Mycolog

Brand: Mycolog

Generic: Nystatin and Triamcinolone Acetonide

Mycolog is a drug used in the treatment of skin candidiasis. It is a soft, smooth cream. It has a light-yellow-to-buff color and is available as an ointment or cream containing nystatin 100,000 units in 1 gram and triamcinolone acetonide 1 milligram in 1 gram in an aqueous, perfumed vanishing cream base with aluminum hydroxide concentrated wet gel. It also contains titanium dioxide, polyethylene glycol monostearate, glyceryl monostearate, simethicone, sorbic acid, propylene glycol, cetearyl alcohol, ceteareth-20, white petrolatum, and sorbitol solution. It is a combination of antifungal and steroid. It stops the growth of fungus and reduces inflammation.  Do not use this medicine if you are allergic to mycolog or if you are already taking mifepristone. Mycolog is for dermatologic use only.

• Nystatin: Nystatin is a polyene antimycotic. It is obtained from Streptomyces noursei. It is a yellow-to-light-tan powder, and it has a cereal-like odor. It is slightly soluble in water and sparingly soluble in alcohol.It has antifungal activity, which it exerts against a variety of pathogenic and non-pathogenic fungi and yeast. It binds to the sterols in the cell membrane, which makes the membrane incapable of functioning as a selective barrier; it also induces anti-candidal activity against Candida albicans and other species of Candida. But nystatin is not active against bacteria, protozoa, trichomonads, or viruses. Nystatin is not absorbed through intact skin or the mucous membrane.
• Triamcinolone acetonide: Triamcinolone acetonide is white-to-cream crystalline powder. It has a slight odor and is practically insoluble in water. It is, however, very soluble in alcohol and has anti-inflammatory, antipuritic, and vasoconstrictive properties. These are the characteristics of the corticosteroid class of drugs. The mechanism of action is not yet known. Patients with mild to severe manifestations of cutaneous candidiasis were clinically studied. Those treated with nystatin and triamcinolone acetonide cream showed a faster, more pronounced clear-up of infection from erythrema and pruritus than the patients who were treated with nystatin or triamcinolone acetonide alone. Hence, it is inferred that a nystatin-steroid combination offers a greater benefit than any of these components alone.

Instructions

You should read the product information leaflet before using this medication. If you have any questions, ask your doctor or pharmacist.

Your dosage is based on your medical condition and how you respond to treatment. Take the drug regularly at the same time each day to experience the most benefits. This should enable you to effectively fight off skin candidiasis.

The drug should be applied only to the skin. Avoid using it on the face, groin, or underarms, or for diaper rash, unless told otherwise by the doctor. While you may experience an outbreak of candidiasis caused by an over-production of candida, you should know it can spread to various parts of the body, from the tips of the toes to the groin and even to the back, unless treated in time. This is why the moment you come across it, you need to consult your healthcare professional and seek treatment. Make sure to keep your doctor up to date on all your medical information, including allergies and any medical supplements you are currently taking.

About Candidiasis

The candida fungus, within normal levels, does not cause infection. However, if, for some reason, your body goes out of sync with its normal functions, or you do not practice good hygiene, it can cause the candida fungus to go into overdrive. This results in a candida infection, or a yeast infection, as it is commonly called, which generally infects areas between the folds of the skin. Some of the zones of the body where a candida infection often breaks out are:

• Between fingers
• Groin
• Buttocks
• Thighs
• Arms
• Armpits
• Lower back

The infection, especially in the groin area, appears as a rash that can be both debilitating and embarrassing; you are bound to experience some discomfort and pain as a result of it. If left untreated, the infection can spread to other parts of the body, so, the moment you notice a suspicious rash in your groin area, buttocks, or other parts of the body, consult your doctor right away.

Candidiasis is extremely infectious and can spread easily from one person to another. So, make a point of carrying a small bottle of hand sanitizer with you always, and clean your hands with disinfectant each time you touch the rash. It is important to maintain some distance from your family to avoid infecting them, and, above all, take care not to touch common-use items, such as utensils, the TV remote, and others, and wash all your clothes in hot water as well. This will help limit the spread of candida in your home.

