Natamycin

Natamycin is an Antifungal agent belonging to the pharmacological class of Polyene Antifungals.

Natamycin has been approved to relieve symptoms and also for the treatment and maintenance of Fungal blepharitis or conjunctivitis, Fungal keratitis.

The common side effects of Natamycin include Mild eye irritation or discomfort, such as redness, stinging, or burning, Allergic reactions, Changes in vision, Chest pain, Corneal opacity (clouding of the cornea), Shortness of breath, Eye swelling, Eye pain, Sensation of something in the eye, Weakness, Excessive tearing.

Natamycin is available in the form of Ophthalmic suspension.

Natamycin is approved in Germany, Japan, Malaysia, India, the U.K., the U.S., and China.

Natamycin, belonging to the pharmacological class of Polyene Antifungal, acts as an Antifungal agent.

Natamycin acts by binding to ergosterol, a crucial sterol that maintains the stability of fungal cell membranes. This interaction leads to a disruption of cell membrane integrity, resulting in the loss of intracellular potassium and other cellular components. Natamycin demonstrates fungicidal activity in a dose-dependent manner, effectively combating various yeast and filamentous fungi in vitro. The antifungal spectrum of natamycin encompasses Candida, Aspergillus, Fusarium, Acremonium (previously known as Cephalosporium), and Penicillium species.

Natamycin has been approved to relieve symptoms and also for the treatment and maintenance of Fungal blepharitis or conjunctivitis, Fungal keratitis.

Natamycin is found to be available in the form of Ophthalmic suspension.

Natamycin can be used in the following treatment:

• Fungal blepharitis or conjunctivitis
• Fungal keratitis

Natamycin can help to relieve symptoms and also for the treatment and maintenance of Fungal blepharitis or conjunctivitis, Fungal keratitis.

Natamycin is approved for use in the following clinical indications:

• Fungal blepharitis or conjunctivitis
• Fungal keratitis

For fungal blepharitis or conjunctivitis:

• Ophthalmic use: Instill 1 drop into the conjunctival sac 4 to 6 times daily.

For fungal keratitis:

• Ophthalmic use: Instill 1 drop into the conjunctival sac every 1 to 2 hours. After 3 to 4 days, reduce to one drop 6 to 8 times daily. The typical treatment duration is 2 to 3 weeks or until the fungal keratitis resolves (it may be beneficial to gradually reduce the dosage at 4- to 7-day intervals to ensure complete elimination of the organism).

Natamycin is available in the following dosage forms and strengths:

• Ophthalmic suspension : 5%

Ophthalmic suspension.

• Dosage Adjustments in Kidney Patients:

There are found to be no dosage adjustments in the manufacturer's labeling.

• Dosage Adjustments in Hepatic Impairment Patients:

There are found to be no dosage adjustments in the manufacturer's labeling.

• Dosage Adjustments in Pediatric Patients:

No specific dosage adjustments of pediatric patients have been found in the manufacturer's labeling

When taking Natamycin, there are certain dietary restrictions that should be followed to ensure the medication's effectiveness and safety:

• There are no specific food warnings associated with the use of Natamycin. The dietary restriction should be individualized as per patient requirements.

Natamycin may be contraindicated under the following conditions:

• Hypersensitivity to the active substance or to any of the excipients.

This medication is intended for topical ophthalmic use only and should not be injected. If there is no improvement in keratitis after 7-10 days of using this drug, it may indicate that the infection is caused by a microorganism not responsive to natamycin.

The decision to continue therapy is to be based on a clinical re-evaluation and additional laboratory studies. It is common for the suspension to adhere to areas of epithelial ulceration or be retained in the fornices.

The excretion of natamycin in human milk is not known. As many drugs are excreted in human milk, caution should be exercised when administering natamycin to nursing women.

Pregnancy:

There has been no animal reproduction studies conducted with natamycin. Its potential to cause harm to fetal development in pregnant women or affect reproductive capacity is also unknown. Natamycin (natamycin ophthalmic suspension) 5% should only be given to pregnant women when it is clearly necessary.

There are certain food-related warnings and precautions to consider when using Natamycin:

• There are no specific food warnings associated with the use of Natamycin.

The adverse reactions related to Natamycin can be categorized as follows:

• Mild eye irritation or discomfort, such as redness, stinging, or burning.
• Allergic reactions.
• Changes in vision.
• Chest pain.
• Corneal opacity (clouding of the cornea).
• Shortness of breath.
• Eye swelling.
• Eye pain.
• Sensation of something in the eye.
• Weakness.
• Excessive tearing.

The clinically relevant drug interactions of Natamycin is briefly summarized here

• No noticeable drug interactions has been found

The following are the side effects involving Natamycin:

• Mild eye irritation or discomfort, such as redness, stinging, or burning.
• Allergic reactions.
• Changes in vision.
• Chest pain.
• Corneal opacity (clouding of the cornea).
• Shortness of breath.
• Eye swelling.
• Eye pain.
• Sensation of something in the eye.
• Weakness.
• Excessive tearing.

The use of Natamycin should be prudent in the following group of special populations:

Pregnancy:

There has been no animal reproduction studies conducted with natamycin. Its potential to cause harm to fetal development in pregnant women or affect reproductive capacity is also unknown. Natamycin (natamycin ophthalmic suspension) 5% should only be given to pregnant women when it is clearly necessary.

Lactation:

The excretion of natamycin in human milk is not known. As many drugs are excreted in the human milk, caution should be exercised when administering natamycin to nursing women.

Pediatric Use:

The safety and effectiveness of natamycin in pediatric patients have not been established.

Geriatric Use:

No significant differences in safety or effectiveness have been observed between elderly and younger patients when using natamycin.

The physician should be vigilant about the knowledge pertaining to the identification and treatment of overdosage of Natamycin.

No detailed information has been found related to the overdose of Natamycin.

Pharmacodynamics:

Natamycin, derived from Streptomyces natalensis, is an antifungal medication used for topical ophthalmic purposes. It is a tetraene polyene antibiotic effective against various yeast and filamentous fungi, including Candida, Aspergillus, Cephalosporium, Fusarium, and Penicillium when tested in vitro. It exhibits dose-dependent antifungal activity and is mainly fungicidal. However, natamycin does not show efficacy against gram-positive or gram-negative bacteria in vitro. When topically administered, natamycin achieves effective concentrations within the corneal stroma but not in the intraocular fluid.

Pharmacokinetics:

No detailed information has been found in the product monographs.

1. https://go.drugbank.com/drugs/DB00826
2. https://www.sciencedirect.com/topics/medicine-and-dentistry/natamycin
3. https://www.drugs.com/cdi/natamycin.html
4. https://reference.medscape.com/drug/natacyn-natamycin-ophthalmic-343665
5. https://www.novartis.com/us-en/sites/novartis_us/files/natacyn.pdf
6. https://www.rxlist.com/natacyn-drug.htm#warnings
7. https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/050514s009lbl.pdf