Boots 3 -> Vamp Scep -> Mana Regen (sometimes chalice, sometimes just a pendant or crystal) -> Anti-Lane Resist item -> Merc's/Tabi based on enemy team comp -> CDR Anti-Lane Resist Item -> Sheen/TF? BC/Ghostblade/Atmogs/FM? I dunno, I get a bit lost past this point. Pure tank works because of Q, but damage/speed tank works better for anti-kiting and wither-Qing the carry all day. CDR-capping Nasus is absolutely vital. Hm.
24% lifesteal at level 3 is just crazy ridiculous sustain. Nasus's lifesteal was not nerfed when lifesteal and sustain overall were. --- If inflaton turns $3 into $0, then $6 turns into $3. -Orca
And as for items I've been going for Gauntlet and Spirit Visage, along with a Warmogs, Sunfire, or other tanky item.. Locket is actually a pretty decent item for him too. As is Shurelya's --- And then John was a zombie.