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Details

Stereochemistry ABSOLUTE
Molecular Formula C30H47NO4S
Molecular Weight 517.763
Optical Activity UNSPECIFIED
Defined Stereocenters 11 / 11
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of RETAPAMULIN

SMILES

C[C@@H]1CC[C@@]23CCC(=O)[C@H]2[C@]1(C)[C@@H](C[C@@](C)(C=C)[C@@H](O)[C@@H]3C)OC(=O)CS[C@H]4C[C@@H]5CC[C@H](C4)N5C

InChI

InChIKey=STZYTFJPGGDRJD-NHUWBDDWSA-N
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

HIDE SMILES / InChI

Molecular Formula C30H47NO4S
Molecular Weight 517.763
Charge 0
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 11 / 11
E/Z Centers 0
Optical Activity UNSPECIFIED

Retapamulin is a topical antibiotic which was approved by FDA (Altabax brand name) for the treatment of impetigo due to Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes. Retapamulin exerts its antibacterial action by binding to 50S subunit of the bacterial ribosome.

Originator

Curator's Comment: Now a part of GlaxoSmithKline.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Curative
ALTABAX

Approved Use

ALTABAX is indicated for use in adults and pediatric patients aged 9 months and older for the topical treatment of impetigo (up to 100 cm2 in total area in adults or 2% total body surface area in pediatric patients aged 9 months or older) due to Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes.

Launch Date

2007
Curative
ALTABAX

Approved Use

ALTABAX is indicated for use in adults and pediatric patients aged 9 months and older for the topical treatment of impetigo (up to 100 cm2 in total area in adults or 2% total body surface area in pediatric patients aged 9 months or older) due to Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes.

Launch Date

2007
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
3.5 ng/mL
1 % 1 times / day multiple, topical
dose: 1 %
route of administration: Topical
experiment type: MULTIPLE
co-administered:
RETAPAMULIN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
49.6 ng × h/mL
1 % 1 times / day multiple, topical
dose: 1 %
route of administration: Topical
experiment type: MULTIPLE
co-administered:
RETAPAMULIN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
6%
1 % 1 times / day multiple, topical
dose: 1 %
route of administration: Topical
experiment type: MULTIPLE
co-administered:
RETAPAMULIN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
1 % 2 times / day multiple, topical
Recommended
Dose: 1 %, 2 times / day
Route: topical
Route: multiple
Dose: 1 %, 2 times / day
Sources:
unhealthy
Disc. AE: Skin irritation, Sensitization...
AEs leading to
discontinuation/dose reduction:
Skin irritation (severe)
Sensitization
Sources:
AEs

AEs

AESignificanceDosePopulation
Sensitization Disc. AE
1 % 2 times / day multiple, topical
Recommended
Dose: 1 %, 2 times / day
Route: topical
Route: multiple
Dose: 1 %, 2 times / day
Sources:
unhealthy
Skin irritation severe
Disc. AE
1 % 2 times / day multiple, topical
Recommended
Dose: 1 %, 2 times / day
Route: topical
Route: multiple
Dose: 1 %, 2 times / day
Sources:
unhealthy
OverviewDrug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
weak [IC50 1.1 uM]
unlikely (co-administration study)
Comment: retapamulin inhibited CYP3A4 isoenzyme activity, IC50 ranged from 1.1 uM with midazolam to 6.2 uM with nifedipine; I/Ki ratios are less than 0.1 for all CYP P450 isoenzymes and no clinically relevant DDI are anticipated when retapamulin is coadministered with other drugs metabolized by CYPs
Page: 6.0
weak [IC50 28.2 uM]
unlikely (co-administration study)
Comment: in vitro inhibitor of digoxin transport by P-gp with a calculated IC50 value of 28.2 uM; it is unlikely that retapamulin will inhibit P-gp mediated transport of co-administered drugs
Page: 5, 6
weak [IC50 >99 uM]
weak [IC50 >99 uM]
weak [IC50 >99 uM]
weak [IC50 >99 uM]
weak [IC50 >99 uM]
weak [IC50 >99 uM]
weak [IC50 >99 uM]
Drug as victimTox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
Sourcing

