Nystatin Oral Suspension Usp

Nystatin Oral Suspension Usp
SPL v8
SPL
SPL Set ID 28b4e26e-206a-4e8a-abfe-774b780e91c3
Route
ORAL
Published
Effective Date 2023-03-08
Document Type 34391-3 HUMAN PRESCRIPTION DRUG LABEL

Drug Facts

Composition & Product

Active Ingredients
Nystatin (100000 [USP'U])
Inactive Ingredients
Alcohol Anhydrous Citric Acid D&c Yellow No. 10 Fd&c Red No. 40 Glycerin Methylparaben Potassium Phosphate, Dibasic Propylene Glycol Propylparaben Water Sucrose Magnesium Aluminum Silicate

Identifiers & Packaging

Pill Appearance
Color: yellow
Marketing Status
ANDA Active Since 2020-07-17 Until 2023-02-01

Description

Rx Only

Indications and Usage

Nystatin Oral Suspension is indicated for the treatment of candidiasis in the oral cavity.

Dosage and Administration

INFANTS: 2 mL (200,000 units) four times daily (in infants and young children, use dropper to place one-half of dose in each side of mouth and avoid feeding for 5 to 10 minutes). NOTE: Limited clinical studies in premature and low birth weight infants indicate that 1 mL four times daily is effective. CHILDREN AND ADULTS: 4 to 6 mL (400,000 to 600,000 units) four times daily (one-half of dose in each side of mouth). The preparation should be retained in the mouth as long as possible before swallowing. Continue treatment for at least 48 hours after perioral symptoms have disappeared and cultures demonstrate eradication of Candida albicans .

Contraindications

The preparation is contraindicated in patients with a history of hypersensitivity to any of its components.

Adverse Reactions

Nystatin is well tolerated even with prolonged therapy. Oral irritation and sensitization have been reported. (See PRECAUTIONS: General ). Gastrointestinal: Diarrhea (including one case of bloody diarrhea), nausea, vomiting, gastrointestinal upset/disturbances. Dermatologic: Rash, including urticaria has been reported rarely. Stevens-Johnson syndrome has been reported very rarely. Other: Tachycardia, bronchospasm, facial swelling, and non-specific myalgia have also been rarely reported. To report SUSPECTED ADVERSE REACTIONS, contact Pharmaceutical Associates, Inc. at 1-800-845-8210 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

How Supplied

Nystatin Oral Suspension USP, 100,000 USP Nystatin Units per mL, is available in a cherry, peppermint flavored, light creamy yellow, ready-to-use suspension, supplied in the following oral dosage forms: NDC 0121-0868-02:  2 fl oz (60mL) bottle with calibrated dropper NDC 0121-0868-16:  16 fl oz (473mL) bottle NDC 0121-0868-05:  5mL unit dose cup.  Case contains 40 unit dose cups of 5 mL (NDC 0121-0868-40) packaged in 4 trays of 10 unit dose cups each, 50 unit dose cups of 5 mL (NDC 0121-0868-50) packaged in 5 trays of 10 unit dose cups each and 100 unit dose cups of 5 mL (NDC 0121-0868-00) packaged in 10 trays of 10 unit dose cups each.


Medication Information

Indications and Usage

Nystatin Oral Suspension is indicated for the treatment of candidiasis in the oral cavity.

Dosage and Administration

INFANTS: 2 mL (200,000 units) four times daily (in infants and young children, use dropper to place one-half of dose in each side of mouth and avoid feeding for 5 to 10 minutes).

NOTE: Limited clinical studies in premature and low birth weight infants indicate that 1 mL four times daily is effective.

CHILDREN AND ADULTS: 4 to 6 mL (400,000 to 600,000 units) four times daily (one-half of dose in each side of mouth). The preparation should be retained in the mouth as long as possible before swallowing.

Continue treatment for at least 48 hours after perioral symptoms have disappeared and cultures demonstrate eradication of Candida albicans.

Contraindications

The preparation is contraindicated in patients with a history of hypersensitivity to any of its components.

