Halobet Mp
Halobet Mp Uses, Dosage, Side Effects, Food Interaction and all others data.
Mupirocin inhibits protein synthesis of the bacteria by binding to isoleucyl transfer ribonucleic acid (RNA)-synthetase. It has bacteriostatic properties at Min inhibitory concentrations and bactericidal properties at the higher concentrations.
Mupirocin is reported to be active against susceptible aerobic gram-positive cocci, such as Staphylococcus aureus, Staphylococcus epidermidis, and other beta-hemolytic streptococciStreptococcus pyogenes. It mediates its antibacterial activity by inhibiting the bacterial protein synthesis and formation of bacterial proteins essential for survival. The minimum bactericidal concentration (MBC) against relevant pathogens is generally eight-fold to thirty-fold higher than the minimum inhibitory concentration (MIC). In one clinical study investigating the therapeutic effectiveness of topical mupirocin in impetigo, the therapeutic response rate was about 94 to 98% after one week following the end of therapy. In clinical studies of patients with primary and secondary skin infections, both elimination of the bacterial pathogen and clinical cure or improvement hav been demonstrated in over 90% of patients receiving topical mupirocin. Mupirocin resistance as high as 81% has been reported previously. Resistance to mupirocin, which occurs more frequently in methicillin-resistant than methicillin-susceptible staphylococci, may occur with the production of a modified isoleucyl-tRNA synthetase, or the acquisition of, by genetic transfer, a plasmid mediating a new isoleucyl-tRNA synthetase.
Ulobetasol is a highly potent corticosteroid. It is structurally related to clobetasol. Due to its high potency, it is mainly prescribed in the treatment of severe plaque psoriasis and corticosteroid responsive dermatoses.
Ulobetasol was granted FDA approval on 17 December 1990.
Corticosteroids bind to the glucocorticoid receptor, inhibiting pro-inflammatory signals, and promoting anti-inflammatory signals. Ulobetasol has a moderate duration of action as it is applied once or twice daily. Corticosteroids have a wide therapeutic window as patients may require doses that are multiples of what the body naturally produces. Patients taking corticosteroids should be counselled regarding the risk of hypothalamic-pituitary-adrenal axis suppression and increased susceptibility to infections.
| Trade Name | Halobet Mp |
| Generic | Mupirocin + Ulobetasol |
| Type | Cream |
| Therapeutic Class | |
| Manufacturer | Ajanta Pharma Ltd |
| Available Country | India |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Mupirocin ointment or cream is used for the topical treatment of impetigo due to Staphylococcus aureus and Streptococcus pyogenes. It is also used for folliculitis and furunculosis.
Ulobetasol is a lipocortin corticosteroid used to treat inflammatory and pruritic corticosteroid-responsive dermatoses.
Ulobetasol cream and ointment are indicated in the treatment of inflammatory and pruritic corticosteroid responsive dermatoses. Ulobetasol lotion is indicated in the treatment of plaque psoriasis.
Halobet Mp is also used to associated treatment for these conditions: Impetigo, Impetigo caused by Staphylococcus aureus, Impetigo caused by streptococcus pyogenes, Secondary infection Skin infection, Staphylococcus aurea colonization of the nasal passagePsoriasis Vulgaris (Plaque Psoriasis), Corticosteroid responsive, Inflammatory Dermatosis, Corticosteroid responsive, pruritic Dermatosis
How Halobet Mp works
Mupirocin specifically and reversibly binds to bacterial isoleucyl transfer-RNA (tRNA) synthetase, which is an enzyme that promotes the conversion of isoleucine and tRNA to isoleucyl-tRNA. Inhibition of this enzyme subsequently leads to the inhibition of the bacterial protein and RNA synthesis. Mupirocin is bacteriostatic at lower concentrations but it exerts bactericidal effects with prolonged exposure, killing 90-99% of susceptible bacteria over a 24 hour period.
The short term effects of corticosteroids are decreased vasodilation and permeability of capillaries, as well as decreased leukocyte migration to sites of inflammation. Corticosteroids binding to the glucocorticoid receptor mediates changes in gene expression that lead to multiple downstream effects over hours to days.
Glucocorticoids inhibit phospholipase 2 and neutrophil apoptosis and demargination, resulting in decreased formation of arachidonic acid derivatives. They also inhibit NF-Kappa B and other inflammatory transcription factors while promoting anti-inflammatory genes like interleukin-10.
Lower doses of corticosteroids provide an anti-inflammatory effect, while higher doses are immunosuppressive. High doses of glucocorticoids for an extended period bind to the mineralocorticoid receptor, raising sodium levels and decreasing potassium levels.
