NYSTATIN AND TRIAMCINOLONE ACETONIDE

Nystatin and Triamcinolone Acetonide Cream USP for dermatologic use contain the antifungal agent nystatin and the synthetic corticosteroid triamcinolone acetonide. Nystatin is a polyene antimycotic obtained from Streptomyces noursei . It is a yellow to light tan powder with a cereal like odor, practically insoluble in water, and practically insoluble in alcohol. Structural formula: C 47 H 75 NO 17 MW = 926.23 Triamcinolone acetonide is designated chemically as 9-fluoro-11β, 16 α, 17, 21-tetrahydroxypregna-1, 4-diene-3, 20-dione cyclic 16, 17-acetal with acetone. The white to cream colored crystalline powder has a slight odor, is practically insoluble in water, and sparingly soluble in dehydrated alcohol. Structural formula: C 24 H 31 FO 6 MW = 434.50 Nystatin and Triamcinolone Acetonide Cream USP is a soft, smooth cream having a light yellow to buff color. Each gram provides 100,000 USP Nystatin units and 1 mg Triamcinolone Acetonide USP in an aqueous perfumed vanishing cream base with cetearyl alcohol and ceteareth-20, dried aluminum hydroxide gel, methylparaben, mono- and di-glycerides, noncrystallizing sorbitol solution, polyoxyl (8) stearate, polysorbate 60, propylene glycol, propylparaben, simethicone emulsion, sorbic acid, titanium dioxide and white petrolatum. image image

Nystatin and Triamcinolone Acetonide Cream USP is indicated for the treatment of cutaneous candidiasis; it has been demonstrated that the nystatin-steroid combination provides greater benefit than the nystatin component alone during the first few days of treatment.

Nystatin and Triamcinolone Acetonide Cream USP is usually applied to the affected areas twice daily in the morning and evening by gently and thoroughly massaging the preparation into the skin. The cream should be discontinued if symptoms persist after 25 days of therapy (see PRECAUTIONS , Laboratory Tests). Nystatin and Triamcinolone Acetonide Cream USP should not be used with occlusive dressings.

These preparations are contraindicated in those patients with a history of hypersensitivity to any of their components.

A single case (approximately one percent of patients studied) of acneiform eruption occurred with use of combined nystatin and triamcinolone acetonide in clinical studies. Nystatin is virtually nontoxic and nonsensitizing and is well tolerated by all age groups, even during prolonged use. Rarely, irritation may occur. The following local adverse reactions are reported infrequently with topical corticosteroids (reactions are listed in an approximate decreasing order of occurrence): burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, perioral secondary infection, skin atrophy, striae and miliaria.