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Formulas

Itraconazole 1%/Levofloxacin 2%/Mupirocin 2% Topical Ointment

The Itraconazole 1%/Levofloxacin 2%/Mupirocin 2% Topical Ointment is a specialized semi-solid formulation designed for external application to the skin. This ointment is dispensed in a tube and provides a greasy or oily base, which facilitates the localized delivery of its active ingredients. Itraconazole, an antifungal agent, is effective in treating fungal infections of the skin. Levofloxacin, a broad-spectrum antibiotic, addresses bacterial infections, including those caused by resistant strains. Mupirocin, another antibiotic, is particularly useful for eradicating skin infections caused by Gram-positive bacteria, such as impetigo. This combination ointment is typically used for the treatment of mixed bacterial and fungal skin infections, as well as for promoting wound healing in infected areas.

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Itraconazole Hydrochloride
Levofloxacin Hydrochloride
Mupirocin Calcium
Topical Ointment
65ae88788fce7b028c2be12d
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Formula Information

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The Itraconazole 1%/Levofloxacin 2%/Mupirocin 2% Topical Ointment is a specialized semi-solid formulation designed for external application to the skin. This ointment is dispensed in a tube and provides a greasy or oily base, which not only facilitates the application but also enhances the delivery and absorption of the active ingredients into the skin. The combination of these three potent agents targets a broad spectrum of skin conditions, particularly those involving inflammation, infections, or the need for wound healing.

Itraconazole, an antifungal component of the ointment, is effective against a wide range of fungal infections. At a concentration of 1%, it works by inhibiting the synthesis of ergosterol, a critical component of fungal cell membranes, thereby disrupting fungal cell integrity and leading to cell death. This makes it particularly useful in treating cutaneous mycoses and some yeast infections of the skin.

Levofloxacin, a broad-spectrum antibiotic included at 2%, is a fluoroquinolone that acts by inhibiting bacterial DNA gyrase and topoisomerase IV. This action prevents bacterial DNA replication and transcription, leading to bacterial cell death. Levofloxacin is effective against a variety of Gram-positive and Gram-negative bacteria, making it a valuable agent for treating bacterial skin infections, including those that are resistant to other antibiotics.

Mupirocin, another antibiotic in the formulation, also at a 2% concentration, has a unique mechanism of action. It inhibits bacterial isoleucyl-tRNA synthetase, thereby preventing the incorporation of isoleucine into bacterial proteins, which is essential for bacterial growth. Mupirocin is particularly effective against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), making it an important option for treating localized skin infections and preventing the spread of MRSA in healthcare settings.

This combination ointment is particularly useful for patients with complex skin conditions that may involve a mixed infection of fungal and bacterial origin or for those who are at risk of secondary infections in areas of skin inflammation or wounds. The ointment should be applied as directed by a healthcare professional, and patients should be advised to follow the prescribed treatment regimen closely to ensure the best therapeutic outcomes.

For prescribers, it is important to consider the potential for drug interactions and contraindications associated with each component of the ointment. Monitoring for signs of local irritation or allergic reaction is also recommended, as with any topical medication. This formulation offers a convenient and effective treatment option for patients with complex dermatological needs.

If you have any questions or require further information about this formulation, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is dedicated to providing the highest quality of care and is ready to assist with any inquiries you may have.

Drug Interactions

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The topical ointment formulation containing Itraconazole 1%, Levofloxacin 2%, and Mupirocin 2% is designed for the treatment of various skin conditions, including fungal and bacterial infections. Itraconazole is an antifungal agent that works by inhibiting the synthesis of ergosterol, a key component of fungal cell membranes. Levofloxacin is a broad-spectrum antibiotic that belongs to the fluoroquinolone class, effective against a variety of bacterial pathogens by inhibiting bacterial DNA gyrase and topoisomerase IV. Mupirocin is another antibiotic that inhibits bacterial isoleucyl-tRNA synthetase, thereby preventing the incorporation of isoleucine into bacterial proteins, leading to the treatment of bacterial skin infections.