The treatment process may vary a bit, but, usually, it involves the use of antibiotics as well as ointments, such as mycology, to fight off the infection. Generally, candidiasis will go away on its own, but, at times, it can spread to other parts of the body, so schedule a visit with your doctor at the earliest and get treated right away.

Pharmacokinetics

The extent to which percutaneuous absorption of topical corticosteroids takes place depends on factors such as vehicle, the integrity of the epidermal barrier, and use of occlusive dressings. Even for normal, intact skin, topical corticosteroids can be absorbed. Percutaneous absorption increases due to inflammation, occlusive dressings, or other disease processes of the skin. Once the corticosteroids are absorbed through the skin, they go through the pharmacokinetic pathway. This pathway is similar to the one through which systemically-administered corticosteroids go. Metabolism of corticosteroids primarily occurs in the liver, and then they are excreted by the kidneys. Some are also excreted through bile.

Precautions

These are a few precautions you can take to avoid a future outbreak of candidiasis:

• Take a bath or shower immediately after working out, as candida thrives in sweat, dust, and grime. Make sure to practice good hygiene and wash after working out.
• Avoid tight-fitting clothes, as this can cause you to perspire more and thus facilitate an outbreak of candidiasis.
• Always carry a bottle of hand sanitizer with you so you can apply it to your hands in public areas. When using public facilities, make sure to use disinfectant soap and dry your hands well.
• Cut the nails on your hands and feet, and always wash your hands, legs, and face upon returning home.
• Make sure you visit your doctor right away if the rash recurs.
• Try to take a bath or shower immediately after using a public swimming pool, and, again, use hand sanitizer.

Application of Mycolog

First, wash and dry your hands before applying; the affected area should be cleansed and dried as well. You should apply a thin film and gently rub it in, as instructed by your doctor.

The cream is to be applied twice daily in the morning and evening in the affected area; the preparation should be gently and thoroughly massaged into the skin. Avoid covering or wrapping the treated area, and wash your hands after use. Avoid contact with the eyes, mouth, and mucous membranes. If contact occurs, rinse with plenty of water until it starts to feel normal again. Mycolog works best if used at the same time daily. Complete your course of treatment in order to clear up the infection completely. If you notice any kind of improvement or if you feel better, keep using the medicine. It is only for external use; do not bring it into contact with your eyes. If it needs to be applied to the groin area, use it sparingly and wear clothes that are loose-fitting. If it is to be applied on skin covered by a diaper, do not use a tight-fitting diaper. If irritation occurs, do not use this drug, or if symptoms worsen or if there is no improvement, discontinue its use. It should not be used on children, since its safety and effectiveness are not yet confirmed. If, after twenty-five days, the symptoms persist, the cream should be discontinued.

If you miss a dose, use it as soon as you remember. Continue to use as prescribed by your doctor or as stated on the packaging label. If you have any doubts, consult your doctor, and make sure you are completely upfront regarding your habits and any addictions you may be suffering from. Unless you are completely honest with your doctor, you will not be able to get effective treatment prescribed to you. Remember to visit your doctor on a regular basis to better monitor your condition and to see if the drug has been effective in limiting and inhibiting candida in your body.

Interactions

Tell your doctor about any prescription and nonprescription/herbal products you are using with mycolog, especially corticosteroids taken by mouth (e.g., prednisone).

Side Effects

Nystatin is non-sensitizing and virtually non-toxic, and is also well-tolerated by all age groups. Rarely, it might cause irritation.

There are no known side effects aside from a possible allergic reaction in people who have a previous or unknown hypersensitivity to the drug.

Common side effects are: acne, cracking, stinging of the skin, burning sensation, excessive hair growth, dryness, skin inflammation around the mouth, hair follicle inflammation, itching, loss of skin color, irritation, secondary infection, skin atrophy and streaking of skin, easy bruising, blistering, and peeling skin.

