idiot question, not had nystatin before, got the tablets and it just says 'take one three times a day'. am I supposed to take like normal tablets, swallow with water? I thought the GP said something about letting them dissove in the mouth, but of course now I get home I can't remember for sure!
i dont know im sorry, i normally ahve nystaton in a liquid with a dropper that you keep in your mouth before swallowing- the liquid i mean. i would ask the pharmacist or ring you gp. Didnt know you get tablets of nystatin.- learn something new everyday!!!
Olive
Hi ali,
I presume you've been given the soft pastilles? You have to let them melt in your mouth slowly, they don't taste very good I'm afraid! Remember if you are taking something afterwards to take the taste away, try not to pick something sweet and sugary like a boiled sweet, it may make the thrush worse.
Hope this helps
Em H
Hmm, no what I have is definitely a tablet - or at least it looks like a smartie, not like a fruit pastille!
Think i will give the pharmacist a ring to check - something that dissolves in the mouth seems to make more sense (to my non-medical brain).
thanks again Em
I'm sorry, Ali, you are quite right, the brown disgusting tasting pastilles I am thinking of are amphotericin lozenges. Clearly they made enough of an impression on me for me to completely forget their name!
I'm not sure about the nystatin, but checking in the BNF, although both tablets and the suspension are listed, only the suspension is listed under 'Oropharyngeal fungal infections'. It also has this to say: 'amphotericin and nystatin are not absorbed from the gastro-intestinal tract and are applied locally (as lozenges or suspension) to the mouth for treating local fungal infections'.
From that I would conclude that the suspension (liquid with a dropper) would be more appropriate, but I would suggest you check it out with your pharmacist.
I presume you're doing all the usual stuff like using a spacer, washing your mouth out thoroughly after using your steroid inhaler, etc?
Hope it clears up soon
Em H
Ok, the pharmacist says to chew them if I am able, otherwise swallowing them will do the same job (and she did check it was for oral thrush).
I have to say I am not convinced ....
I don't fancy crunching them, think i might just go with swallowing (even if it doesnt do much good it wont do any harm, right?)
Yes Em, I'm pretty good with rinsing - use symbicort so spacer is not an option. TBH although I always have a claggy throat and hoarse voice I have been putting this down to PND rather than thrush - it's never really sore, so not something I have been too bothered about.
thanks again
Hi there
I have had all three over the years. I have to say I prefer the tablets which my GPs are struggling to get (I live in a rural area so the GPs dispense my medication). I just swallowed them with water and they cleared up the oral thrush the best. Now they can only get the liquid so I am stuck with that.
I go to long lengths to prevent getting oral thrush - its not good to loose your voice when you work with kids! I am now on symbicort and the instructions did suggest that you rinse your mouth after use (well thats ok at home - but at work!). I rinse my mouth when I can and I have started to use an extremely small amount of oraldene to rinse around my mouth as a second rinse. A hassle yes - but so far so good.
Good Luck
Judi
Based on what it says in the BNF about the poor absorption of nystatin orally, I wouldn't expect swallowing the tablets to be that effective in comparison to the pastilles or the suspension, so it's interesting to hear that you've found the opposite, Judi. In my experience, the most commonly prescribed treatments are usually the nystatin suspension or amphoteracin lozenges, and then if those don't work, a course of oral fluconazole (these are all prescription only medications; the fluconzole given as a course is at a different dose to the one-off single dose fluconazole tablets that you can buy over the counter for vaginal thrush, and the two should not be considered interchangable). A lot of cases of oral thrush will probably resolve spontaneously without treatment, in any case, especially if good oral hygiene is adhered to, so it's often difficult to tell whether a specfic treatment has made much difference.
I had a really nasty and very sore bout of oral thrush when I was last in hospital, back in January - I was on IV hydrocort and IV antibiotics at the time as well as the inhaled steroids, so ample reason for it! The nystatin suspension helped a bit initially, but failed to settle it, so I eventually had a course of oral fluconazole tablets which did the trick. I also use chlorhexadine mouthwash and occasionally Bonjela for the soreness. Some people swear by using live yoghurt to keep it at bay, although I can't say I've ever found much of a difference.
I must admit that I hadn't considered the implications of the Symbicort SMART regimen in that you are taking inhaled steroids when out and about and may not be able to rinse your mouth out. I usually carry a water bottle around with me when I am out anyway. If there are no toilet facilities, rinsing your mouth with water and then swallowing it is probably better than not rinsing it at all. It should still help reduce the chances of getting thrush as the drug won't be in contact with the oral mucosa for so long, and it shouldn't increase the systemic (body wide) absorption of the steroid too much, as budesonide that is absorped into the blood stream via the gut tends to be very rapidly removed from the blood by the liver. Obviously, though, rinsing and spitting is better, if you can, and certainly if you are using mouthwash these usually shouldn't be swallowed!
It would be interesting to hear what other people do when they have used their Symbicort when they are out and about - as I said, it hadn't really occured to me before that it would be an issue.
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