Drug & supplement interaction

Squill + Retapamulin

Retapamulin brand names: Altabax, Altargo.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Retapamulin falls into 2 drug categories that Squill can interact with; the most serious is rated moderate. Macrolide antibiotics appear to increase the gastrointestinal absorption of oral digoxin.

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

Squill and Retapamulin

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

Why Are There 2 Interactions?

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

Moderate

MACROLIDE ANTIBIOTICS

1 of 2

Why this applies to Retapamulin

Retapamulin falls under MACROLIDE ANTIBIOTICS — the group Squill interacts with.

Macrolide antibiotics appear to increase the gastrointestinal absorption of oral digoxin. Theoretically, concomitant use of macrolide antibiotics might increase the absorption of the cardiac glycosides found in squill.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Here's some good news that should ease your mind: Retapamulin (Altabax) is a skin ointment you rub directly on impetigo, not a pill you swallow. The interaction on file comes from how some antibiotics, when taken by mouth, may boost how much of squill's heart-acting compounds your gut absorbs. Since retapamulin stays on the skin and barely gets into your bloodstream, that concern really doesn't apply here.

I'll also be honest: this warning is theoretical, based on how the drugs work on paper rather than real cases. My bigger worry is squill itself, which contains potent heart chemicals much like digoxin and can be dangerously toxic. Please don't use squill without a doctor's close supervision, and check with your pharmacist if you have questions.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.
Moderate

TETRACYCLINE ANTIBIOTICS

2 of 2

Retapamulin also falls under TETRACYCLINE ANTIBIOTICS.

Tetracycline antibiotics appear to increase the gastrointestinal absorption of oral digoxin. Theoretically, concomitant use of tetracycline antibiotics might increase the absorption of the cardiac glycosides found in squill.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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 oral tetracycline antibiotics possibly boosting how much of squill's heart-active compounds get absorbed from the gut. But retapamulin (Altabax, Altargo) is a totally different animal. It's a cream you spread on the skin to clear up impetigo, and very little of it gets into your bloodstream. It also isn't a tetracycline at all.

So this particular concern really doesn't apply to a skin cream that stays on the skin. The bigger issue here is squill itself, which contains potent digoxin-like compounds that can affect your heart rhythm and is genuinely risky to take. If you're using or considering squill for any reason, please loop in your pharmacist or doctor about that part.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.

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

Squill Also Interacts With Other Medications

Squill has 1 major, 154 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.

Major 1 Moderate 154 No known interaction 2,675 (incl. Retapamulin)
Taking anything else?

Check Another of Your Medications Against Squill

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

Everything else you take

See Every Supplement That Interacts With Retapamulin

This page covers Squill 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 Squill as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2 real supplement products containing Squill, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Squill. Your product may carry other ingredients that interact with Retapamulin too, on top of Squill — 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 Squill 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 Squill
Top half

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

29 days ago today
Medication Retapamulin
Steady interest

#1,977 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 Squill

What is Squill?

Squill
  • Cough and chest congestion
  • Fluid retention (diuretic)
  • Heart conditions (traditional 'cardiac tonic')
  • Hair loss (topical use)
  • Rodenticide (red squill, non-medicinal)

Squill is a bulb plant that contains potent cardiac glycosides, which can affect the heart much like the drug digoxin. While it has a long history of use as a cough remedy and heart tonic, it can be dangerously toxic and there is little solid evidence for its modern use, so we do not recommend taking it without close medical supervision.

Read the full Squill 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 & Squill

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

1Major
154Moderate
0Minor
2,674No known interaction
1 Major 154 Moderate 2,674 No interaction
Major

1 interaction

Moderate

154 interactions

Showing 60 of 154 moderate interactions — see all 154 on the Squill page.

No interaction 2,674 drugs checked — show the list

We also checked Squill against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,674 medications checked with no known interaction — see the full Squill list.

See the full Squill interactions page
See every supplement checked against Retapamulin, ranked by severity
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

Keep exploring
Squill monograph › Uses, safety, and every drug interaction in one place Retapamulin supplement interactions › Every supplement checked against Retapamulin, ranked by severity Retapamulin drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Squill and Retapamulin Together: Common Questions

Can you take Squill 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 Squill and Retapamulin?
Retapamulin belongs to more than one drug category, and Squill 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 Squill 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

Still Have a Question About Retapamulin and Squill?

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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.