Adverse Reactions

Nystatin is well tolerated even with prolonged therapy. Oral irritation and sensitization have been reported. (See PRECAUTIONS: General ).

Gastrointestinal: Diarrhea (including one case of bloody diarrhea), nausea, vomiting, gastrointestinal upset/disturbances.

Dermatologic: Rash, including urticaria has been reported rarely. Stevens-Johnson syndrome has been reported very rarely.

Other: Tachycardia, bronchospasm, facial swelling, and non-specific myalgia have also been rarely reported.

To report SUSPECTED ADVERSE REACTIONS, contact Pharmaceutical Associates, Inc. at 1-800-845-8210 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

How Supplied

Nystatin Oral Suspension USP, 100,000 USP Nystatin Units per mL, is available in a cherry, peppermint flavored, light creamy yellow, ready-to-use suspension, supplied in the following oral dosage forms:

NDC 0121-0868-02:  2 fl oz (60mL) bottle with calibrated dropper

NDC 0121-0868-16:  16 fl oz (473mL) bottle

NDC 0121-0868-05:  5mL unit dose cup.  Case contains 40 unit dose cups of 5 mL (NDC 0121-0868-40) packaged in 4 trays of 10 unit dose cups each, 50 unit dose cups of 5 mL (NDC 0121-0868-50) packaged in 5 trays of 10 unit dose cups each and 100 unit dose cups of 5 mL (NDC 0121-0868-00) packaged in 10 trays of 10 unit dose cups each.

Description

Nystatin is an antimycotic polyene antibiotic obtained from Streptomyces noursei.

Structural formula:

C 47H 75NO 17     MW 926.13

Nystatin Oral Suspension USP, for oral administration, contains 100,000 USP Nystatin Units per mL. Inactive ingredients: alcohol (≤ 1% v/v), artificial peppermint flavor, cherry flavor, citric acid, D&C Yellow No. 10, FD&C Red No. 40, glycerin, magnesium aluminum silicate, methylparaben, potassium phosphate dibasic, propylene glycol, propylparaben, purified water and sucrose.

Section 42229-5

Rx Only

General

This medication is not to be used for the treatment of systemic mycoses. Discontinue treatment if sensitization or irritation is reported during use.

Storage

Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature]. Avoid freezing.

Overdosage

Oral doses of nystatin in excess of five million units daily have caused nausea and gastrointestinal upset. There have been no reports of serious toxic effects of superinfections (See CLINICAL PHARMACOLOGY, Pharmacokinetics ).

Microbiology

Nystatin is both fungistatic and fungicidal in vitro against a wide variety of yeasts and yeast-like fungi. Candida albicans demonstrates no significant resistance to nystatin in vitro on repeated subculture in increasing levels of nystatin; other Candida species become quite resistant. Generally, resistance does not develop in vivo. Nystatin acts by binding to sterols in the cell membrane of susceptible Candida species with a resultant change in membrane permeability allowing leakage of intracellular components. Nystatin exhibits no appreciable activity against bacteria, protozoa, or viruses.

Pediatric Use
Nursing Mothers

It is not known whether nystatin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when nystatin is administered to a nursing woman.

Pharmacokinetics

Gastrointestinal absorption of nystatin is insignificant. Most orally administered nystatin is passed unchanged in the stool. In patients with renal insufficiency receiving oral therapy with conventional dosage forms, significant plasma concentrations of nystatin may occasionally occur.

Teratogenic Effects

Animal reproduction studies have not been conducted with nystatin oral suspension. It is also not known whether nystatin oral suspension can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Nystatin oral suspension should be given to a pregnant woman only if clearly needed.

Principal Display Panel 60 Ml Bottle Label

60 mL

NDC 0121-0868-02

Nystatin Oral Suspension, USP

100,000 units per mL

SHAKE WELL BEFORE USING

Packaged with Calibrated Dropper

DO NOT USE IF TAMPER EVIDENT

SEAL IS BROKEN OR MISSING. 

Rx ONLY

Pharmaceutical Associates, Inc.

