Nebulising Amphotericin B or Nystatin

[Inez]

Hi I'm looking to treat my chronic sinus infection which I believe is fungal with nebulised Amphotericin B or Nystatin as Dr Neil Nathan recommends. I've bought the Rhino clear sprint nasal nebuliser. I'm having trouble figuring out which form of Amphotericin B or Nystatin I can buy. Is it safe to nebulise a tablet that has other ingredients in like any of the following:
Hydrogenated soy phosphatidylcholine

Cholesterol

Distearoylphosphatidylglycerol (sodium salt)

Alpha tocopherol

Sucrose

Disodium succinate hexahydrate

Sodium hydroxide (for pH adjustment)

Hydrochloric acid (for pH adjustment)

I can't find anything totally free of excipients. I don't have access to a compounding pharmacy that will prescribe this as I'm in the UK. I'm relying on goldpharma etc. What should I do?

 

[ruben]

A private doctor did recommend i take Nystatin back in the 1980s. It never did nothing for me.

 

[Shanti1]

If you think the fungal infection is localized to the sinuses and is not in the lungs, you should be able to use a netipot or sinus spray bottle instead of nebulizing, or does the Rhino clear sprint nasal nebulizer only reach the sinuses? I wouldn't nebulize nystatin with all those excipients if the device you have goes into the lungs as well as the sinuses. I have dissolved a nystatin tablet in a sinus spray bottle and used it that way. However, that doesn't mean it is a good idea, mostly because of the excipients.

If you were thinking of using the amphotericin B powder for IV, it is in a liposomal form, so one has to consider that anything nebulized or sprayed intranasally using that preparation could be absorbed systemically, even so, it seems like a small systemic dose compared to what you would get if you took the whole dose IV. I'm not knowledgeable enough to know if the fats in the liposomal formula would be a problem for the lungs if nebulized. The amphotericin B lozenge I have is called Fungilin and it has quite a few sweetners. I'd be hesitant to use it as a nasal spray.

Mostly, I've taken and continue to take nystatin and amphotericin B orally for oral/intestinal Candida krusei infection. The nystatin I take as a tablet and the amphotericin B as a lozenge. I don't have side effects from the nystatin, but the amphotericin B increases my fatigue, even though it is considered poorly absorbed orally. Nystatin has negligible oral absorption. I only tried the nystatin nasal spray a couple of times.