Sourcing

Vendor/AggregatorIDURL
PubMed

PubMed

TitleDatePubMed
Retapamulin: an antibacterial with a novel mode of action in an age of emerging resistance to Staphylococcus aureus.
2010-10
Retapamulin: an emerging antimicrobial allergen.
2010-05-22
The pleuromutilin antibiotics: a new class for human use.
2010-02
Retapamulin: a novel topical antibiotic.
2010-01-12
Retapamulin.
2010-01
Retapamulin: what is the role of this topical antimicrobial in the treatment of bacterial infections in atopic dermatitis?
2010-01
Daptomycin: a novel lipopeptide antibiotic against Gram-positive pathogens.
2010
Allergic contact dermatitis from retapamulin ointment.
2009-10-07
Mutilins derivatives: from veterinary to human-used antibiotics.
2009-10
Allergic contact cermatitis to retapamulin ointment.
2009-08
Lost in translation: differences in antimicrobial indication approval policies between the United States and Europe.
2009-07
Microbiological profile of a new topical antibacterial: retapamulin ointment 1%.
2009-04
Agents for the decolonization of methicillin-resistant Staphylococcus aureus.
2009-03
[Pediatric dermatology. New aspects of bacterial skin infections in children].
2009-03
Topical retapamulin in the management of infected traumatic skin lesions.
2009-02
Retapamulin for impetigo and other infections.
2008-10
In vitro activity of retapamulin against Staphylococcus aureus isolates resistant to fusidic acid and mupirocin.
2008-10
Gateways to clinical trials.
2008-09
Local antibiotics in dermatology.
2008-06-20
Efficacy and safety of retapamulin ointment as treatment of impetigo: randomized double-blind multicentre placebo-controlled trial.
2008-05
A primer on topical antibiotics for the skin and eyes.
2008-04
Drug treatments for skin disease introduced in 2007.
2008-03
Retapamulin (Altabax)--a new topical antibiotic.
2008-02-25
Retapamulin: a new topical antibiotic for the treatment of uncomplicated skin infections.
2008-02
Clones and drones: do variants of Panton-Valentine leukocidin extend the reach of community-associated methicillin-resistant Staphylococcus aureus?
2008-01-15
Current and novel antibiotics against resistant Gram-positive bacteria.
2008
Spotlight on retapamulin in impetigo and other uncomplicated superficial skin infections.
2008
Retapamulin: a review of its use in the management of impetigo and other uncomplicated superficial skin infections.
2008
Retapamulin: a semisynthetic pleuromutilin compound for topical treatment of skin infections in adults and children.
2007-12
Altabax approved to treat impetigo.
2007-10
Altabax (retapamulin ointment), 1%.
2007-09-06
[Introduction to cutaneous bacterial infections].
2007-09
New drugs: retapamulin, bismuth subcitrate potassium, and rotigotine.
2007-07-10
Gateways to clinical trials.
2007-06
Gateways to clinical trials.
2007-05
In vitro activity against anaerobes of retapamulin, a new topical antibiotic for treatment of skin infections.
2007-04
Topical retapamulin ointment, 1%, versus sodium fusidate ointment, 2%, for impetigo: a randomized, observer-blinded, noninferiority study.
2007
Molecule of the month. Retapamulin.
2006-12
Topical retapamulin ointment (1%, wt/wt) twice daily for 5 days versus oral cephalexin twice daily for 10 days in the treatment of secondarily infected dermatitis: results of a randomized controlled trial.
2006-12
Gateways to clinical trials.
2006-10
Retapamulin ointment twice daily for 5 days vs oral cephalexin twice daily for 10 days for empiric treatment of secondarily infected traumatic lesions of the skin.
2006-09-08
Activity of retapamulin (SB-275833), a novel pleuromutilin, against selected resistant gram-positive cocci.
2006-07
Patents

Patents

Sample Use Guides

A thin layer of retapamulin (Altabax) should be applied to the affected area (up to 100 cm2 in total area in adults or 2% total body surface area in pediatric patients aged 9 months or older) twice daily for 5 days.
Route of Administration: Topical
In vitro activity of retapamulin was determinde against methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and linezolid and methicillin-resistant S. aureus (LR-MRSA). MSSA and MRSA isolates were susceptible to retapamulin, with an MIC90 of 0.094 mg/L and 0.125 mg/L respectively, but retapamulin MICs for the 18 LR-MRSA strains were over 32 mg/L in all cases.
Substance Class Chemical
Created
by admin
on Mon Mar 31 18:07:27 GMT 2025
Edited
by admin
on Mon Mar 31 18:07:27 GMT 2025
Record UNII
4MG6O8991R
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
RETAPAMULIN
EMA EPAR   INN   MART.   MI   ORANGE BOOK   USAN   VANDF   WHO-DD  
USAN   INN  
Official Name English
ALTABAX
Preferred Name English
retapamulin [INN]
Common Name English
RETAPAMULIN [MI]
Common Name English
RETAPAMULIN [EMA EPAR]
Common Name English
SB275833
Code English
RETAPAMULIN [MART.]
Common Name English
(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
Common Name English
SB-275833
Code English
RETAPAMULIN [ORANGE BOOK]
Common Name English
RETAPAMULIN [USAN]
Common Name English
RETAPAMULIN [VANDF]
Common Name English
ALTARGO
Brand Name English
Retapamulin [WHO-DD]
Common Name English
ACETIC ACID, (((3-EXO)-8-METHYL-8-AZABICYCLO(3.2.1)OCT-3-YL)THIO)-, (3AS,4R,5S,6S,8R,9R,9AR,10R)-6-ETHENYLDECAHYDRO-5-HYDROXY-4,6,9,10-TETRAMETHYL-1-OXO-3A,9-PROPANO-3AH-CYCLOPENTACYCLOOCTEN-8-YL ESTER
Common Name English
NSC-759885
Code English
Classification Tree Code System Code
WHO-ATC D06AX13
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
WHO-VATC QD06AX13
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
NDF-RT N0000175434
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
NDF-RT N0000175433
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
NCI_THESAURUS C258
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
EMA ASSESSMENT REPORTS ALTARGO(AUTHORIZED IMPETIGO)
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
Code System Code Type Description
FDA UNII
4MG6O8991R
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
WIKIPEDIA
RETAPAMULIN
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
EPA CompTox
DTXSID00870265
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
INN
8494
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
CAS
224452-66-8
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
DRUG BANK
DB01256
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
MESH
C508887
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
EVMPD
SUB25391
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
RXCUI
642274
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY RxNorm
SMS_ID
100000089366
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
MERCK INDEX
m9551
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY Merck Index
USAN
PP-62
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
NSC
759885
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
NCI_THESAURUS
C61924
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
DAILYMED
4MG6O8991R
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
ChEMBL
CHEMBL409542
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
DRUG CENTRAL
2371
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
LACTMED
Retapamulin
Created by admin on Mon Mar 31 18:07:27 GMT 2025 , Edited by admin on Mon Mar 31 18:07:27 GMT 2025
PRIMARY
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