How to Use Nystatin Oral Suspension
For nystatin to work effectively, it must come into direct contact with the Candida infection — meaning it should be held in the mouth for as long as possible before swallowing. Swallowing immediately reduces effectiveness because the suspension does not stay in contact with the affected oral surfaces.

Standard adult and child dosing:

For oral thrush (adults and children):

• 1mL (100,000 units), four times a day
• Held in the mouth, swirled around, and then swallowed
• Continue for at least 7 days, and for 48 hours after symptoms have resolved to prevent relapse
  
  

Step-by-step usage for oral thrush:

• Shake the bottle well before use to ensure even distribution
• Measure the dose carefully using the dropper or oral syringe provided — do not use a household teaspoon
• Place the suspension in the mouth and hold it there for at least 1 minute (or as long as comfortable) — swirling around the mouth
• Swallow the suspension to also treat any Candida in the throat or upper gut
• Avoid eating or drinking for at least 30 minutes afterwards to allow the medication to remain in contact with the affected areas
• Continue treatment for at least 48 hours after symptoms have settled to prevent recurrence

Important usage tips:

• Hold in the mouth, don't just swallow — contact time is essential
• Continue for the full prescribed course, even if symptoms improve quickly
• Clean dentures thoroughly every night and soak in chlorhexidine if you wear them — they can harbour Candida
• Sterilise infant feeding equipment (bottles, teats, dummies) daily during treatment
• Avoid sharing utensils, towels, or feeding equipment to prevent reinfection

Important Precautions
Treating the underlying cause: Oral thrush often develops because of an underlying condition or medication. To prevent recurrence, also consider:

• Improving diabetes control if applicable
• Reviewing inhaled corticosteroids — rinse the mouth and gargle with water after use to reduce Candida colonisation
• Reviewing recent antibiotic use — antibiotics disrupt normal oral flora
• Stopping smoking — smoking promotes Candida growth
• Treating dry mouth (xerostomia) — saliva is naturally protective against Candida
• Reviewing immunosuppressive medications
• Pregnancy and breastfeeding: Nystatin is considered safe in pregnancy and breastfeeding, as systemic absorption is negligible. It is widely used during these periods, including for breastfeeding-associated nipple and oral thrush. Always confirm with your clinician.

Drug interactions: Nystatin oral suspension has very few significant drug interactions because it is not absorbed systemically. However, it may slightly alter the absorption of other medications taken at the same time — separate doses by 1–2 hours where possible.

Excipients: The suspension contains sucrose, ethanol (small amounts), and parahydroxybenzoates. Patients with allergies to these, hereditary fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase insufficiency should avoid this formulation. Sugar-free alternatives may be preferred in patients with diabetes or those at high risk of dental caries — discuss with your clinician.

Driving and machinery: Nystatin oral suspension does not affect driving or operating machinery.

Alcohol: No specific interaction with alcohol; however, alcohol may worsen oral irritation during a Candida infection.