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Pharmacy and Medications

Treatment for oral thrush during pregnancy

01/18/2006

Question:

i am 12 weeks pregnant and i developed oral thrush (tongue) after taking antibiotics for 7 days.my doctor is hesistant to give me any antifungal because of the risk (to the baby). Is there a safe and effective antifungal for pregnant women/ fetus? Is it also true that even without treatment, oral thrush will be resolved? i am really worried, please help me

Answer:

Oral thrush is an infection caused by yeast that affects the mucous membranes of the mouth. Thrush is most often seen in patients taking certain antibiotics, or after chemotherapy treatment, but can occur due to other causes. Oral thrush of the tongue and inner cheeks may be painful and bleed slightly when rubbed or scraped.

Oral thrush is commonly treated with antifungal drugs. Even though there are a wide number of antifungal agents to choose from, they are not all safe in pregnancy. Nystatin may be a good alternative for pregnant women since it is minimally absorbed into the body. Nystatin is listed as a Pregnancy "Category C" drug, which means that animal reproduction studies have not been conducted using the drug. Designation of Category C also indicates that it is not known whether a drug may cause fetal harm when administered to a pregnant woman or affect reproduction capacity. Studies in humans have not shown that oral Nystatin causes birth defects or other problems. Nystatin may be given to a pregnant woman if clearly needed for a yeast/fungal infection.

There are many different forms of Nystatin. The dry powder, lozenge (pastille), and liquid forms of this medicine are commonly used to treat fungal infections of the mouth. Many physicians prescribe Nystatin oral suspension. Use of the ssuspension involves placing one-half of the dose in each side of the mouth, holding it there, swishing it around for as long as possible, then spitting it out or swallowing it per doctors orders. The goal of treatment is to stop the rapid spread of the fungus, and get control of it as soon as possible. Symptomatic relief usually occurs within 24-72 hours after starting therapy. Therapy for a period of 2 weeks is usually sufficient but more prolonged therapy may be necessary. Therapy should be continued for 48 hours after symptoms have disappeared to prevent relapse.

Submitted by Tenesha Harrington, PharmD candidate, University of Cincinnati

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Response by:

Jan Scaglione, MT, PharmD, D.ABAT
Assistant Professor of Pharmacy Practice
College of Medicine
University of Cincinnati