Candio-hermal

Candio-hermal Medicine

Overdose

Coated tablet; Film-coated tablet; Ointment for external use; Rectal suppositories; Substance; Substance-powder; Vaginal suppositoryCream; Cutaneous solution; Ointment; Pastille; Powder; Suspension

Since the absorption of Candio-Hermal from the gastro-intestinal tract is negligible, overdosage or accidental ingestion causes no systemic toxicity. Oral doses of Candio-Hermal in excess of 5 million units daily have caused nausea and gastrointestinal upset.

No information provided.

Contraindications

Coated tablet; Film-coated tablet; Ointment for external use; Rectal suppositories; Substance; Substance-powder; Vaginal suppositoryCream; Cutaneous solution; Ointment; Pastille; Powder; Suspension

Nystatin topical preparations are contraindicated in patients with a history of hypersensitivity to any of their components.

Incompatibilities

Not applicable.

Candio-Hermal price

We have no data on the cost of the drug.
However, we will provide data for each active ingredient

Undesirable effects

Coated tablet; Film-coated tablet; Ointment for external use; Rectal suppositories; Substance; Substance-powder; Vaginal suppositoryCream; Cutaneous solution; Ointment; Pastille; Powder; Suspension

Candio-Hermal is generally well tolerated by all age groups, even during prolonged use. If irritation or sensitisation develops, treatment should be discontinued. Nausea has been reported occasionally during therapy.

Large oral doses of Candio-Hermal have occasionally produced diarrhoea, gastrointestinal distress,nausea and vomiting. Rash, including urticaria has been reported rarely. Steven-Johnson Syndrome has been reported very rarely. Hypersensitivity and angioedema, including facial oedema have been reported.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme: www.mhra.gov.uk/yellowcard.

The frequency of adverse events reported in patients using Candio-Hermal (nystatin) ® preparations is less than 0.1%. The more common events that were reported include allergic reactions, burning, itching, rash, eczema, and pain on application. (See PRECAUTIONS: General.)

Preclinical safety data

No long-term animal studies have been performed to evaluate the carcinogenic potential of Candio-Hermal. No studies have been performed to determine the mutagenicity of Candio-Hermal or its effect on male or female fertility.

Therapeutic indications

Coated tablet; Film-coated tablet; Ointment for external use; Rectal suppositories; Substance; Substance-powder; Vaginal suppositoryCream; Cutaneous solution; Ointment; Pastille; Powder; Suspension

Indications

The prevention and treatment of candidal infections of the oral cavity, oesophagus and intestinal tract.

The suspension also provides effective prophylaxis against oral candidosis in those born of mothers with vaginal candidosis.

Nystatin topical preparations are indicated in the treatment of cutaneous or mucocutaneous mycotic infections caused by Candida albicans and other susceptible Candida species.

These preparations are not indicated for systemic, oral, intravaginal or ophthalmic use.

Pharmacotherapeutic group

Antifungals for topical use, ATC code: D01AA01

Pharmacodynamic properties

Pharmacotherapeutic group: Antifungals for topical use, ATC code: D01AA01

Candio-Hermal is a mixture of antifungal polyenes produced by the growth of certain strains of Streptomyces noursei, or by any other means. It consists largely of Candio-Hermal A1.

Candio-Hermal is active against a wide range of yeasts and yeast-like fungi, including Candida albicans.

Pharmacokinetic properties

Coated tablet; Film-coated tablet; Ointment for external use; Rectal suppositories; Substance; Substance-powder; Vaginal suppositoryCream; Cutaneous solution; Ointment; Pastille; Powder; Suspension

Candio-Hermal is a tetraene macrolide. There is no data available on the pharmacokinetics as it is not absorbed from the gastro-intestinal tract, skin or vagina and most of the use is topical. Microbial growth-inhibiting concentrations have been shown to be in the range 3-6mg/l.

Nystatin is not absorbed from intact skin or mucous membrane.

Name of the medicinal product

Candio-Hermal

Qualitative and quantitative composition

Nystatin

Special warnings and precautions for use

Coated tablet; Film-coated tablet; Ointment for external use; Rectal suppositories; Substance; Substance-powder; Vaginal suppositoryCream; Cutaneous solution; Ointment; Pastille; Powder; Suspension

Candio-Hermal Oral Suspension BP contains sucrose. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine. This should also be taken into account in patients with diabetes mellitus.

