Nystatin Suspension
FDA Label NDC 81033-015

Full FDA labeling including Indications, Dosage, Usage, and Precautions

Structured Product Label

The following Structured Product Label (SPL) was submitted to the FDA by Kesin Pharma Corporation for the product Nystatin (NDC 81033-015). This document serves as the official prescribing information, containing essential scientific data and clinical materials required for healthcare providers and patients.

This specific version of the label includes detailed information regarding description, clinical pharmacology, indications and usage, contraindications, precautions, adverse reactions, overdosage, dosage and administration, and other regulatory disclosures. Use the navigation below to review specific sections of the FDA submission.

Description

Nystatin is an antimycotic polyene antibiotic obtained from Streptomyces noursei.
Structural formula:

Image Description (Nystatin Oral Suspension Structure)

Image Description (Nystatin Oral Suspension Structure)

Nystatin Oral Suspension, USP for oral administration, is cherry/mint flavored, containing 100,000 USP Nystatin Units per mL. Inactive ingredients: disodium edetate, sodium benzoate, sodium hexametaphosphate, dibasic sodium phosphate heptahydrate, monobasic sodium phosphate monohydrate, glycerin, methyl paraben, propyl paraben, sucrose, cherry flavor and peppermint oil.

Clinical Pharmacology

Pharmacokinetics
Gastrointestinal absorption of nystatin is insignificant. Most orally administered nystatin is passed unchanged in the stool. In patients with renal insufficiency receiving oral therapy with conventional dosage forms, significant plasma concentrations of nystatin may occasionally occur.
Microbiology
Nystatin is both fungistatic and fungicidal in vitro against a wide variety of yeasts and yeast-like fungi. Candida albicans demonstrates no significant resistance to nystatin in vitro on repeated subculture in increasing levels of nystatin; other Candida species become quite resistant. Generally, resistance does not develop in vivo. Nystatin acts by binding to sterols in the cell membrane of susceptible Candida species with a resultant change in membrane permeability allowing leakage of intracellular components. Nystatin exhibits no appreciable activity against bacteria, protozoa, or viruses.

Indications And Usage

Nystatin Oral Suspension is indicated for the treatment of candidiasis in the oral cavity.

Contraindications

The preparation is contraindicated in patients with a history of hypersensitivity to any of its components.

Precautions

General
This medication is not to be used for the treatment of systemic mycoses. Discontinue treatment if sensitization or irritation is reported during use.
Carcinogenesis, Mutagenesis, Impairment of Fertility
No long-term animal studies have been performed to evaluate carcinogenic potential. There also have been no studies to determine mutagenicity or whether this medication affects fertility in males or females.
Pregnancy
Teratogenic Effects Category C
Animal reproduction studies have not been conducted with nystatin oral suspension. It is also not known whether nystatin oral suspension can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Nystatin oral suspension should be given to a pregnant woman only if clearly needed.
Nursing Mothers
It is not known whether nystatin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when nystatin is administered to a nursing woman.
Pediatric Use
See DOSAGE AND ADMINISTRATION.

Adverse Reactions

Nystatin is well tolerated even with prolonged therapy. Oral irritation and sensitization have been reported. (See PRECAUTIONS: General).

Gastrointestinal: Diarrhea (including one case of bloody diarrhea), nausea, vomiting, gastrointestinal upset/disturbances.

Dermatologic: Rash, including urticaria has been reported rarely. Stevens-Johnson syndrome has been reported very rarely.

Other: Tachycardia, bronchospasm, facial swelling, and non-specific myalgia have also been rarely reported.

To report SUSPECTED ADVERSE REACTIONS, contact Kesin Pharma at 1-833-537-4679 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Overdosage

Oral doses of nystatin in excess of five million units daily have caused nausea and gastrointestinal upset. There have been no reports of serious toxic effects of superinfections (see CLINICAL PHARMACOLOGY, Pharmacokinetics).

Dosage And Administration

INFANTS: 2 mL (200,000 units) four times daily (in infants and young children, use dropper to place one-half of dose in each side of mouth and avoid feeding for 5 to 10 minutes).

NOTE: Limited clinical studies in premature and low birth weight infants indicate that 1 mL four times daily is effective.

CHILDREN AND ADULTS:4-6 mL (400,000 to 600,000 units) four times daily (one-half of dose in each side of mouth). The preparation should be retained in the mouth as long as possible before swallowing.

Continue treatment for at least 48 hours after perioral symptoms have disappeared and cultures demonstrate eradication of Candida albicans.

How Supplied

Nystatin Oral Suspension, USP 100,000 USP Nystatin Units per mL, is available as a cherry-mint flavored, yellow, ready-to-use suspension, supplied in the following oral dosage forms:

NDC 81033-015-05: 5 mL unit-dose cup
NDC 81033-015-01: Case containing 100 unit-dose cups of 5 mL each
NDC 81033-015-54: Carton containing 50 unit-dose cups of 5 mL each
Contains ≤ 1% v/v alcohol
Rx Only

Principal Display Panel

NDC: 81033-015-54

Nystatin Oral Suspension, USP

500,000 units per 5 mL

Delivers 5 mL

50 x 5 mL

Nystatin Carton Of 50 Label (Nystatinos Carton 5ml 50ct)

Nystatin Carton Of 50 Label (Nystatinos Carton 5ml 50ct)

NDC: 81033-015-01

Nystatin Oral Suspension, USP

500,000 units per 5 mL

Delivers 5 mL

Case = 100 UD Cups (Do Not Break Case)

Nystatin Case Of 100 Label (Nystatinos Case 5ml 100ct)

Nystatin Case Of 100 Label (Nystatinos Case 5ml 100ct)

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