Greenville, SC 29605

Each mL of cherry, peppermint flavored  oral suspension contains 100,000 units Nystatin, USP and alcohol (≤ 1% v/v).

USUAL DOSAGE: For Infants: 2 mL(200,000 units) four times daily (in infants and young children, use dropper to place one half of dose in each side of the mouth and avoid feeding feeding for 5 to 10 minutes). See insert. 

WARNINGS:  Keep this and all drugs out of reach of children. In case of accidenta loverdose, seek professional assistance or contact a Poison Control Center immediately.

Keep tightly closed. Protect from light.

Store at 20° to 25°C (68° to 77°F)

[See USP Controlled Room Temperature}.

AVOID FREEZING

X0868020120         R01/20

Principal Display Panel 5 Ml Unit Dose Cup Label

Delivers 5 mL

NDC 0121-0868-05

NYSTATIN  ORAL  SUSPENSION, USP

500,000 units/5 mL

Alcohol ≤ 1% v/v   SHAKE WELL

Package Not Child-Resistant

Rx ONLY

PHARMACEUTICAL ASSOCIATES, INC.,

GREENVILLE, SC 29605

SEE INSERT

A0868051021

Carcinogenesis, Mutagenesis, Impairment of Fertility

No long-term animal studies have been performed to evaluate carcinogenic potential. There also have been no studies to determine mutagenicity or whether this medication affects fertility in males or females.


Structured Label Content

Section 42229-5 (42229-5)

Rx Only

General

This medication is not to be used for the treatment of systemic mycoses. Discontinue treatment if sensitization or irritation is reported during use.

Storage

Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature]. Avoid freezing.

Overdosage (OVERDOSAGE)

Oral doses of nystatin in excess of five million units daily have caused nausea and gastrointestinal upset. There have been no reports of serious toxic effects of superinfections (See CLINICAL PHARMACOLOGY, Pharmacokinetics ).

Description (DESCRIPTION)

Nystatin is an antimycotic polyene antibiotic obtained from Streptomyces noursei.

Structural formula:

C 47H 75NO 17     MW 926.13

Nystatin Oral Suspension USP, for oral administration, contains 100,000 USP Nystatin Units per mL. Inactive ingredients: alcohol (≤ 1% v/v), artificial peppermint flavor, cherry flavor, citric acid, D&C Yellow No. 10, FD&C Red No. 40, glycerin, magnesium aluminum silicate, methylparaben, potassium phosphate dibasic, propylene glycol, propylparaben, purified water and sucrose.

How Supplied (HOW SUPPLIED)

Nystatin Oral Suspension USP, 100,000 USP Nystatin Units per mL, is available in a cherry, peppermint flavored, light creamy yellow, ready-to-use suspension, supplied in the following oral dosage forms:

NDC 0121-0868-02:  2 fl oz (60mL) bottle with calibrated dropper

NDC 0121-0868-16:  16 fl oz (473mL) bottle

NDC 0121-0868-05:  5mL unit dose cup.  Case contains 40 unit dose cups of 5 mL (NDC 0121-0868-40) packaged in 4 trays of 10 unit dose cups each, 50 unit dose cups of 5 mL (NDC 0121-0868-50) packaged in 5 trays of 10 unit dose cups each and 100 unit dose cups of 5 mL (NDC 0121-0868-00) packaged in 10 trays of 10 unit dose cups each.

Microbiology

Nystatin is both fungistatic and fungicidal in vitro against a wide variety of yeasts and yeast-like fungi. Candida albicans demonstrates no significant resistance to nystatin in vitro on repeated subculture in increasing levels of nystatin; other Candida species become quite resistant. Generally, resistance does not develop in vivo. Nystatin acts by binding to sterols in the cell membrane of susceptible Candida species with a resultant change in membrane permeability allowing leakage of intracellular components. Nystatin exhibits no appreciable activity against bacteria, protozoa, or viruses.

Pediatric Use
Nursing Mothers

It is not known whether nystatin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when nystatin is administered to a nursing woman.

