Drug & supplement interaction

Manganese + Retapamulin

Retapamulin brand names: Altabax, Altargo.

Moderate Interaction
The bottom line Moderate

Retapamulin falls into 2 drug categories that Manganese can interact with; the most serious is rated moderate. Theoretically, manganese might reduce the absorption of quinolone antibiotics.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Manganese and Retapamulin

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Manganese interacts with whole categories of medication. Retapamulin falls into 2 of those categories, so it can interact with Manganese in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

QUINOLONE ANTIBIOTICS

1 of 2

Why this applies to Retapamulin

Retapamulin falls under QUINOLONE ANTIBIOTICS — the group Manganese interacts with.

Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's some good news that should put your mind at ease. The interaction on file talks about manganese binding to quinolone antibiotics in the gut and blocking their absorption when you swallow them. But Retapamulin (Altabax) isn't taken by mouth at all. It's a topical ointment you spread directly on the skin to treat impetigo, so there's no real overlap with a manganese supplement you'd swallow.

On top of that, this concern is purely theoretical, based on how minerals like calcium and iron can grab onto oral antibiotics. It was never really meant for a skin cream. I wouldn't lose sleep over it, but if you have any questions about either product, your pharmacist is always happy to double-check things with you.

References
  1. Hansten PD, Horn JR. Hansten and Horn's Drug Interactions Analysis and Management. Vancouver, CAN:Appl Therapeut, 1999.
Moderate

TETRACYCLINE ANTIBIOTICS

2 of 2

Retapamulin also falls under TETRACYCLINE ANTIBIOTICS.

Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced tetracycline absorption have been reported between tetracyclines and other multivalent cations, such as calcium and iron.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's some good news that should put your mind at ease. The concern on file is that minerals like manganese can bind to tetracycline-type antibiotics in the gut and block them from being absorbed, which would weaken the antibiotic. But that applies to pills you swallow. Retapamulin (Altabax) is different. It's an ointment you rub on the skin to treat impetigo, so it isn't competing with your manganese supplement in your stomach at all.

On top of that, this interaction is only theoretical, based on how the minerals behave chemically, not on real cases. Because retapamulin works right on the skin, a manganese supplement is very unlikely to affect how well it clears your infection. Still, it never hurts to mention your supplements to your pharmacist or doctor.

References
  1. Hansten PD, Horn JR. Hansten and Horn's Drug Interactions Analysis and Management. Vancouver, CAN:Appl Therapeut, 1999.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Manganese Also Interacts With Other Medications

Manganese has 82 moderate known drug interactions in our database — the Retapamulin one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Manganese

Covers the 2,830 medications we’ve checked against Manganese. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Retapamulin

This page covers Manganese only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Retapamulin page lists 81 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Oleander (major), Para-aminobenzoic Acid (paba) (major), Acerola (moderate), Alpha-lipoic Acid (moderate) and Bacillus Coagulans (moderate).

By severity: 2 major · 71 moderate · 8 minor.

Open the Retapamulin interaction page

One more smart check

Taking Manganese as Part of a Dietary Supplement Product? Check It for Interactions

We hold 16,006 real supplement products containing Manganese, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Manganese. Your product may carry other ingredients that interact with Retapamulin too, on top of Manganese — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Manganese and Retapamulin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Manganese
Top 5%

#18 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Retapamulin
Steady interest

#1,921 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Manganese

What is Manganese?

Manganese
  • Bone health support
  • Antioxidant and enzyme support
  • Filling dietary gaps
  • Metabolism support
  • Wound healing

Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements may help if you have a genuine deficiency, but too much can be harmful—especially to the nervous system—so do not take high doses without guidance from a pharmacist or doctor.

Read the full Manganese monograph & all interactions
Medication

About Retapamulin

What Is Retapamulin Used For?

Brand names: Altabax, Altargo

  • Retapamulin is used to treat impetigo (a skin infection caused by bacteria) in children and adults. Retapamulin is in a class of medications called antibacterials. It works by killing and stopping the growth of bacteria on the skin.

See full Retapamulin drug information
Keep checking

Other Drugs & Manganese

Browse every other medication we’ve checked against Manganese — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
82Moderate
0Minor
2,747No known interaction
Moderate

82 interactions

Showing 60 of 82 moderate interactions — see all 82 on the Manganese page.

No interaction 2,747 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Manganese and Retapamulin Together: Common Questions

Can you take Manganese with Retapamulin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Manganese and Retapamulin?
Retapamulin belongs to more than one drug category, and Manganese interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Manganese and Retapamulin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.