Mupirocin (Taro-Mupirocin)

1. Health Canada Product Monograph — Mupirocin

• Mupirocin ointment treats impetigo caused by susceptible Staphylococcus and Streptococcus species.
• Mupirocin ointment treats superficially infected dermatoses and moist, weeping skin lesions caused by susceptible bacteria.
• Mupirocin ointment can be used on minor cuts, abrasions, and wounds to help prevent infection by susceptible gram-positive bacteria.
• Mupirocin should be used only for infections proven or strongly suspected to be caused by susceptible bacteria, to help limit the development of antibiotic resistance.

• The safety of mupirocin during pregnancy has not been established; if used in pregnancy, the potential benefits should be weighed against any possible risk to the baby, though animal studies have not shown evidence of harm to the developing fetus.

• There is no information on whether mupirocin passes into human breast milk, so caution is advised when using it in nursing mothers; if treating a cracked nipple, wash the area thoroughly before breastfeeding or expressing milk, and discard any milk expressed from a treated breast.

• Mupirocin has not been specifically studied in patients over 65, so its use in this age group should be discussed with a healthcare provider.

• Mupirocin's use in children under 12 years old should be discussed with a healthcare provider, since it has not been specifically studied in this age group.

• Apply a small amount of mupirocin ointment to cover the affected area three times a day for up to 10 days, depending on response.
• The treated area may be covered with a gauze dressing if desired.
• Wash your hands before and after applying the ointment.
• Discard any product remaining at the end of the treatment course.
• Do not mix mupirocin with other creams, lotions, or ointments, as this can dilute it and reduce its antibacterial effect.
• Use caution when applying to patients with moderate to severe kidney impairment, since excess absorption of the ointment base through damaged skin could occur.

If overdose is suspected, seek emergency medical attention immediately or contact your regional Poison Control Centre without delay.

• The product monograph notes that overdose has not been known to occur with topical use of mupirocin ointment, and describes no specific toxic syndrome for this route.

• A burning sensation at the site of application may occur.
• Itching at the application site may occur.
• Redness at the application site may occur.
• Stinging at the application site may occur.
• Dryness of the skin at the application site may occur.

Serious side effects require immediate discussion with the prescriber or emergency care.

• Rarely, mupirocin can cause a skin sensitization reaction (contact allergy) to the medication or its ointment base.
• Very rarely, systemic allergic reactions, including anaphylaxis, hives, swelling (angioedema), and widespread rash, have been reported.
• Very rarely, inflammation of the bowel with diarrhea, sometimes containing blood or mucus, along with stomach cramps and fever, has been reported with antibiotic use, including topical mupirocin.
• Seek urgent medical attention for signs of a severe allergic reaction, such as swelling of the face, lips, tongue, or throat, hives, or difficulty breathing.

• Use with caution in patients with moderate to severe kidney impairment, especially when applying to large areas of broken or damaged skin, due to potential absorption of the ointment base.
• Use with caution near the eyes; if accidental contact occurs, rinse thoroughly with water.
• This ointment is not suitable for use in the eyes, inside the nose, or in conjunction with catheters or intravenous lines.
• Discontinue use and consult a healthcare provider if irritation, sensitization, or worsening of the condition occurs.
• If the infection does not improve after 10 days of treatment, consult a healthcare provider, since prolonged use may allow overgrowth of non-susceptible organisms.

• Contraindicated in patients with a known hypersensitivity to mupirocin or any ingredient in the ointment.

• No known serious drug interactions have been identified with topically applied mupirocin.
• There is no evidence of cross-resistance between mupirocin and other classes of antibiotics.

• Mupirocin is applied to the skin, not taken by mouth, so food and meal timing do not apply to its use.

• Apply mupirocin ointment at evenly spaced times, three times a day, to maintain consistent antibacterial coverage of the treated area.
• Since this is a topical medicine applied to the skin, there is no relationship between application and meals.

• Store mupirocin ointment between 15°C and 25°C, and do not freeze it.

• Mupirocin is an antibiotic ointment for bacterial skin infections; it will not help viral infections such as cold sores.
• Complete the full course as directed, even if the skin looks better early, to help fully clear the infection and reduce the risk of resistance.
• Avoid contact with the eyes, and stop using the product and contact a healthcare provider if irritation, an allergic reaction, or worsening of the infection occurs.