)O2

General References

1. Akaike N, Harata N: Nystatin perforated patch recording and its applications to analyses of intracellular mechanisms. Jpn J Physiol. 1994;44(5):433-73. [Article]
2. Dos Santos AG, Marques JT, Carreira AC, Castro IR, Viana AS, Mingeot-Leclercq MP, de Almeida RFM, Silva LC: The molecular mechanism of Nystatin action is dependent on the membrane biophysical properties and lipid composition. Phys Chem Chem Phys. 2017 Nov 15;19(44):30078-30088. doi: 10.1039/c7cp05353c. [Article]
3. Karlgren M, Vildhede A, Norinder U, Wisniewski JR, Kimoto E, Lai Y, Haglund U, Artursson P: Classification of inhibitors of hepatic organic anion transporting polypeptides (OATPs): influence of protein expression on drug-drug interactions. J Med Chem. 2012 May 24;55(10):4740-63. doi: 10.1021/jm300212s. Epub 2012 May 15. [Article]
4. Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, Reboli AC, Schuster MG, Vazquez JA, Walsh TJ, Zaoutis TE, Sobel JD: Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016 Feb 15;62(4):e1-50. doi: 10.1093/cid/civ933. Epub 2015 Dec 16. [Article]
5. Yamasaki M, Tamura N, Nakamura K, Sasaki N, Murakami M, Rajapakshage W, Kumara B, Tamura Y, Lim SY, Ohta H, Takiguchi M: Effects and mechanisms of action of polyene macrolide antibiotic nystatin on Babesia gibsoni in vitro. J Parasitol. 2011 Dec;97(6):1190-2. doi: 10.1645/GE-2799.1. Epub 2011 Jul 14. [Article]
6. Silva L, Coutinho A, Fedorov A, Prieto M: Competitive binding of cholesterol and ergosterol to the polyene antibiotic nystatin. A fluorescence study. Biophys J. 2006 May 15;90(10):3625-31. Epub 2006 Feb 24. [Article]
7. Liu W, Guan X, Yu Z, Chen K, Benet L, Zhai S: A Drug-drug Interaction Between Cyclosporine and Nystatin. Clin Ther. 2018 Apr;40(4):660-662. doi: 10.1016/j.clinthera.2018.02.008. Epub 2018 Mar 16. [Article]
8. FDA Approved Drug Products: Nystatin oral suspension [Link]
9. DPD Approved Drugs: Nystatin [Link]
10. DPD Approved Drugs: Viaderm K.C.® [Link]
11. ThermoFisher Scientific: Nystatin MSDS [Link]
12. MedSafe NZ: Nystatin [Link]
13. DPD Approved Drugs: Flagystatin® vaginal ovules [Link]

External LinksHuman Metabolome DatabaseHMDB0014784KEGG DrugD00202KEGG CompoundC12155PubChem Compound11953884PubChem Substance46504780ChemSpider23078586RxNav7597ChEBI473992ChEMBLCHEMBL450895ZINCZINC000253387941Therapeutic Targets DatabaseDAP000879PharmGKBPA450666RxListRxList Drug PageDrugs.comDrugs.com Drug PagePDRhealthPDRhealth Drug PageWikipediaNystatinFDA labelMSDSClinical Trials PhaseStatusPurposeConditionsCount

4	Completed	Health Services Research	Renal Failure, Chronic Renal Failure	1
4	Completed	Prevention	Candidiasis / Critically Ill Patients / Fungal Prophylaxis / Surgery	1
4	Completed	Prevention	Systemic Fungal Infections	1
4	Completed	Prevention	Very Low Birthweight Infants	1
4	Completed	Treatment	Photochemotherapy Reaction	1
4	Completed	Treatment	Vaginal Inflammation	1
4	Unknown Status	Prevention	Anticandidal Property of Saccharomyces Boulardii on Very Low Birth Weight Infants	1
4	Unknown Status	Prevention	Oral Mucositis	1
3	Active Not Recruiting	Treatment	Candida albicans infection / Smoking, Cigarette	1
3	Completed	Supportive Care	Chronic Myeloproliferative Disorders / Infection / Leukemias / Malignant Lymphomas / Multiple Myeloma and Plasma Cell Neoplasm / Myelodysplastic Syndromes (MDS)	1