When considering drug interactions for this topical ointment, it is important to note that systemic absorption of these agents is generally low when applied topically. However, interactions can still occur, particularly in cases where the skin barrier is compromised or when the ointment is applied to large surface areas of the skin for prolonged periods. Patients should be advised to inform their healthcare provider of all medications they are currently taking, including over-the-counter drugs, herbal supplements, and topical products.

For Itraconazole, there are known interactions with drugs that either increase its serum concentration, such as some HMG-CoA reductase inhibitors, or decrease its effectiveness, such as antacids and H2 blockers. Caution should be exercised when co-administering drugs that can prolong the QT interval, as Itraconazole can also cause QT prolongation. Levofloxacin may interact with cationic agents, such as antacids containing magnesium or aluminum, sucralfate, and multivitamins containing iron or zinc, which can reduce the absorption of levofloxacin. Concurrent use of drugs known to affect the QT interval should be avoided. Mupirocin has fewer reported interactions, but it is important to avoid mixing it with other topical preparations unless directed by a healthcare provider, as there may be incompatibilities or altered efficacy.

Patients with a known hypersensitivity to any of the components should not use this ointment. Additionally, the use of this ointment in combination with other topical therapies should be approached with caution, and healthcare providers should be consulted before combining treatments. It is also important to monitor for signs of local irritation or allergic reaction, which may necessitate discontinuation of the ointment.

Overall, while the risk of systemic drug interactions with this topical ointment is low, it is not negligible, and both prescribers and patients should be aware of the potential for interactions. If you have any questions or require further information regarding this formulation and its potential interactions, please reach out to us at Bayview Pharmacy for assistance.

How Does it Work

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The Itraconazole 1%/Levofloxacin 2%/Mupirocin 2% Topical Ointment is a specialized medication compounded to provide targeted treatment for various skin conditions, particularly those involving infections and inflammation. This ointment is a semi-solid formulation that is dispensed in a tube for easy application. The base of the ointment is designed to be greasy or oily, which not only facilitates the delivery of the active ingredients to the affected area but also provides a protective layer over the skin, enhancing the medication's effectiveness and patient comfort.

Itraconazole is an antifungal agent that works by inhibiting the synthesis of ergosterol, a vital component of fungal cell membranes. By disrupting the cell membrane formation, itraconazole effectively treats fungal infections of the skin. This makes the ointment particularly useful for conditions like ringworm, athlete's foot, or yeast infections that are localized on the skin's surface.

Levofloxacin, a fluoroquinolone antibiotic, is included in the formulation for its broad-spectrum antibacterial activity. It functions by inhibiting bacterial DNA gyrase and topoisomerase IV, enzymes critical for DNA replication and cell division in bacteria. This action helps to eliminate bacterial infections, including those caused by gram-positive and gram-negative bacteria, making the ointment effective against a variety of bacterial skin infections.

Mupirocin is another antibiotic, but it works differently from levofloxacin. It inhibits bacterial isoleucyl-tRNA synthetase, thereby preventing the incorporation of isoleucine into bacterial proteins, which is essential for bacterial growth. Mupirocin is particularly effective against Staphylococcus aureus, including methicillin-resistant strains (MRSA), making it a valuable component for treating localized skin infections, impetigo, and for eradicating nasal colonization with MRSA.

The combination of these three agents in one ointment allows for a broad-spectrum approach to treating skin infections, reducing inflammation, and promoting healing. The ointment is intended for external use only and should be applied to the affected area as directed by a healthcare provider. The specific concentration of each ingredient has been carefully chosen to maximize therapeutic effects while minimizing the potential for side effects.

Patients should be advised to use the ointment as prescribed and report any signs of adverse reactions or allergies. It is also important to note that prolonged use of antibiotics can lead to the development of resistance, so the treatment course should be followed as recommended by the prescriber. If you have any questions or require further information about this formulation, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to support both patients and prescribers in the effective use of this medication.

