Retapamulin
Pronunciation: RE-te-PAM-ue-lin
Class: Antibacterial agent
Trade Names
Altabax
- Ointment, topical 1% (10 mg/g)
Pharmacology
Selectively inhibits bacterial protein synthesis, inhibiting peptidyl transfer, blocking P-site interactions, and preventing normal formation of active 50S ribosomal subunits.
Pharmacokinetics
Absorption
Systemic exposure after topical application to intact and debrided skin is low. Following twice-daily topical application, 11% of patients had measurable retapamulin concentrations with a median concentration of 0.8 ng/mL.
Distribution
Protein binding is approximately 94%.
Metabolism
In vitro studies indicate that CYP3A4 is the major enzyme responsible for the metabolism of retapamulin to numerous metabolites.
Indications and Usage
Topical treatment of impetigo caused by Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes .
Contraindications
None well documented.
Dosage and Administration
AdultsTopical Apply a thin layer to the affected area (up to 100 cm 2 in total area) twice daily for 5 days.
Children 9 mo of age and olderTopical Apply a thin layer to the affected area (up to 2% of total BSA) twice daily for 5 days.
Storage/Stability
Store between 59° and 86°F.
Drug Interactions
CYP3A4 inhibitors (eg, ketoconazole)Retapamulin plasma levels may be increased; however, dosage adjustments are unnecessary.
Adverse Reactions
CNS
Headache (2%).
Dermatologic
Eczema (1%).
EENT
Nasopharyngitis (2%).
GI
Diarrhea (2%); nausea (1%).
Local
Application-site irritation, application-site pruritus (2%).
Precautions
Pregnancy
Category B .
Lactation
Undetermined.
Children
Safety and efficacy not established in children younger than 9 mo of age.
Superinfection
May promote overgrowth of nonsusceptible microorganisms.
Local effects
If sensitization or severe local irritation occurs, discontinue use and wipe off ointment.
Mucosal or systemic use
Not intended for ingestion; oral, intranasal, ophthalmic, or intravaginal use; or use on mucosal surfaces.
Overdosage
Symptoms
Not reported.
Patient Information
- Advise patient that product is not intended for ingestion; oral, intranasal, ophthalmic, or intravaginal use; or use on mucosal surfaces (eg, lips, mouth, inside nose).
- Advise patient that treated area may be covered by a sterile bandage or gauze dressing, if desired.
- Instruct patients to use product for the full time recommended by health care provider, even if symptoms have improved.
- Instruct patients to notify health care provider if there is no improvement in symptoms within 3 to 4 days of starting treatment.
- Instruct patients to notify health care provider if irritation, redness, itching, burning, swelling, blistering, or oozing worsens in the area applied.
Copyright © 2009 Wolters Kluwer Health.
