Nystatin for early voice prosthesis failure due to candida

Nystatin is an anti-fungal medicine, and is regularly prescribed to treat fungal yeast (candida) infections in the mouth. Nystatin comes as a liquid (suspension).

Evidence has shown that it can also be used to treat candida growth on a laryngectomy voice prosthesis.

Using nystatin to treat your voice prosthesis is effective, but it is classed as an ‘unlicensed’ use of the medicine. This means that the manufacturer has not authorised that it can be used in this way. We will tell you how to use nystatin correctly and safely.

Medicine – using an unlicensed medicine

Read our information about unlicensed medicines. You can also call our pharmacy medicines helpline, phone 020 7188 8748, Monday to Friday, 9am to 5pm, email [email protected] . We aim to respond to emails within 2 working days.

How to use nystatin

To treat or prevent voice prosthesis infections, nystatin is used in 2 separate ways:

  • by mouth
  • direct application to the voice prosthesis

For the first 14 days only

Take 1ml of nystatin medicine 4 times each day, using the dropper or small spoon provided with the medicine. Space the doses evenly throughout the day

Hold the medicine in your mouth for at least 30 seconds, then swallow it, so that it coats your throat and back of the voice prosthesis.

Try to not eat or drink for 30 to 60 minutes afterwards. This is to allow the medicine to stay in contact with the back of your voice prosthesis for longer.

One time each day from the start of treatment

After cleaning the voice prosthesis, drop a small amount of nystatin onto the cleaning brush and brush through the voice prosthesis. Avoid dipping the brush into the medicine bottle, to avoid contamination.

Your speech and language therapist will tell you how long you should do this for. Some people will be advised to continue using nystatin on the cleaning brush as a long-term treatment.

Please contact the speech and language therapy team if you are unsure about how long you should take the medicine for.

If you forget to use this medicine

If you forget to take the medicine, don’t worry. Just take the next dose as usual. Do not take 2 doses to make up for a missed one.

If you forget to use it on your cleaning brush, just use it the next time you clean your voice prosthesis.

Side effects

It is very rare for nystatin medicine to cause any side effects, even with long-term use. Mild soreness in the mouth has been reported. If you get this side effect, contact your speech and language therapist to see if you should continue to use nystatin.

Nystatin medicine should be stored in a cool, dark place, but a fridge is too cold.

Repeat prescriptions

Your GP can give you a repeat prescription, unless your speech and language therapist has advised that this medicine is no longer appropriate for you.

Resource number: 5361/VER1
Last reviewed: May 2023
Next review: May 2026

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Contact us

If you have any questions about this treatment, please contact the Guy’s Hospital head and neck speech and language therapy department.

Phone 020 7188 6233, Monday to Friday, 9am to 5pm.

Do you have any comments or concerns about your care?

Contact our Patient Advice and Liaison Service (PALS)

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