Summary of Use during Lactation

Although no information exists on the milk excretion of nystatin, it is virtually unabsorbed orally, therefore most reviewers and clinicians consider it acceptable for use in nursing mothers, including topical application to the nipples.[1-3] Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[4] Any excess cream should be removed from the nipples before nursing. Nystatin is less effective than other topical agents for the treatment of thrush.[5,6]

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

(Systemic) Amphotericin B, Fluconazole; (Topical) Clotrimazole, Miconazole

References

1.

Mactal-Haaf C, Hoffman M, Kuchta A. Use of anti-infective agents during lactation, Part 3: Antivirals, antifungals, and urinary antiseptics. J Hum Lact. 2001;17:160–6. [PubMed: 11847833]

2.

Ilett KF, Kristensen JH. Drug use and breastfeeding. Expert Opin Drug Saf. 2005;4:745–68. [PubMed: 16011452]

3.

Brent NB. Thrush in the breastfeeding dyad: Results of a survey on diagnosis and treatment. Clin Pediatr (Phila). 2001;40:503–6. [PubMed: 11583049]

4.

Noti A, Grob K, Biedermann M, et al. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003;38:317–25. [PubMed: 14623482]

5.

Huggins KE, Billon SF. Twenty cases of persistent sore nipples: Collaboration between lactation consultant and dermatologist. J Hum Lact. 1993;9:155–60. [PubMed: 8260031]

6.

Hoppe JE, Hahn H. Randomized comparison of two nystatin oral gels with miconazole oral gel for treatment of oral thrush in infants. Antimycotics Study Group. Infection. 1996;24:136–9. [PubMed: 8740106]

Substance Name

Nystatin

CAS Registry Number

1400-61-9

Drug Class

Breast Feeding

Lactation

Antifungal Agents