Watch out for signs of allergic reactions, such as:

• Rash: If you develop a rash as a result of using this cream, you need to stop right away and inform your doctor.
• Itching: If you develop severe itching upon using this medication, stop and inform your doctor to seek a viable alternative.
• Swelling: If you experience swelling in the area where you applied the cream, it could be an allergic reaction to mycolog. Consult your doctor right away and ask for a better alternative to treat your candidiasis.

If allergic reactions are severe, contact the doctor right away. These include rash, hives, itching, difficulty breathing, swelling of the mouth, face, lips or tongue, and tightness in the chest.

If you experience any other side effects, contact your healthcare provider.

Warnings

Before taking this medication, tell your doctor or pharmacist if you have the following:

• Allergy to nystatin, triamcinolone, or other corticosteroids (e.g., hydrocortisone, prednisone): If you are not sure what you are allergic to, ask your doctor to run a full-panel allergy test to determine the various allergens you are sensitive to. This will have a bearing on the prescribed treatment, so consult your doctor to find out if you are allergic to the cream or not.
• Pregnancy or lactation: If you are pregnant or lactating, tell your doctor;  another cream or ointment may be prescribed, if deemed necessary. The benefits and risks of using this drug during pregnancy need to be discussed with the doctor. It is not yet known whether mycolog enters the breast milk, hence, check with the doctor about any possible risks to your baby. Generally, corticosteroids have a teratogenic effect in laboratory animals when administered at a lower dose. However, there have been no teratogenic studies with combined nystatin and triamcinolone acetonide. Hence, any topical preparation that contains corticosteroids should not be used on pregnant patients extensively or in large amounts, or for prolonged periods.
• Pediatric use: In pediatric patients ranging from twelve years of age, mycolog cleared the disease in many of them, however, pediatric patients may be more susceptible to HPA axis suppression and Cushing’s syndrome because of a larger surface-area-to-body-weight ratio. In children receiving topical corticosteroids, HPA axis suppression, Cushing’s syndrome, and intracranial hypertension have been reported. Thus, the use of this drug should be limited, since chronic corticosteroids may interfere with the growth and development of children.
• If you are taking any prescription or non-prescription medicine, dietary supplements, or herbal preparations, some medicine might interact with mycolog. If any or little mycolog is absorbed into the blood, the risk of interaction with other medicines is low. Check with your healthcare provider whether mycolog may interact with any medicine you are taking. Check before you start, stop, or change the dose.
• If you are allergic to any medicines, foods, or other substances.
• If you have measles, had a skin test for tuberculosis, have tuberculosis, shingles, chicken pox, or wasting of the skin, or if you were vaccinated with a live or inactive vaccine.
• If you are diabetic, inform your doctor and ask your doctor to either change your diet or your dosage of antidiabetic medicine.

Topical corticosteroids are usually absorbed in sufficient amounts. With dermatologic use, over-dosage and serious adverse effects are unlikely.

In some patients, systemic absorption of topical corticosteroids have been observed to produce reversible hypothalamic-pituitary-adrenal axis suppression, manifestations of Cushing’s syndrome, and glycosuria. Conditions that trigger systemic absorption are an application of more potent steroids, application over a larger surface area, prolonged used, and the addition of occlusive dressings. Hence, such patients using large doses of potent topical steroids and applying them on a large surface area should be evaluated from time to time for HPA axis suppression. This evaluation can be done by using the urinary free cortisal and ACTH stimulation tests. They should also be checked for impairment of thermal homeostasis. If any of these occur, the drug should be stopped or frequency should be reduced, or it should be substituted with a less potent steroid. After the discontinuation of this drug, recovery from HPA axis suppression and thermal homeostasis is prompt.

Storage

Properly store the medicine at room temperature away from moisture and sunlight. Avoid freezing. Follow the instruction or labeling about storage. Keep out of the reach of children.

This cream is supplied in 15g, 30g, and 60g tubes and 120g jars.