Manufacturers

• Bayer pharmaceuticals corp
• Bristol myers squibb co
• Alpharma us pharmaceuticals division
• Lederle laboratories div american cyanamid co
• Actavis mid atlantic llc
• Altana inc
• Perrigo new york inc
• Taro pharmaceuticals usa inc
• Teva pharmaceuticals usa inc
• Vintage pharmaceuticals llc
• Westwood squibb pharmaceuticals inc
• Bristol myers squibb
• Barlan pharmacal co inc
• Dava pharmaceuticals inc
• Paddock laboratories inc
• Coastal pharmaceuticals inc
• Kv pharmaceutical co
• Par pharmaceutical inc
• Upsher smith laboratories inc
• X gen pharmaceuticals inc
• Warner chilcott co llc
• Apothecon inc div bristol myers squibb
• Glenmark generics inc usa
• Bausch and lomb pharmaceuticals inc
• E fougera div altana inc
• Morton grove pharmaceuticals inc
• Pharmaderm div altana inc
• Pharmafair inc
• Roxane laboratories inc
• Vintage pharmaceuticals inc
• Vistapharm inc
• Wockhardt eu operations (swiss) ag
• Savage laboratories inc div altana inc
• Mutual pharmaceutical co inc
• Quantum pharmics ltd
• Sandoz inc
• Usl pharma inc
• Watson laboratories inc
• Holland rantos co inc
• Odyssey pharmaceuticals inc

Packagers

• Actavis Group
• Advanced Pharmaceutical Services Inc.
• Aidarex Pharmacuticals LLC
• Apothecon
• A-S Medication Solutions LLC
• Atlantic Biologicals Corporation
• Bausch & Lomb Inc.
• Bryant Ranch Prepack
• Cardinal Health
• Contract Pharm
• Cutis Pharma Inc.
• Dept Health Central Pharmacy
• Dispensing Solutions
• Diversified Healthcare Services Inc.
• Duramed
• E. Fougera and Co.
• E.R. Squibb and Sons LLC
• Gallipot
• Glenmark Generics Ltd.
• Major Pharmaceuticals
• Medisca Inc.
• Metrics Inc.
• Midlothian Labs
• Murfreesboro Pharmaceutical Nursing Supply
• Mutual Pharmaceutical Co.
• Novopharm Ltd.
• Nycomed Inc.
• Odyssey Pharmaceuticals Inc.
• Paddock Labs
• Palmetto Pharmaceuticals Inc.
• Par Pharmaceuticals
• PD-Rx Pharmaceuticals Inc.
• PEDiNOL
• Perrigo Co.
• Pharmaceutical Association
• Pharmaceutics International Inc.
• Pharmedix
• Physicians Total Care Inc.
• Pliva Inc.
• Precision Dose Inc.
• Preferred Pharmaceuticals Inc.
• Qualitest
• Rebel Distributors Corp.
• Sandoz
• Savage Labs
• Stat Scripts LLC
• Taro Pharmaceuticals USA
• Teva Pharmaceutical Industries Ltd.
• USL Pharma Inc.
• Vintage Pharmaceuticals Inc.
• Vistapharm Inc.
• Wockhardt Ltd.
• Xactdose Inc.
• X-Gen Pharmaceuticals