Dosage
Halobet Mp dosage
Secondary skin infections:
- Adult: As 2% cream: Apply to affected area three times daily for up to 10 days; re-evaluate after 3-5 days if no clinical response.
- Child: ≥3 mth Same as adult dose.
Impetigo:
- Adult: As 2% oint: Apply to affected area three times daily for 5-10 days; re-evaluate after 3-5 days if no clinical response.
- Child: ≥2 mth Same as adult dose.
Side Effects
Burning, stinging, pruritus, pain, rash, erythema, dry skin, tenderness, cellulitis, pain or bleeding secondary to eczema, secondary wound infection, urticaria, swelling, increased exudates, contact dermatitis, furunculosis, exfoliative dermatitis. Rarely, systemic reactions (e.g. nausea, headache, dizziness, abdominal pain, ulcerative stomatitis, systemic allergic reactions).
Toxicity
LD50 and Nonclinical Toxicity
The oral LD50 value in rats is 5000 mg/kg. Studies evaluating the carcinogenic potential of mupirocin have not been performed. In various in vivo animal and in vitro bacterial assays, there was no evidence of genotoxicity caused by mupirocin. In reproduction studies using male and female rats, there were no signs of impaired fertility upon subcutaneous administration of mupirocin.
Use in special populations
Mupirocin was found to be excreted in human milk. As there is limited data on the use of topical mupirocin in pregnant women, the use of this drug in these patients should be undertaken with caution. Based on the findings in clinical trials, topical mupirocin was shown to be safe and effective in pediatric patients aged 2 months to 16 years.
Data regarding acute overdoses of glucocorticoids are rare. Chronic high doses of glucocorticoids can lead to the development of cataract, glaucoma, hypertension, water retention, hyperlipidemia, peptic ulcer, pancreatitis, myopathy, osteoporosis, mood changes, psychosis, dermal atrophy, allergy, acne, hypertrichosis, immune suppression, decreased resistance to infection, moon face, hyperglycemia, hypocalcemia, hypophosphatemia, metabolic acidosis, growth suppression, and secondary adrenal insufficiency. Overdose may be treated by adjusting the dose or stopping the corticosteroid as well as initiating symptomatic and supportive treatment.
Precaution
Mupirocin is not suitable for ophthalmic or intra-nasal use. When Mupirocin ointment is used on the face, care should be taken to avoid the eyes. In common with other polyethylene-based ointments, this drug should be used with caution if there is evidence of moderate or severe renal impairment. As with other antibacterial products, prolonged use may result in overgrowth of nonsusceptible organisms, including fung.
Interaction
Chloramphenicol may interfere with the antibacterial action of mupirocin in RNA synthesis.
Volume of Distribution
No information available.
Elimination Route
Systemic or percutaneous absorption of mupirocin following dermal application is expected to be minimal in adults and children. Occlusive dressings do not significantly enhance drug absorption, but damaged skin may allow enhanced penetration of the drug across the skin barrier.
Ulobetasol lotion reaches a Cmax of 201.1 ± 157.5 pg/mL, with a Tmax of 3 hours, and an AUC of 1632 ± 1147 pg*h/mL. Absorption can be influenced by skin integrity, the vehicle used, inflammation, or disease processes.
Half Life
In healthy male volunteers, the elimination half-life of mupirocin was about 20 to 40 minutes following intravenous administration. The elimination half-life of monic acid was about 30 to 80 minutes.
In vitro experiments show halobetasol propionate, a derivative of ulobetasol, has a half life of 33 minutes.
Clearance
No information available.
Elimination Route
Any mupirocin reaching the systemic circulation is rapidly metabolized to form the inactive monic acid, which is eliminated by renal excretion. Following the application of Centany (mupirocin ointment),2% to a 400 cm2 area on the back of 23 healthy volunteers once daily for 7 days, the mean (range) cumulative urinary excretion of monic acid over 24 hrs following the last administration was 1.25% (0.2% to 3.0%) of the administered dose of mupirocin.
Corticosteroids are eliminated predominantly in the urine.
Pregnancy & Breastfeeding use
Use in Pregnancy: Because animal studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Use in lactation: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Mupirocin ointment is administered to a nursing woman.
Contraindication
This drug is contraindicated in individuals with a history of sensitivity reactions to Mupirocin or any of the components of the preparation.
Special Warning
Pediatric Use: The safety and effectiveness of Mupirocin ointment have been established in the age range of 2 months to 16 years. Use of the ointment in these age groups is supported by evidence from adequate and well-controlled studies of Mupirocin in impetigo in pediatric patients.
Storage Condition
Store at or below 25° C. Do not freeze.
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