COMPOUNDING HOTLINE

Q: I was wondering whether you know how to compound nystatinsuspension using stevia, with no sugar allowed.

A: s question is asked frequently. The patient may beundergoing a whole-body Candida infection. In such cases,nystatin is given without sugar; in fact, sugars are eliminated fromthe patient's diet as much as possible.

For Nystatin for Oral Suspension, use Nystatin, Powder, USP(formerly Nystatin for Extemporaneous Preparation of Oral SuspensionUSP). This product is pure nystatin and is provided inconvenient dispensing quantities, sometimes with a dose spoon.The product is dispensed in the sealed container. The patient isinstructed to refrigerate the product. Once opened, the producthas a finite expiration date (usually 90 days when refrigerated).

Extemporaneous preparation of the suspension is accomplishedby adding the powder to water (or sometimes to a beverage).Nystatin has a very short half-life in an aqueous medium wheresucrose is not present.

The pharmacist should not attempt to compound a sugar-freesuspension of nystatin.

Commercially prepared nystatin suspension is stored at roomtemperature; sucrose in the suspension stabilizes the nystatin.

Mr. Erickson is director of professional affairs at Gallipot Inc.

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