Pharmacokinetics

Gastrointestinal absorption of nystatin is insignificant. Most orally administered nystatin is passed unchanged in the stool. In patients with renal insufficiency receiving oral therapy with conventional dosage forms, significant plasma concentrations of nystatin may occasionally occur.

Adverse Reactions (ADVERSE REACTIONS)

Nystatin is well tolerated even with prolonged therapy. Oral irritation and sensitization have been reported. (See PRECAUTIONS: General ).

Gastrointestinal: Diarrhea (including one case of bloody diarrhea), nausea, vomiting, gastrointestinal upset/disturbances.

Dermatologic: Rash, including urticaria has been reported rarely. Stevens-Johnson syndrome has been reported very rarely.

Other: Tachycardia, bronchospasm, facial swelling, and non-specific myalgia have also been rarely reported.

To report SUSPECTED ADVERSE REACTIONS, contact Pharmaceutical Associates, Inc. at 1-800-845-8210 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Contraindications (CONTRAINDICATIONS)

The preparation is contraindicated in patients with a history of hypersensitivity to any of its components.

Teratogenic Effects

Animal reproduction studies have not been conducted with nystatin oral suspension. It is also not known whether nystatin oral suspension can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Nystatin oral suspension should be given to a pregnant woman only if clearly needed.

Indications and Usage (INDICATIONS AND USAGE)

Nystatin Oral Suspension is indicated for the treatment of candidiasis in the oral cavity.

Dosage and Administration (DOSAGE AND ADMINISTRATION)

INFANTS: 2 mL (200,000 units) four times daily (in infants and young children, use dropper to place one-half of dose in each side of mouth and avoid feeding for 5 to 10 minutes).

NOTE: Limited clinical studies in premature and low birth weight infants indicate that 1 mL four times daily is effective.

CHILDREN AND ADULTS: 4 to 6 mL (400,000 to 600,000 units) four times daily (one-half of dose in each side of mouth). The preparation should be retained in the mouth as long as possible before swallowing.

Continue treatment for at least 48 hours after perioral symptoms have disappeared and cultures demonstrate eradication of Candida albicans.

Principal Display Panel 60 Ml Bottle Label (PRINCIPAL DISPLAY PANEL - 60 mL Bottle Label)

60 mL

NDC 0121-0868-02

Nystatin Oral Suspension, USP

100,000 units per mL

SHAKE WELL BEFORE USING

Packaged with Calibrated Dropper

DO NOT USE IF TAMPER EVIDENT

SEAL IS BROKEN OR MISSING. 

Rx ONLY

Pharmaceutical Associates, Inc.

Greenville, SC 29605

Each mL of cherry, peppermint flavored  oral suspension contains 100,000 units Nystatin, USP and alcohol (≤ 1% v/v).

USUAL DOSAGE: For Infants: 2 mL(200,000 units) four times daily (in infants and young children, use dropper to place one half of dose in each side of the mouth and avoid feeding feeding for 5 to 10 minutes). See insert. 

WARNINGS:  Keep this and all drugs out of reach of children. In case of accidenta loverdose, seek professional assistance or contact a Poison Control Center immediately.

Keep tightly closed. Protect from light.

Store at 20° to 25°C (68° to 77°F)

[See USP Controlled Room Temperature}.

AVOID FREEZING

X0868020120         R01/20

Principal Display Panel 5 Ml Unit Dose Cup Label (PRINCIPAL DISPLAY PANEL - 5 mL Unit Dose Cup Label)

Delivers 5 mL

NDC 0121-0868-05

NYSTATIN  ORAL  SUSPENSION, USP

500,000 units/5 mL

Alcohol ≤ 1% v/v   SHAKE WELL

Package Not Child-Resistant

Rx ONLY

PHARMACEUTICAL ASSOCIATES, INC.,

GREENVILLE, SC 29605

SEE INSERT

A0868051021

Carcinogenesis, Mutagenesis, Impairment of Fertility

No long-term animal studies have been performed to evaluate carcinogenic potential. There also have been no studies to determine mutagenicity or whether this medication affects fertility in males or females.


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