Drug & supplement interaction

Zinc + Retapamulin

Retapamulin brand names: Altabax, Altargo.

Moderate Interaction
The bottom line Moderate

Retapamulin falls into 2 drug categories that Zinc can interact with; the most serious is rated moderate. Zinc can decrease the levels and clinical effects of quinolones antibiotics.

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

Zinc and Retapamulin

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

Why Are There 2 Interactions?

Zinc interacts with whole categories of medication. Retapamulin falls into 2 of those categories, so it can interact with Zinc 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 Zinc interacts with.

Zinc can decrease the levels and clinical effects of quinolones antibiotics.
Quinolones form complexes with zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. Advise patients to take these drugs at least 2 hours before, or 4-6 hours after, zinc supplements.
Severity Moderate Likelihood Probable Evidence B

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: the interaction we have on file describes zinc binding up oral quinolone antibiotics in the gut, which lowers how much medicine gets absorbed. But Retapamulin (Altabax) isn't a pill you swallow. It's a topical ointment you rub onto a skin infection like impetigo, so it works right at the surface and barely enters your bloodstream.

Because of that, taking a zinc supplement by mouth shouldn't meaningfully change how this ointment fights the bacteria on your skin. The gut-binding problem just doesn't apply to a cream. The category warning was really written for swallowed quinolones, not for a surface-acting drug like this. Still, if you have any questions or are using other antibiotics too, your pharmacist can confirm what's right for you.

References
  1. Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
  2. Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
  3. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  4. Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Moderate

TETRACYCLINE ANTIBIOTICS

2 of 2

Retapamulin also falls under TETRACYCLINE ANTIBIOTICS.

Zinc might reduce levels of tetracycline antibiotics.
Tetracyclines form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both the tetracycline and zinc when taken at the same time. Taking zinc sulfate 200 mg with tetracycline reduces absorption of the antibiotic by 30% to 40%. Demeclocycline and minocycline cause a similar interaction. However, doxycycline does not seem to interact significantly with zinc. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements to avoid any interactions.
Severity Moderate Likelihood Probable Evidence B

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: the interaction on file describes zinc binding up oral tetracycline pills in your stomach and lowering how much antibiotic gets absorbed. But Retapamulin (Altabax) isn't a tetracycline at all, and more importantly, it's an ointment you rub onto the skin to treat impetigo. It works right at the surface and isn't meant to be swallowed.

Because zinc taken by mouth and a skin cream don't really cross paths in the gut, this binding problem doesn't apply here. Your zinc supplement shouldn't weaken how well Retapamulin clears up the infection. As always, if you have questions about either product, your pharmacist is happy to double-check things with you.

References
  1. Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
  2. Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
  3. Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.

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

Zinc Also Interacts With Other Medications

Zinc has 62 moderate, 4 minor 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 Zinc

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

Everything else you take

See Every Supplement That Interacts With Retapamulin

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

We hold 26,692 real supplement products containing Zinc, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Zinc. Your product may carry other ingredients that interact with Retapamulin too, on top of Zinc — 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 Zinc 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 Zinc
Top 10

#8 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 Zinc

What is Zinc?

Zinc
  • Zinc deficiency
  • Immune support
  • Cold symptoms
  • Acne
  • Wound healing

Zinc is an essential mineral that your body needs for immune function, wound healing, taste, and smell. Most people get enough from food, but supplements can help correct or prevent a deficiency. Taking too much zinc for too long can cause harm, so check with a pharmacist or doctor before using high-dose supplements.

Read the full Zinc 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 & Zinc

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

0Major
62Moderate
4Minor
2,763No known interaction
Moderate

62 interactions

Showing 60 of 62 moderate interactions — see all 62 on the Zinc page.

Minor

4 interactions

No interaction 2,763 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 Zinc and Retapamulin Together: Common Questions

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