U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

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

[H][C@@]12C(=O)CC[C@]13CC[C@@H](C)[C@@]2(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: Page: p.1
unhealthy
Health Status: unhealthy
Condition: impetigo due to Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes
Sources: Page: p.1
Disc. AE: Skin irritation, Sensitization...
AEs leading to
discontinuation/dose reduction:
Skin irritation (severe)
Sensitization
Sources: Page: p.1
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: Page: p.1
unhealthy
Health Status: unhealthy
Condition: impetigo due to Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes
Sources: Page: p.1
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: Page: p.1
unhealthy
Health Status: unhealthy
Condition: impetigo due to Staphylococcus aureus (methicillin-susceptible isolates only) or Streptococcus pyogenes
Sources: Page: p.1
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
Molecule of the month. Retapamulin.
2006 Dec
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 Dec
Activity of retapamulin (SB-275833), a novel pleuromutilin, against selected resistant gram-positive cocci.
2006 Jul
Gateways to clinical trials.
2006 Oct
Topical retapamulin ointment, 1%, versus sodium fusidate ointment, 2%, for impetigo: a randomized, observer-blinded, noninferiority study.
2007
In vitro activity against anaerobes of retapamulin, a new topical antibiotic for treatment of skin infections.
2007 Apr
Gateways to clinical trials.
2007 Jun
Gateways to clinical trials.
2007 May
Altabax approved to treat impetigo.
2007 Oct
[Introduction to cutaneous bacterial infections].
2007 Sep
Current and novel antibiotics against resistant Gram-positive bacteria.
2008
Spotlight on retapamulin in impetigo and other uncomplicated superficial skin infections.
2008
Retapamulin (Altabax)--a new topical antibiotic.
2008 Feb 25
Retapamulin for impetigo and other infections.
2008 Oct
In vitro activity of retapamulin against Staphylococcus aureus isolates resistant to fusidic acid and mupirocin.
2008 Oct
Gateways to clinical trials.
2008 Sep
Microbiological profile of a new topical antibacterial: retapamulin ointment 1%.
2009 Apr
Allergic contact dermatitis from retapamulin ointment.
2009 Jul-Aug
Mutilins derivatives: from veterinary to human-used antibiotics.
2009 Oct
Daptomycin: a novel lipopeptide antibiotic against Gram-positive pathogens.
2010
The pleuromutilin antibiotics: a new class for human use.
2010 Feb
Retapamulin.
2010 Jan
Retapamulin: what is the role of this topical antimicrobial in the treatment of bacterial infections in atopic dermatitis?
2010 Jan
Retapamulin: an emerging antimicrobial allergen.
2010 May-Jun
Retapamulin: an antibacterial with a novel mode of action in an age of emerging resistance to Staphylococcus aureus.
2010 Oct
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 Fri Dec 15 15:45:10 GMT 2023
Edited
by admin
on Fri Dec 15 15:45:10 GMT 2023
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
retapamulin [INN]
Common Name English
RETAPAMULIN [MI]
Common Name English
ALTABAX
Brand 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 Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
WHO-VATC QD06AX13
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
NDF-RT N0000175434
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
NDF-RT N0000175433
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
NCI_THESAURUS C258
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
EMA ASSESSMENT REPORTS ALTARGO(AUTHORIZED IMPETIGO)
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
Code System Code Type Description
FDA UNII
4MG6O8991R
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
WIKIPEDIA
RETAPAMULIN
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
EPA CompTox
DTXSID00870265
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
INN
8494
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
CAS
224452-66-8
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
DRUG BANK
DB01256
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
MESH
C508887
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
EVMPD
SUB25391
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
RXCUI
642274
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY RxNorm
SMS_ID
100000089366
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
MERCK INDEX
m9551
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY Merck Index
USAN
PP-62
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
NSC
759885
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
NCI_THESAURUS
C61924
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
DAILYMED
4MG6O8991R
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
ChEMBL
CHEMBL409542
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
DRUG CENTRAL
2371
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
LACTMED
Retapamulin
Created by admin on Fri Dec 15 15:45:10 GMT 2023 , Edited by admin on Fri Dec 15 15:45:10 GMT 2023
PRIMARY
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