Natamycin (Pimaricin, Pimafucin, Natadrops, Natacyn) is a polyene antifungal agent originally isolated from Streptomyces natalensis found in a soil sample from Natal, South Africa. Natamycin was discovered in DSM laboratories in 1955. Similar to other polyenes, natamycin binds to ergosterol in the fungal cell membrane. Natamycin blocks fungal growth by binding specifically to ergosterol without permeabilizing the membrane where it inhibits vacuole fusion at the priming phase and interferes with membrane protein functions. Natamycin is also used in the food industry as an effective preservative (E number E235).
Dose & Delivery
Natamycin is only used topically and it should be protected from light. As a 5% ophthalmic suspension, natamycin is used in the treatment of fungal keratitis, especially for Fusarium infection. Hourly use is important early in therapy.
Early intense treatment with natamycin results in a 75% visual recovery in patients with moderate or mild fungal keratitis and a 60% recovery in those with severe fungal keratitis.
A 1% ointment is also available and may be used for skin fungal infection.
Natamycin 10mg lozenges are used to treat oral candidiasis. They are taken 4-6 times daily for 14 days for treatment, or 3 times daily for prevention of oral candidiasis. They have also bee used to treat Candida vaginitis or thrush, and might have a particular place in treating fluconazole resistant Candida glabrata vaginitis.
Fungi - the drug is active against.
Natamycin is active against most Candida spp. Aspergillus spp., Fusarium spp. and other rarer fungi that cause keratitis. Secondary or acquired resistance is probably rare, but not extensively studied.
Metabolism distribution and excretion.
Natamycin is poorly soluble in water and not absorbed through the skin or mucous membranes, including the vagina. Very little is absorbed through the gastrointestinal tract. After ocular application, therapeutic concentrations are present within the infected cornea, but not in intra-ocular fluid.
Drug/ Drug interactions
There are very few drug/drug interactions with Natamycin. View drug interactions database.
Natamycin may cause some irritation on skin or mucous membranes.
Structure of natamycin