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Polyene antifungals !

Antifungals that bind ergosterol and open holes in the fungal membrane. Amphotericin B goes by vein; nystatin works only on skin and mucosa.

Updated 2026-11-01

What they are

Large ring-shaped molecules made by Streptomyces bacteria. Amphotericin B is the broad, fungicidal drug for life-threatening invasive mycoses; nystatin is barely absorbed and is used only locally for Candida in the mouth, gut and skin.

Mechanism of action

Polyenes bind ergosterol, the main sterol of fungal membranes, and group into channels that let potassium and other ions leak out until the cell dies. They also bind cholesterol in human membranes, less strongly, which explains amphotericin B's kidney and infusion toxicity.

Target: Ergosterol in the fungal cell membrane

Drugs in this class

Others in the class

  • natamycin (eye drops)

Test yourself

Think of the answer, then tap the question to see it.

Why does amphotericin B damage human cells at all?

It prefers ergosterol but also binds cholesterol in human membranes, especially in the kidney tubule, which causes leaks and nephrotoxicity.

Can nystatin treat candidaemia?

No. It is almost not absorbed from the gut or skin, so it only acts where it is applied: mouth, gut or skin.

Which two electrolytes are watched most closely with amphotericin B?

Potassium and magnesium, which are lost through the damaged kidney tubule.

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← All of pharmacology

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: DailyMed - AMPHOTERICIN B injection, powder, lyophilized, for solution (DailyMed (U.S. National Library of Medicine), 2022); DailyMed - AMPHOTERICIN B injectable, liposomal (DailyMed (U.S. National Library of Medicine), 2026); DailyMed - NYSTATIN ORAL SUSPENSION- nystatin suspension (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 61 (McGraw Hill, 2023).

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Representative model, for educational purposes only.