Comparative Pharmacology
Head-to-head clinical analysis: AMPHOTERICIN B versus NYSTATIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AMPHOTERICIN B versus NYSTATIN.
AMPHOTERICIN B vs NYSTATIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Binds to ergosterol in fungal cell membranes, forming pores that increase permeability and cause leakage of intracellular contents, leading to cell death.
Nystatin binds to sterols in the fungal cell membrane, primarily ergosterol, altering membrane permeability and causing leakage of intracellular components, leading to fungal cell death.
0.5-1.5 mg/kg/day IV over 2-6 hours; for invasive aspergillosis, 1 mg/kg/day; for cryptococcal meningitis, 0.7 mg/kg/day IV in combination with flucytosine; liposomal formulation: 3-5 mg/kg/day IV. Maximum dose: 1.5 mg/kg/day for conventional amphotericin B deoxycholate.
Oral: 500,000 to 1,000,000 units (5-10 mL suspension) swish and swallow 3-4 times daily; Vaginal: 1 vaginal tablet (100,000 units) once or twice daily; Topical: Apply cream/ointment 2-3 times daily; duration depends on indication.
MODERATE Risk
MODERATE Risk
Clinical Note
moderateAmphotericin B + Digoxin
"The risk or severity of adverse effects can be increased when Amphotericin B is combined with Digoxin."
Clinical Note
moderateAmphotericin B + Digitoxin
"The risk or severity of adverse effects can be increased when Amphotericin B is combined with Digitoxin."
Clinical Note
moderateAmphotericin B + Deslanoside
"The risk or severity of adverse effects can be increased when Amphotericin B is combined with Deslanoside."
Clinical Note
moderateTerminal half-life: 24–48 hours initially, prolonged to 15 days with repeated dosing due to tissue redistribution.
Due to minimal systemic absorption, a terminal elimination half-life is not clinically relevant. In vitro plasma degradation half-life is approximately 1.5 hours, but this is not applicable in vivo.
Renal: ~2-5% unchanged; biliary/fecal: ~40% as metabolites; extensive tissue binding delays excretion.
Nystatin is not absorbed from the gastrointestinal tract after oral administration; virtually 100% of the ingested dose is excreted unchanged in the feces. After topical application, systemic absorption is negligible; any absorbed drug is excreted via bile and feces (<1% renal).
Category C
Category A/B
Antifungal
Antifungal
Amphotericin B + Acetyldigitoxin
"The risk or severity of adverse effects can be increased when Amphotericin B is combined with Acetyldigitoxin."