Retapamulin (Topical)

It is the first pleuromutilin antibiotic to receive approval for use amongst humans, being approved by the FDA in April 2007, and the European Medicines Agency in May of the same year.


Retapamulin is topically-applied antibiotic, the first of the pleuromutilin class of these drugs that was approved for use in humans. It is most commonly prescribed for the treatment of bacterial skin disorders caused by infection, such as impetigo, though the clinical assessment of the drug has indicated certain levels of efficacy in its treatment of the MRSA bacteria, and several other Gram-positive bacteria.

Retapamulin is marketed in the United States as an ointment as Altargo and Altabax.

Retapamulin is an antibacterial treatment that works by killing the bacteria causing the infection. More significantly, it is a protein synthesis inhibitor, is function happening by selectively inhibiting the synthesis of protein amongst bacteria, thus denying further spread of the infection.

Retapamulin is well-known for provoke limited side effects among patients. The most commonly reported negative impact from using the drug is a slight irritation at the site of its application.

Retapamulin is only available under a prescription from a medical professional.

Retapamulin is available in the following forms:

  • ointment

Conditions Treated

Type of Medicine

  • Pleuromutilin antibiotic
  • Protein synthesis inhibitor

Side Effects

As well as is desired and necessary impact, many medications can provoke several unwanted reactions. Although the effects listed below are thought to be rare occurrences among patients using retapamulin, should you begin to exhibit any of them, you will need to speak to your prescribing doctor.

Consult a medical professional as soon as possible, should any of the side effects listed here start to present themselves.

  • warm skin (unusually so)
  • an oozing, scaly, and encrusted skin rash
  • pain at the application site
  • swelling of the skin
  • soreness, itching, severe reddening, or scaling of the skin
  • flushing and reddening of the skin
  • soreness, swelling, rash, reddening, itching, or burning at the site of application
  • flaking, dryness, crusting, burning, and blistering of the skin

There are other side effects that can occur when using retapamulin that, unlike those listed above, are unlikely to require the attention of a medical expert. Such effects tend to dissipate throughout your treatment, because your body becomes used to the medication. Additionally, your prescribing doctor might be able to offer some information and tips on the best ways to mitigate some of the effects listed below. If any of these effects continue beyond a couple of days, or should any of them begin to bother you, speak to a medical expert to discuss the matter.

The effects listed above are the most widely reported to occur as a result of taking retapamulin. It is possible that other negative effects will present themselves among certain patients. Should you suffer from any ill-effects not listed here during your course of treatment with the drug, ensure that you speak to your prescribing doctor about the matter.


The dose of retapamulin you are prescribed will doubtless differ from one patient to another. Always follow the instructions on the medicine's label or the direct advice of your prescribing doctor. The information provided here is solely based on the average prescribed dosage of retapamulin, and your dosage could well be different. Under no circumstances should you change it, unless advised otherwise by your examining doctor.

The amount of retapamulin that you use will be determined by the strength of the lotion itself. The length of your course of treatment, the number of applications, and the time you should allow to pass between each one will also be determined by your specific medical condition.

For topical dosage ointment:

For impetigo:

Adults and children over the age of nine months: apply retapamulin to the area of skin affected twice per day, for a period of five days.

Children under the age of nine months: use and dosage of retapamulin will be decided upon by the child's prescribing doctor.

If you happen to miss a dosage of retapamulin, you should apply it again as soon as you can. Should it be nearly time for you to take your next dosage, however, you should skip the dosage that you missed, and return to the original, prescribed, regular dosage schedule.


Using retapamulin in conjunction with any of the medications listed below is not normally recommended, but it might be necessary under certain conditions. If one of the following is prescribed alongside retapamulin, your prescribing doctor might choose to amend the dosage, or the frequency of application to mitigate any known interactions.

  • Voriconazole
  • Tipranavir
  • Telithromycin
  • Telaprevir
  • Saquinavir
  • Ritonavir
  • Posaconazole
  • Nelfinavir
  • Nefazodone
  • Lopinavir
  • Ketoconazole
  • Itraconazole
  • Indinavir
  • Conivaptan
  • Cobicistat
  • Clarithromycin
  • Boceprevir
  • Atazanavir


Whenever you decide to use a particular medicine, you ought to compare the potential risks involved in using that particular drug against the possible benefit it will have in treating your condition. You should discuss the matter fully with your prescribing doctor.

For using Retapamulin, you should have consideration of the following issues.

Let your doctor know if you have used Retapamulin in the past, and have suffered any allergic, unusual, or otherwise negative reaction to the drug. Likewise, if you have suffered an allergic reaction to some other kind of medication, this is something you should also be telling your prescribing doctor about. Additionally, if you are allergic to any non-medicated products - dyes, for examples, or foods and preservatives - you doctor should be made aware of the fact.

There have been no appropriate studies performed upon the relationship between the effects of retapamulin and the age of the patient in children under the age of nine months. The efficacy and safety of the treatment in such patients have yet to be established.

Such studies as have been performed to date have failed to demonstrate any problems specific to the geriatric population that would inhibit or limit the use of retapamulin amongst the elderly.

Retapamulin is only to be used on the surface of the skin. On no account should you get this drug in your mouth, nose, eyes, or vagina. Do not apply to areas of skin that have scrapes, cuts, or abrasions. Should it accidentally get applied to such areas, it is important to rinse the ointment off immediately.

Before applying Retapamulin, it is advised that you wash your hands thoroughly with water and soap. Likewise, unless your hands are the area being treated, you are recommended to wash your hands thoroughly with water and soap immediately following application, as failure to do so can lead to the infection spreading to other parts of the body.

Before you apply Retapamulin, ensure that you wash the affected skin area itself with water and soap, before drying the area thoroughly. Once dry, you can apply a small amount of ointment in a thin layer upon the affected patch of skin, gently rubbing it in.

Once Retapamulin has been applied, you can cover the treated area of skin with a gauze dressing, or a sterile bandage should you choose to do so.

Continue to apply Retapamulin for the full course of treatment, even if it appears that you symptoms have begun to resolve themselves after a couple of applications. If you cease using Retapamulin too soon into your course, there is a risk of the infection not clearing up.

Should your skin condition fail to improve after three or four days, or if it starts to worsen, you should speak to your prescribing doctor.

Suffering from other medical conditions can affect how you use Retapamulin. If you suffer from any other condition, especially one listed below, inform your doctor prior to starting your treatment with Retapamulin.

Retapamulin should not be used if you suffer from the following conditions:

  • skin infections (apart from impetigo)


Retapamulin should be kept at room temperature, in a closed container, and kept away from direct light, moisture, and heat. Be sure to keep retapamulin from freezing.

Retapamulin should always be kept away from children.

If your prescription of retapamulin is no longer required, or out of date, do not keep hold of it.

Be sure to ask your doctor about the best way to dispose of any retapamulin that you no longer require.


Retapamulin is pleuromutilin antibiotic, the first of its kind to be approved for human use. It is commonly utilised in the treatment of bacterial skin infections, such as impetigo.

Retapamulin is applied topically to the affected areas of skin in the form of an ointment.

Whilst most commonly prescribed to treat impetigo, studies have shown that it proves most effective against certain strains of MRSA and several other Gram-positive bacteria.

It works by inhibiting the synthesis of protein among the infecting bacteria, restricting growth, and ultimately killing off the bacteria itself, whilst preventing the further spread of infection.


Last Reviewed:
January 30, 2018
Last Updated:
January 27, 2018