Label: NYSTATIN cream

  • NDC Code(s): 13668-595-01, 13668-595-02
  • Packager: Torrent Pharmaceuticals Limited
  • Category: HUMAN PRESCRIPTION DRUG LABEL
  • DEA Schedule: None
  • Marketing Status: Abbreviated New Drug Application

Drug Label Information

Updated July 30, 2019

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  • DESCRIPTION

    Nystatin is a polyene antifungal antibiotic obtained from Streptomyces nursei.

    Structural formula:

    Image
    Molecular formula
    :
    C47H75NO17
    Molecular weight
    :
    926.09 g/mol

    Nystatin cream is for dermatologic use.

    Nystatin cream, USP for topical use, contains 100,000 USP nystatin units per gram. Inactive ingredients: aluminium hydroxide gel, ceteareth-15, mono- and di- glyceride, polyoxyl 8 stearate, propylene glycol, simethicone emulsion, sorbitol solution, titanium dioxide, white petrolatum, methylparaben and propylparaben.

  • CLINICAL PHARMACOLOGY

    Pharmacokinetics

    Nystatin is not absorbed from intact skin or mucous membrane.

    Microbiology

    Nystatin is an antibiotic which is both fungistatic and fungicidal in vitro against a wide variety of yeasts and yeast-like fungi, including Candida albicans, C. parapsilosis, C. tropicalis, C. guilliermondi, C. pseudotropicalis, C. krusei, Torulopsis glabrata, Tricophyton rubrum, T. mentagrophytes. Nystatin acts by binding to sterols in the cell membrane of susceptible species resulting in a change in membrane permeability and the subsequent leakage of intracellular components. On repeated subculturing with increasing levels of nystatin, Candida albicans does not develop resistance to nystatin. Generally, resistance to nystatin does not develop during therapy. However, other species of Candida (C. tropicalis, C. guilliermondi, C. krusei, and C. stellatoides) become quite resistant on treatment with nystatin and simultaneously become cross resistant to amphotericin as well. This resistance is lost when the antibiotic is removed. Nystatin exhibits no appreciable activity against bacteria, protozoa, or viruses.

  • INDICATIONS AND USAGE

    Nystatin cream is indicated in the treatment of cutaneous or mucocutaneous mycotic infections caused by Candida albicans and other susceptible Candida species.

    This cream is not indicated for systemic, oral, intravaginal or ophthalmic use.

  • CONTRAINDICATIONS

    Nystatin cream is contraindicated in patients with a history of hypersensitivity to any of their components.

  • PRECAUTIONS

    General

    Nystatin cream should not be used for the treatment of systemic, oral, intravaginal or ophthalmic infections.

    If irritation or sensitization develops, treatment should be discontinued and appropriate measures taken as indicated. It is recommended that KOH smears, cultures, or other diagnostic methods be used to confirm the diagnosis of cutaneous or mucocutaneous candidiasis and to rule out infection caused by other pathogens.

  • INFORMATION FOR PATIENTS

    Patients using these medications should receive the following information and instructions:

    1.      The patient should be instructed to use these medications as directed (including the replacement of missed doses). This medication is not for any disorder other than that for which it is prescribed.

    2.      Even if symptomatic relief occurs within the first few days of treatment, the patient should be advised not to interrupt or discontinue therapy until the prescribed course of treatment is completed.

    3.      If symptoms of irritation develop, the patient should be advised to notify the physician promptly.

    Laboratory Tests

    If there is a lack of therapeutic response, KOH smears, cultures, or other diagnostic methods should be repeated.

    Carcinogenesis, Mutagenesis, Impairment of Fertility

    No long-term animal studies have been performed to evaluate the carcinogenic potential of nystatin. No studies have been performed to determine the mutagenicity of nystatin or its effects on male or female fertility.

    Pregnancy

    Teratogenic Effects

    Category C.

    Animal reproduction studies have not been conducted with any nystatin cream. It also is not known whether this cream can cause fetal harm when used by a pregnant woman or can affect reproductive capacity. Nystatin cream should be prescribed for a pregnant woman only if the potential benefit to the mother outweighs the potential risk to the fetus.

    Nursing Mothers

    It is not known whether nystatin is excreted in human milk. Caution should be exercised when nystatin is prescribed for a nursing woman.

    Pediatric Use

    Safety and effectiveness have been established in the pediatric population from birth to 16 years.

    (See DOSAGE AND ADMINISTRATION)

    Geriatric Use

    Clinical studies with nystatin cream did not include sufficient numbers of subjects aged 65 years and older to determine whether they respond differently than younger subjects. Other reported clinical experience has not identified differences in responses between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.

  • ADVERSE REACTIONS

    The frequency of adverse events reported in patients using nystatin cream is less than 0.1%. The more common events that were reported include allergic reactions, burning, itching, rash, eczema, and pain on application.

    (See PRECAUTIONS: General.)

  • DOSAGE AND ADMINISTRATION

    Adults and Pediatric Patients (Neonates and Older)

    Apply liberally to affected areas twice daily or as indicated until health is complete.

  • HOW SUPPLIED

    Nystatin Cream, USP, 100,000 units per gram is a yellow to light green color cream available as follows:

    NDC 13668-595-01 15 g tube

    NDC 13668-595-02 30 g tube

  • STORAGE AND HANDLING

    Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C and 30°C (59°F and 86°F) [see USP Controlled Room Temperature]. Avoid freezing.

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    Manufactured by:

    TORRENT PHARMACEUTICALS LTD., Pithampur-454775, INDIA.

    Manufactured for:

    TORRENT PHARMA INC., Basking Ridge, NJ 07920

    8069674                                                                                                                  June 2019

  • PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

    Nystatin Cream, USP 15 grams (Tube label)

    Nystatin Cream, USP 15 grams (Tube label)

    Nystatin Cream, USP 15 grams (Carton Label)

    Nystatin Cream, USP 15 grams (Carton Label)

    Nystatin Cream, USP 30 grams (Tube Label)

    Nystatin Cream, USP 30 grams (Tube Label)

    Nystatin Cream USP,  30 grams (Carton Label)

    Nystatin Cream USP, 30 grams (Carton Label)

  • INGREDIENTS AND APPEARANCE
    NYSTATIN 
    nystatin cream
    Product Information
    Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC:13668-595
    Route of AdministrationTOPICAL
    Active Ingredient/Active Moiety
    Ingredient NameBasis of StrengthStrength
    NYSTATIN (UNII: BDF1O1C72E) (NYSTATIN - UNII:BDF1O1C72E) NYSTATIN100000 U  in 1 g
    Inactive Ingredients
    Ingredient NameStrength
    ALUMINUM HYDROXIDE (UNII: 5QB0T2IUN0)  
    CETEARETH-15 (UNII: 867H4YOZ8Z)  
    DIMETHICONE (UNII: 92RU3N3Y1O)  
    GLYCERYL MONOSTEARATE (UNII: 230OU9XXE4)  
    METHYLPARABEN (UNII: A2I8C7HI9T)  
    PETROLATUM (UNII: 4T6H12BN9U)  
    POLYOXYL 8 STEARATE (UNII: 2P9L47VI5E)  
    PROPYLENE GLYCOL (UNII: 6DC9Q167V3)  
    PROPYLPARABEN (UNII: Z8IX2SC1OH)  
    SORBITOL (UNII: 506T60A25R)  
    TITANIUM DIOXIDE (UNII: 15FIX9V2JP)  
    Product Characteristics
    ColorYELLOW (Yellow to light green) Score    
    ShapeSize
    FlavorImprint Code
    Contains    
    Packaging
    #Item CodePackage DescriptionMarketing Start DateMarketing End Date
    1NDC:13668-595-0115 g in 1 TUBE; Type 0: Not a Combination Product07/24/2019
    2NDC:13668-595-0230 g in 1 TUBE; Type 0: Not a Combination Product07/24/2019
    Marketing Information
    Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
    ANDAANDA21255707/24/2019
    Labeler - Torrent Pharmaceuticals Limited (916488547)