MUPIROCIN
Clinical safety rating: safe
Animal studies have demonstrated safety
Mupirocin reversibly binds to bacterial isoleucyl-tRNA synthetase, inhibiting protein synthesis.
| Metabolism | Mupirocin is rapidly metabolized to monic acid, its inactive metabolite, following systemic absorption. |
| Excretion | Renal: <1% unchanged (topical); hepatic metabolism to monic acid, eliminated renally and fecally. After IV administration, 60-70% renal, 20-30% fecal/biliary. |
| Half-life | Intravenous: ~30 min (0.5 h). Topical: systemically absorbed amount negligible, local half-life not defined. |
| Protein binding | 95-97% bound to serum albumin. |
| Volume of Distribution | IV: 0.2-0.3 L/kg (small, limited to extracellular fluid; not distributed into CNS). |
| Bioavailability | Topical: minimal systemic absorption (<0.24% of dose); oral: negligible; IV: 100%. |
| Onset of Action | Topical: within 24-48 hours for bacterial inhibition; clinical improvement typically 3 days. |
| Duration of Action | Topical: bacteriostatic for up to 8 hours at site; clinical course treated for 5-14 days depending on indication. |
Apply a small amount of 2% ointment or cream to affected area three times daily for 5 to 14 days.
| Dosage form | CREAM |
| Renal impairment | No dosage adjustment required for topical use; oral absorption negligible. For intravenous use, mupirocin not available systemically. |
| Liver impairment | No dosage adjustment required for topical use; mupirocin is not hepatically metabolized. |
| Pediatric use | Age 2 months and older: Apply small amount of 2% ointment or cream to affected area three times daily for 5 to 14 days. For intranasal use: Apply half of a single-use tube (approximately 0.5 g) into each nostril twice daily for 5 days. |
| Geriatric use | No specific adjustments; use same dosing as adults. Monitor for skin irritation due to age-related skin changes. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
No significant drug interactions For topical use only not for ophthalmic use.
| Breastfeeding | Unknown if mupirocin is excreted in human milk following topical application. Due to minimal systemic absorption, risk to nursing infant is likely low. Use with caution. |
| Teratogenic Risk | Animal studies have not shown evidence of fetal harm at topical doses. No well-controlled human studies. Systemic absorption is minimal. Use during pregnancy only if clearly needed. |
| Fetal Monitoring |
■ FDA Black Box Warning
None.
| Common Effects | Itching Burning sensation Stinging sensation Pain |
| Serious Effects |
["Hypersensitivity to mupirocin or any component of the formulation.","Not for use in patients with known history of severe allergic reactions to mupirocin."]
| Precautions | ["Prolonged use may result in overgrowth of non-susceptible organisms including fungi.","Not for intranasal use in infants less than 1 month of age (calcium mupirocin formulation).","For topical use only; avoid contact with eyes.","Severe allergic reactions including anaphylaxis have been reported."] |
Loading safety data…
| No specific monitoring required for topical use. For systemic toxicity (rare), monitor renal function if extensive application. |
| Fertility Effects | No known effects on fertility in animal studies. |