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Paul A. Pham Pharm.D. and John G. Bartlett M.D.
07-30-2008
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Available formulation in Zambia: Lozenge: 100 000 IU. Pessary: 100 000 IU. Tablet: 100 000 IU; 500 000 IU.
- Oral candidiasis: one oral lozenge (troche) sucked q6h x 5 days.
- Dermatophytic infections (tinea): nystatin 100, 000 IU/g apply to affected area q8h. Continue for 14 days after lesion resolution.
Zambia Information Author: Paul A. Pham, Pharm. D.
- Oropharyngeal candidiasis
- Vulvovaginal candidiasis
- Cutaneous candidiasis
brand
name
| generic
| Mfg
| brand
forms
| cost*
|
| Nystatin | Nystatin | Generic manufacturers (Paddock, Teva and others) | oral
tablet
500,000U | $0.68 |
|
|
|
| vaginal
tablet
100,000U | $0.47 |
| Mycostatin | Nystatin | Generic manufacturers (Apothecon, Bristol-Myers Squibb, and others) | oral
suspension
100,000 U/mL ( 60mLor 480 mL) | $1.66 per 5 mL |
|
|
|
| topical
powder
100,000U/gram | $5.50 |
|
|
|
| topical
cream or ointment
100,000U/gram (15gm, 30gm) | $4.25 (15gm); $6.50 (30gm) |
*Prices represent cost per unit specified and are representative of "Average Wholesale Price" (AWP).
AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer's
information, and the McKesson database.
^Dosage is indicated in mg unless otherwise noted.
- Thrush: 500,000 to 1,000,000 Units (1-2 tabs or 5-10ml ) 3-5 x d.
- Vaginitis: 1 vaginal tablet (100,000 units) daily for 2 weeks
- Topical candidiases: Apply cream or ointment to affected areas twice-daily.
Usual dose
Usual dose
Usual dose; HD: usual dose
Usual dose
Usual dose
Usual dose
- Oral preparations: bad taste
- Oral preparations: GI distress:nausea, vomiting and diarrhea
- Topical preparations: skin irritation
None
Candida albicans and other Candida spp. at higher concentrations; no activity against dermatophytes.
Causes GI side effects and may not be as effective as clotrimazole since the bitter taste prevents pts from keeping it in their mouth for prolong periods of time. Poor adherence due to four times a day administration (suspension). Efficacy dependent on contact time with mucosa. Clotrimazole lozenges preferred by most pts. In contrast to topical clotrimazole, topical nystatin not effective for Tinea corporis.
- National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the HIV Medicine Association of the Infectious Diseases Society of America (HIVMA/IDSA) ;
Guidelines for Prevention and Treatment of Opportunistic Infections inHIV-Infected Adults and Adolescents ;
http://aidsinfo.nih.gov/ ;
2008 ; Vol.
Rating:
Basis for recommendation
Comments:Initial episodes of oropharyngeal candidiasis can be treated with topical therapy, such as clotrimazole troches or nystatin suspension.
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