mupirocin (Rx)

Brand and Other Names:Bactroban, Bactroban Nasal, more...Centany
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

cream/topical ointment

  • 2%

nasal ointment

  • 2%

Impetigo

Apply 2% ointment to affected area q8hr

If no response in 3-5 days, reevaluate

Secondary Skin Infection

Apply cream to affected area q8hr x10 days

If no response in 3-5 days, reevaluate

Elimination of MRSA Colonization

Intranasal: Apply one-half of ointment from a single-use tube into each nostril q12hr for 5 days

Dosage Forms & Strengths

cream/topical ointment

  • 2%

nasal ointment

  • 2%

Impetigo

>2 months: Apply 2% ointment to affected area q8hr

If no response in 3-5 days, reevaluate

Secondary Skin Infection

>3 months: Apply cream to affected area q8hr x10 days

If no response in 3-5 days, reevaluate

Elimination of MRSA Colonization

Safety and efficacy not established

>12 years (intranasal): Apply one-half of ointment from a single-use tube into each nostril q12hr for 5 days

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Adverse Effects

1-10%

Headache (1.7%)

Nausea (1.7%)

Burning (1-3%)

Stinging (1-3%)

Pain (1-3%)

Pruritus (1-3%)

Rash (1-3%)

Cellulitis (1%)

Dry skin (1%)

Erythema (1%)

Incr exudate (1%)

Pain or bleeding secondary to eczema (1%)

Secondary wound infection (1%)

Swelling (1%)

Tenderness (1%)

Urticaria (1%)

Frequency Not Defined

Abdominal pain

Dizziness

Ulcerative stomatitis

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Warnings

Contraindications

Hypersensitivity

Cautions

Anaphylaxis, urticaria, angioedema, and generalized rash reported

Manufacturer cautions against use of mupirocin ointment in burn patients, particularly those with extensive burns, since potentially toxic amounts of polyethylene glycol (PEG) contained in the vehicle may be absorbed percutaneously

Avoid contact with eyes; in case of accidental contact, rinse well with water

Discontinue use in event of sensitization or severe local irritation from ointment

Clostridium difficile-associated diarrhea (CDAD) reported with use; if CDAD suspected or confirmed, discontinue ongoing antibacterial drug use not directed against C. difficile; institute appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C. difficile, and surgical evaluation, as clinically indicated

Prolonged use may result in overgrowth of nonsusceptible organisms, including fungi

Not formulated for use on mucosal surfaces; intranasal use has been associated with isolated reports of stinging and drying

Not for use in conditions where absorption of large quantities of polyethylene glycol possible, especially if there is evidence of moderate or severe renal impairment; polyethylene glycol can be absorbed from open wounds and damaged skin and is excreted by the kidneys

Ointment should not be used with intravenous cannulae or at central intravenous sites because of the potential to promote fungal infections and antimicrobial resistance

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Pregnancy & Lactation

Pregnancy

There are insufficient human data to establish whether there is drug-associated risk with therapy in pregnant women; systemic absorption of mupirocin through intact human skin is minimal following topical administration of mupirocin ointment; no developmental toxicity was observed in rats or rabbits treated with mupirocin subcutaneously during organogenesis at doses of 160 or 40 mg per kg per day, respectively (22 and 11 times the human topical dose based on calculations of dose divided by the entire body surface area)

Lactation

Not known whether mupirocin is present in human milk, has effects on breastfed child, or has effects on milk production; however, breastfeeding is not expected to result in exposure of child to drug due to minimal systemic absorption following topical administration; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from underlying maternal condition

To minimize oral exposure of drug to children, a breast and/or nipple being treated with mupirocin ointment should be thoroughly washed prior to breastfeeding

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Bactericidal; inhibits protein synthesis in susceptible bacteria by reversibly binding to bacterial isoleucine-tRNA ligase (isoleucyl-tRNA synthetase), the enzyme that catalyzes the formation of isoleucyl-tRNA from isoleucine and tRNA

Absorption

<0.3%

Distribution

Protein bound: 95-97% in vitro

Metabolism

Enzymes present within skin may partially inactivate mupirocin by metabolizing drug to monic acid

Elimination

Excretion: Urinary concentrations range from undetectable to 10.03 mcg/mL in adults and from undetectable to 1.3 mcg/mL in children

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Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.