Retapamulin

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Retapamulin
Retapamulin.svg
Retapamulin 3D sticks.png
Names
Trade namesAltabax, Altargo
  • (3aS,4R,5S,6S,8R,9R,9aR,10R)-6-ethenyl-5-hydroxy-4,6,9,10-tetramethyl-1-oxodecahydro-3a,9-propano-3aH-cyclopenta[8]annulen-8-yl{[(1R,3s,5S)-8-methyl-8-azabicyclo[3.2.1]oct-3-yl]sulfanyl}acetate
Clinical data
Pregnancy
category
  • US: B (No risk in non-human studies)
Routes of
use
Topical (ointment)
External links
AHFS/Drugs.comMonograph
MedlinePlusa607049
Legal
License data
Legal status
Pharmacokinetics
BioavailabilityLow
Protein binding94%
MetabolismLiver, CYP3A4-mediated
Elimination half-lifeUndetermined
ExcretionUndetermined
Chemical and physical data
FormulaC30H47NO4S
Molar mass517.77 g·mol−1
3D model (JSmol)
  • C[C@@H]1CC[C@@]23CCC(=O)[C@H]2[C@@]1([C@@H](C[C@@]([C@H]([C@@H]3C)O)(C)C=C)OC(=O)CS[C@@H]4C[C@H]5CC[C@@H](C4)N5C)C
  • InChI=1S/C30H47NO4S/c1-7-28(4)16-24(35-25(33)17-36-22-14-20-8-9-21(15-22)31(20)6)29(5)18(2)10-12-30(19(3)27(28)34)13-11-23(32)26(29)30/h7,18-22,24,26-27,34H,1,8-17H2,2-6H3/t18-,19+,20-,21+,22-,24-,26+,27+,28-,29+,30+/m1/s1 ☒N
  • Key:STZYTFJPGGDRJD-NHUWBDDWSA-N ☒N

Retapamulin, sold as the brand name Altabax among others, is a antibiotic which is applied to the skin to threat impetigo, a bacterial skin infection.[1] It is not useful against MRSA.[1]

Common side effects include irritation at the site it is used.[1] Other side effects may include allergic reactions such as angioedema.[1] It generally works by stopping bacterial growth by inhibiting the bacterial ribosome.[1]

Retapamulin was approved for medical use in the United States and Europe in 2007.[1][2] It; however, was withdrawn from the market in 2019 in Europe.[2] In the United States 15 grams of 1% cream costs about 325 USD as of 2021.[3] It was original made from a fungus.[4]

Medical uses

Retapamulin is used for the topical treatment of impetigo due to Staphylococcus aureus (methicillin-susceptible only) or Streptococcus pyogenes.[5]

Dosage

It is used twice per day for 5 days.[4]

Contraindications

None yet reported.[5]

Side effects

The most common reported adverse reaction was irritation at the application site.[5]

Pharmacology

Mechanism of action

Retapamulin is an antibacterial agent, specifically a protein synthesis inhibitor. The medication selectively inhibits bacterial protein synthesis by interacting at a site on the 50S subunit of the bacterial ribosome through an interaction that differs from other antibiotics.[5]

Pharmacokinetics

Systemic exposure following topical application through intact skin is low.[5]

History

It is the first drug in the new class of pleuromutilin antibiotics to be approved for human use.

It was withdrawn from the market in 2019 by Glaxo Group as they did not consider it commercially viable.[6]

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 "Retapamulin Monograph for Professionals". Drugs.com. Archived from the original on 6 August 2020. Retrieved 21 July 2021.
  2. 2.0 2.1 "Altargo". Archived from the original on 9 April 2021. Retrieved 21 July 2021.
  3. "Retapamulin Prices, Coupons & Savings Tips - GoodRx". GoodRx. Retrieved 21 July 2021.
  4. 4.0 4.1 Hartman-Adams, Holly; Banvard, Christine; Juckett, Gregory (15 August 2014). "Impetigo: Diagnosis and Treatment". American Family Physician. 90 (4): 229–235. ISSN 0002-838X. Archived from the original on 24 May 2021. Retrieved 21 July 2021.
  5. 5.0 5.1 5.2 5.3 5.4 Borrza, S.; Philippi, E., eds. (2007). Physicians' Desk Reference (62nd ed.). pp. 1318–20. ISBN 978-1-56363-660-8.
  6. "Altargo Withdrawal of the marketing authorisation in the European Union" (PDF). Archived (PDF) from the original on 18 March 2019. Retrieved 21 July 2021.

External links

Identifiers: