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Disclaimer to the On-line Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

GENTIAN VIOLET

Indication

  • the treatment of persisting mucocutaneous candidiasis (caused by Candida albicans) which is not responsive to nystatin oral suspension

Pharmacology

  • gentian violet is known by several other names, including crystal violet, methylrosaniline and hexamethylpararosaniline
  • it occurs as a dark green powder; the solution becomes a dark, purple colour
  • the mechanism of action of its antifungal action is unknown; gentian violent is, however, also active against Gram-positive bacteria and is thought to act on the cell wall

Side Effects

  • usually well tolerated, but may cause irritation or sensitivity reactions and ulceration of mucous membranes
  • esophagitis, laryngitis or tracheitis may result from swallowing the solution
  • tattooing of the skin may result if gentian violet is applied to granulation tissue; therefore, do not use on ulcerative lesions
  • will stain clothing and skin
  • buccal mucosal ulceration has occurred with gentian violet 0.5 to 1% solution; alcohol-free gentian violet (or minimal alcohol content) may prevent this

Dose

  • a 0.25% or 0.5% solution may be as effective as a 1% solution; paint the inside of the mouth where the lesions occur with a Q-tip. INFANTS SHOULD BE TURNED FACE DOWNWARD AFTER APPLICATION TO MINIMIZE ANY INGESTION OF THIS DRUG
  • specify alcohol-free when ordering this drug
  • therapy may be very effective with as few as 1 or 2 applications, but may be used for up to 3 days if required
  • applied 2 or 3 times daily

Supplied

  • 0.25, 0.5, 1% solutions of gentian violet (alcohol free)

    (Be sure to indicate "alcohol free" when ordering this medication)

References

  1. McEvoy G K (ed): AHFS Drug Information, American Society of Hospital Pharmacists, 1991.
  2. Cloherty JP and Stark AR (eds): Manual of Neonatal Intensive Care, Little, Brown and Company, 1991.
  3. Drugs Dex, Denver, Colorado, 1992.
  4. Bhatt DR, Furman GI, Reber DJ et al: Neonatal Drug Formulary, 1990-1991, 2nd Edition, Fontana, California 92334.



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