Candio-Hermal Oral Suspension contains 0.3 mmol (or 1.3 mg) sodium per 1 ml dose. To be taken into consideration by patients on a controlled sodium diet.

Candio-Hermal Oral Suspension contains sodium metabisulphite (E223) which may rarely cause severe hypersensitivity reactions and bronchospasm.

Candio-Hermal Oral Suspension contains propyl p-hydroxybenzoate and methyl p-hydroxybenzoate which may cause allergic reactions (possibly delayed).

Candio-Hermal oral preparations should not be used for treatment of systemic mycoses.

WARNINGS

No information provided.

PRECAUTIONS General

Nystatin, topical preparations should not be used for the treatment of systemic, oral, intravaginal or ophthalmic infections.

If irritation or sensitization develops, treatment should be discontinued and appropriate measures taken as indicated. It is recommended that KOH smears, cultures, or other diagnostic methods be used to confirm the diagnosis of cutaneous or mucocutaneous candidiasis and to rule out infection caused by other pathogens.

Laboratory Tests

If there is a lack of therapeutic response, KOH smears, cultures, or other diagnostic methods should be repeated.

Carcinogenesis, Mutagenesis, Impairment of Fertility

No long-term animal studies have been performed to evaluate the carcinogenic potential of nystatin. No studies have been performed to determine the mutagenicity of nystatin or its effects on male or female fertility.

Pregnancy: Teratogenic Effects

Category C. Animal reproduction studies have not been conducted with any nystatin topical preparation. It also is not known whether these preparations can cause fetal harm when used by a pregnant woman or can affect reproductive capacity. Nystatin topical preparations should be prescribed for a pregnant woman only if the potential benefit to the mother outweighs the potential risk to the fetus.

Nursing Mothers

It is not known whether nystatin is excreted in human milk. Caution should be exercised when nystatin is prescribed for a nursing woman.

Pediatric Use

Safety and effectiveness have been established in the pediatric population from birth to 16 years. (See DOSAGE AND ADMINISTRATION.)

Geriatric Use

Clinical studies with Candio-Hermal (Nystatin) Cream and Candio-Hermal (Nystatin) Topical Powder did not include sufficient numbers of subjects aged 65 years and older to determine whether they respond differently than younger subjects. Other reported clinical experience has not identified differences in responses between elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.

Effects on ability to drive and use machines

Not relevant.

Dosage (Posology) and method of administration

Coated tablet; Film-coated tablet; Ointment for external use; Rectal suppositories; Substance; Substance-powder; Vaginal suppositoryCream; Cutaneous solution; Ointment; Pastille; Powder; Suspension

Posology

Oral Candidiasis

Infants (1 month to 2 years)

1ml should be dropped into the mouth four times a day.

Children (> 2 years) and adults

For the treatment of denture sores, and oral infections in children (> 2 years) and adults caused by candidas albicans. 1ml of the suspension should be dropped into the mouth four times daily; it should be kept in contact with the affected areas as long as possible.

Intestinal candidiasis

Infants (1 month to 2 years)

1ml should be dropped into the mouth four times a day.

Adults

For the treatment of intestinal candidosis 5ml of the suspension should be dropped into the mouth four times daily.

Paediatric population (> 2 years)

1ml should be dropped into the mouth four times a day.

For prophylaxis a total daily dosage of 1 million units has been found to suppress the overgrowth of candidas albicans in patients receiving broad-spectrum antibiotic therapy.

For prophylaxis in the newborn the suggested dose is 1ml once daily.

The longer the suspension is kept in contact with the affected area in the mouth before swallowing, the greater will be its effect.

Administration should be continued for 48 hours after clinical cure to prevent relapse.

Older people

No specific dosage recommendations or precautions.

If signs and symptoms worsen or persist (beyond 14 days of treatment), the patient should be reevaluated, and alternate therapy considered.

Very moist lesions are best treated with the topical dusting powder.

Candio-Hermal (nystatin) ® Cream

Adults and Pediatric Patients (Neonates and Older): Apply liberally to affected areas twice daily or as indicated until healing is complete.

Candio-Hermal (nystatin) ® Topical Powder

Adults and Pediatric Patients (Neonates and Older): Apply to candidal lesions two or three times daily until healing is complete. For fungal infection of the feet caused by Candida species, the powder should be dusted on the feet, as well as, in all foot wear.

Special precautions for disposal and other handling

Shake well before use.

Dilution is not recommended as this may reduce therapeutic efficacy.

Any unused medicinal product or waste material should be disposed of in accordance with local requirements.