Dosage Forms FormRouteStrength

Cream	Topical	100000 IU/g
Ointment	Topical	100000 IU/g
Suspension	Oral	100000 IU/g
Tablet, film coated	Oral	500000 IU
Gel	Topical	100000 IU/g
Suspension	Oral
Tablet, sugar coated	Oral	500000 IU/1
Kit	Topical	25 G
Paste	Topical
Cream	Topical	100000 USP
Ointment	Topical	100000 USP
Suspension	Oral	100000 USP
Gel	Topical	250000 USP
Paste	Topical	100000 USP
Cream	Topical
Solution / drops; suspension / drops		100 IU/ML
Cream	Topical	250 mg
Ointment	Topical	2.5 mg
Suspension	Oral	100000 IU/ML
Kit	Oral
Suppository	Vaginal	500 mg
Solution / drops	Oral	100000 unit / mL
Powder, for suspension	Oral
Suspension	Oral	1710.623 mg
Capsule	Vaginal
Suspension	Oral	100 IU/L
Paste	Topical	100000 IU/g
Cream	Vaginal
Insert	Vaginal
Insert	Vaginal	500 mg
Paste	Topical
Cream	Vaginal	100000 IU/g
Pill		500000 U
Powder	Topical	100000 [USP'U]/1g
Suspension	Oral	100000 UI/ML
Tablet, film coated	Oral
Suspension	Oral
Ointment	Topical
Liquid	Oral	100000 unit / mL
Powder	Topical	100000 unit / g
Suspension	Oral	100000 unit / mL
Tablet	Vaginal	100000 unit
Tablet	Oral	500000 unit / tab
Cream	Vaginal	100000 unit / g
Tablet	Vaginal	100000 unit / tab
Suspension	Oral	100000 IU
Suspension	Oral	0 IU
Tablet, coated	Oral
Insert	Vaginal	100 IU
Tablet	Vaginal	100 IU
Suspension	Oral	10000000 IU
Suspension	Oral	2000 mg
Suspension	Oral	1.94 g
Cream	Topical	10 millions
Insert	Vaginal	100000 IU
Tablet, coated	Oral	500000 IU
Suspension	Oral	100 IU/ML
Cream	Vaginal	25000 unit / g
Suppository	Vaginal
Kit	Topical	100000 U/1g
Cream	Oral; Topical	100000 [USP'U]/1g
Cream	Topical	100000 U/1g
Cream	Topical	100000 [USP'U]/1g
Cream	Topical	100000 mg/1g
Cream	Topical	100000 1/1g
Insert	Vaginal	100000 [USP'U]/1
Ointment	Topical	100000 [USP'U]/1g
Ointment	Topical	100000 U/1g
Ointment	Topical	100000 1/1g
Powder	Topical	100000 1/1g
Powder	Topical	100000
Powder, for suspension	Oral	5000
Solution / drops; suspension / drops
Suspension	Oral	100000 [iU]/1mL
Suspension	Oral	100000 [USP'U]/1mL
Suspension	Oral	100000
Suspension	Oral	100000 [USP'U]/15mL
Suspension	Oral	500000 [USP'U]/5mL
Tablet	Vaginal
Tablet, coated	Oral	500000 [USP'U]/1
Tablet, film coated	Oral	500000 [USP'U]/1
Tablet, sugar coated	Oral
Powder	Oral
Cream	Topical
Ointment	Topical
Solution	Oral	100000 [USP'U]/1mL
Tablet, sugar coated	Oral	500000 IU
Tablet	Oral
Powder	Topical	100000 U/1g
Tablet	Vaginal	100000 units
Ointment	Auricular (otic)
Kit	Topical	100000 [USP'U]/1g
Suspension	Oral	500000 u/5ml
Capsule	Vaginal	35000 iu
Cream	Topical	100000 unit / g
Ointment	Topical	100000 unit / g
Tablet	Oral	500000 unit
Cream	Topical	2.059 g
Suppository	Vaginal
Capsule	Oral
Suspension	Oral	100000 UNITS/1ML
Tablet, sugar coated	Oral	500000 UNITS
Tablet	Vaginal	100000 iu
Tablet	Vaginal

Prices Unit descriptionCostUnit

Nystatin 10 billion unit powder	3014.1USD	each
Nystatin 5 billion unit powder	2096.1USD	each
Nystatin 2 billion unit powder	1116.9USD	each
Nystatin 1 billion unit powder	452.08USD	each
Nystat-rx 5 billion unit powder	447.0USD	each
Nystatin 500 million unit powder	130.75USD	each
Pedi-Dri 100000 unit/gm Powder 56.7 gm Bottle	105.87USD	bottle
Nystatin 150mu Bottle	94.5USD	bottle
Nystatin 150 million unit powder	42.25USD	each
Nystatin 150000000 unit powder	42.0USD	each
Nystatin Nystatin Powder 50 Million unit Bottle	39.99USD	bottle
Mycostatin 100000 unit/gm Powder 15 gm Bottle	36.99USD	bottle
Nystop 100000 unit/gm Powder 15 gm Bottle	29.99USD	bottle
Nystatin 50 million unit powder	19.75USD	each
Nystatin 100000 unit/gm Ointment 15 gm Tube	12.99USD	tube
Nystatin 100000 unit/gm Cream 15 gm Tube	6.5USD	tube
Nystatin 100000 unit tablet	5.29USD	tablet
Nystatin vaginal tablet	5.0USD	tablet
Pedi-dri topical powder	1.82USD	g
Nystop 100000 unit/gm powder	1.6USD	g
Nystatin 500000 unit tablet	0.71USD	tablet
Nystatin 500000 unit oral tablet	0.68USD	tablet
Mycostatin 500000 unit orl tablet	0.48USD	tablet
Nystatin 100000 unit/ml Suspension	0.25USD	ml
Ratio-Nystatin 500000 unit Tablet	0.25USD	tablet
Nystatin 100000 unit/gm cream	0.1USD	g
Pms-Nystatin 100000 unit/ml Suspension	0.05USD	ml
Ratio-Nystatin 100000 unit/ml Suspension	0.05USD	ml

DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.

