MOUTH - Thrush (Candida albicans)

 

Nystatin

(Mycostatin®, Nilstat®)

Generics available

Pregnancy: B; Lactation: Safe

 

Oral Susp: 100,000 U/mL

 

Oral Pastilles (lozenge): 200,000

 

Newborns: 100,000 U/mL - 1/2 mL in each cheek four times daily for 10-14 days.

 

Infants: 100,000 U/mL - 1 mL in each cheek four times daily for 10-14 days.

 

Children: 100,000 U/mL - 3 mL in each cheek four times daily OR 1-2 pastilles four to five times a day for 10-14 days.

 

Adult: 4-6 mL swish/swallow four times daily OR 1-2 pastilles four to five times a day for 10-14 days.

 

Retain in mouth as long as possible.

Pastilles should be dissolved slowly.

Side effects: Diarrhea.

 

Clotrimazole

(Mycelex®)

Pregnancy: C; Lactation: Unk

 

Troche: 10 mg  

 

 

Children >3 years and Adults: Dissolve one troche in mouth slowly (15-30 minutes) five times daily for 7-10 days or until 2-3 days after symptoms clear.

 

Side effects: Nausea, unpleasant sensation in mouth, elevated LFTs.

 

Fluconazole*

(Diflucan®)

Pregnancy: C; Lactation: Likley Safe

 

Tabs: 50 mg, 100 mg,

 

Oral Susp:

10 mg/mL

 

 

 

Children: 6 mg/kg (max 200 mg) PO

once x 1 day, then 3 mg/kg/day

(max 100 mg) PO daily for 13 days.

 

10 mg/mL @ 3 mg/kg/day (double for

6 mg/kg)

10 kg (22 lb) = 3 mL Q24H

15 kg (33 lb) = 41/2 mL Q24H

20 kg (44 lb) = 6 mL Q24H

 

40 mg/mL @ 3 mg/kg/day (double for 6 mg/kg)

20 kg (44 lb) = 11/2 mL Q24H

30 kg (66 lb) = 2.5 mL (1/2 tsp) Q24H or 100 mg tablet

 

Adult: 200 mg PO once, then 100 mg daily for 10-14 days

 

 

Food: May be taken without regard to food.

 

Side effects: Nausea, dizziness, hepatitis rash (potentially exfoliative). Encourage patient to report rash or nausea, epigastric discomfort, yellowing of eye(s) or skin, or easy bruising.