Comparative Pharmacology
Head-to-head clinical analysis: MYCOSTATIN versus VFEND.
Peer-Reviewed Evidence
Head-to-head clinical analysis: MYCOSTATIN versus VFEND.
MYCOSTATIN vs VFEND
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Mycostatin (nystatin) is a polyene antifungal antibiotic that binds to ergosterol in the fungal cell membrane, forming pores that increase membrane permeability, leading to leakage of intracellular contents and cell death.
Inhibits fungal cytochrome P450 14α-demethylase (CYP51), blocking ergosterol synthesis and disrupting fungal cell membrane integrity.
Nystatin suspension: 400,000-600,000 units (4-6 mL) orally four times daily for 7-14 days. Nystatin pastilles: 200,000-400,000 units (1-2 pastilles) orally four to five times daily for 7-14 days.
IV: Loading dose of 6 mg/kg every 12 hours for 2 doses, then 4 mg/kg every 12 hours. Oral: Weight ≥40 kg: Loading dose of 400 mg every 12 hours for 2 doses, then 200 mg every 12 hours; weight <40 kg: Loading dose of 200 mg every 12 hours for 2 doses, then 100 mg every 12 hours.
None Documented
None Documented
Not applicable (nystatin is not absorbed systemically; no meaningful plasma half-life exists). For reference, if absorbed, the terminal half-life would be approximately 4-6 hours, but this is not clinically relevant.
Terminal half-life is approximately 24 hours (range 12–30 h) in adults. Prolonged in hepatic impairment (Child-Pugh A: 48 h; B: 72 h).
Nystatin is not absorbed from the gastrointestinal tract, skin, or mucous membranes. After oral administration, virtually all of the drug is excreted unchanged in feces. Renal excretion is negligible (<0.1%).
Primarily hepatic metabolism; <2% excreted unchanged in urine. Fecal excretion accounts for ~80% of metabolites. Renal excretion of unchanged drug is negligible.
Category C
Category C
Antifungal
Antifungal