PatentsNot AvailableStateSolidExperimental Properties PropertyValueSource

melting point (°C)	160 °C (decomposes)	MSDS
water solubility	360 mg/L (at 24 °C)	YALKOWSKY,SH & DANNENFELSER,RM (1992)
logP	0.5	Not Available

Predicted Properties PropertyValueSource

Water Solubility	0.086 mg/mL	ALOGPS
logP	-3.1	ALOGPS
logP	-1.9	ChemAxon
logS	-4	ALOGPS
pKa (Strongest Acidic)	3.61	ChemAxon
pKa (Strongest Basic)	9.11	ChemAxon
Physiological Charge	0	ChemAxon
Hydrogen Acceptor Count	17	ChemAxon
Hydrogen Donor Count	12	ChemAxon
Polar Surface Area	319.61 Å2	ChemAxon
Rotatable Bond Count	3	ChemAxon
Refractivity	243.55 m3·mol-1	ChemAxon
Polarizability	100.62 Å3	ChemAxon
Number of Rings	3	ChemAxon
Bioavailability	0	ChemAxon
Rule of Five	No	ChemAxon
Ghose Filter	No	ChemAxon
Veber's Rule	No	ChemAxon
MDDR-like Rule	No	ChemAxon

Predicted ADMET Features PropertyValueProbability

Human Intestinal Absorption	-	0.8641
Blood Brain Barrier	-	0.9581
Caco-2 permeable	-	0.741
P-glycoprotein substrate	Substrate	0.5182
P-glycoprotein inhibitor I	Non-inhibitor	0.814
P-glycoprotein inhibitor II	Non-inhibitor	0.6721
Renal organic cation transporter	Non-inhibitor	0.96
CYP450 2C9 substrate	Non-substrate	0.8313
CYP450 2D6 substrate	Non-substrate	0.867
CYP450 3A4 substrate	Non-substrate	0.5273
CYP450 1A2 substrate	Non-inhibitor	0.916
CYP450 2C9 inhibitor	Non-inhibitor	0.9374
CYP450 2D6 inhibitor	Non-inhibitor	0.9354
CYP450 2C19 inhibitor	Non-inhibitor	0.9243
CYP450 3A4 inhibitor	Non-inhibitor	0.931
CYP450 inhibitory promiscuity	Low CYP Inhibitory Promiscuity	0.987
Ames test	Non AMES toxic	0.8992
Carcinogenicity	Non-carcinogens	0.9731
Biodegradation	Not ready biodegradable	0.8601
Rat acute toxicity	2.1245 LD50, mol/kg	Not applicable
hERG inhibition (predictor I)	Weak inhibitor	0.9462
hERG inhibition (predictor II)	Non-inhibitor	0.8971

ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Mass Spec (NIST)Not AvailableSpectraNot Available

Targets

Transporters

KindProteinOrganismHumansPharmacological action

Unknown

Actions

Inhibitor

General FunctionSodium-independent organic anion transmembrane transporter activitySpecific Function Mediates the Na(+)-independent uptake of organic anions such as pravastatin, taurocholate, methotrexate, dehydroepiandrosterone sulfate, 17-beta-glucuronosyl estradiol, estrone sulfate, prostagland...Gene NameSLCO1B1Uniprot IDQ9Y6L6Uniprot NameSolute carrier organic anion transporter family member 1B1Molecular Weight76447.99 Da

References

1. Karlgren M, Vildhede A, Norinder U, Wisniewski JR, Kimoto E, Lai Y, Haglund U, Artursson P: Classification of inhibitors of hepatic organic anion transporting polypeptides (OATPs): influence of protein expression on drug-drug interactions. J Med Chem. 2012 May 24;55(10):4740-63. doi: 10.1021/jm300212s. Epub 2012 May 15. [Article]

KindProteinOrganismHumansPharmacological action

Unknown

Actions

Inhibitor

General FunctionSodium-independent organic anion transmembrane transporter activity Specific FunctionMediates the Na(+)-independent uptake of organic anions such as 17-beta-glucuronosyl estradiol, taurocholate, triiodothyronine (T3), leukotriene C4, dehydroepiandrosterone sulfate (DHEAS), methotre...Gene NameSLCO1B3Uniprot IDQ9NPD5Uniprot NameSolute carrier organic anion transporter family member 1B3Molecular Weight77402.175 Da

References

1. Karlgren M, Vildhede A, Norinder U, Wisniewski JR, Kimoto E, Lai Y, Haglund U, Artursson P: Classification of inhibitors of hepatic organic anion transporting polypeptides (OATPs): influence of protein expression on drug-drug interactions. J Med Chem. 2012 May 24;55(10):4740-63. doi: 10.1021/jm300212s. Epub 2012 May 15. [Article]

Drug created at June 13, 2005 13:24 / Updated at October 21, 2022 22:07