Other Uses

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Bayview Pharmacy's compounded Itraconazole 1%/Levofloxacin 2%/Mupirocin 2% Topical Ointment is a multi-purpose medicated formulation designed to address a variety of dermal concerns. While primarily used for treating fungal and bacterial skin infections, as well as promoting wound healing, this ointment may serve additional therapeutic roles. It presents an option for managing complex secondary infections in chronic wounds, such as diabetic foot ulcers, where polymicrobial flora may be present. Moreover, its composition has potential utility in treating infected dermatoses where both fungal and bacterial overgrowth are contributing to the pathology.

The antifungal component, Itraconazole, makes this ointment suitable for use in cutaneous candidiasis, ringworm, or other dermatophytoses where resistance to other topical antifungals may be a concern. The inclusion of Levofloxacin, a broad-spectrum antibiotic, may help combat troublesome bacteria not susceptible to other agents, and could be advantageous in addressing infected eczema, folliculitis, or as part of a treatment regimen for mild to moderately infected pressure sores. Mupirocin’s role in eradicating staphylococcal skin infections, including methicillin-resistant Staphylococcus aureus (MRSA), makes this ointment a viable choice for both treatment and decolonization strategies involving this resistant pathogen.

Beyond these indications, off-label uses for this compounded ointment can be considered, guided by clinician expertise and individual patient needs, acknowledging the absence of large-scale studies on such applications. This may include treatment of certain nail infections, when the affected area is not extensive or overly thickened, or in localized areas of inflamed, antibiotic-resistant skin conditions. The anti-inflammatory effect of the excipients in the ointment base may also offer symptomatic relief in inflammatory skin conditions when infection is a complicating factor.

Patients and prescribers should note that the use of this triple-combination ointment should be based on the clinical judgment of the healthcare provider and the specific clinical scenario. Cultures and susceptibilities may be warranted to identify the causative pathogens and enable targeted therapy. It is also important to consider the potential for drug interactions, contraindications, and adverse effects specific to each active ingredient, particularly in patients with a known history of hypersensitivity or extensive medication profiles.

For further guidance, personalized formulations, or if there are any questions regarding the potential uses and suitability of this topical ointment, we at Bayview Pharmacy are eager to assist. Our trained compounding pharmacists can provide individualized support to ensure both patients and prescribers are informed and can utilize our custom-compounded medications with confidence and safety.

Frequently Asked Questions

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What is this topical ointment used for?

This ointment is utilized for the treatment of various skin conditions, including inflammation, infections, or to promote wound healing. The active ingredients - Itraconazole, Levofloxacin, and Mupirocin - target fungal infections, bacterial infections, and aid in preventing infection in minor skin wounds, respectively.

How should I apply this compounded ointment?

Clean and dry the affected area gently before application. Apply a thin layer of the ointment to the affected skin area as directed by your healthcare provider, usually once or twice a day. Cover the area with a sterile bandage if advised by your healthcare provider.

Are there any storage instructions for the ointment?

Store the ointment in a cool, dry place, away from direct light and heat. Do not freeze the ointment, and keep the tube tightly closed when not in use.

Can I use this ointment with other medications?

Before using this ointment with other topical or systemic medications, consult with your healthcare provider to avoid potential interactions. It is important to inform your healthcare provider of all medications you are currently taking, including over-the-counter products and supplements.

What side effects may occur when using this ointment?

Common side effects may include mild skin irritation, redness, or itching at the site of application. If you experience severe reactions, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, seek immediate medical attention.

What should I do if I miss a dose?

If you miss a dose, apply the ointment as soon as you remember. However, if it is almost time for the next scheduled dose, skip the missed dose and apply the next one on time. Do not double the dose to catch up.

Is this ointment safe for children?

This ointment should only be used for children if prescribed by a pediatrician. The safety and effectiveness in pediatric patients may be different than in adults, so use in children should be closely monitored by a healthcare provider.

What precautions should I take while using this ointment?

Avoid contact with eyes, nose, or mouth. If contact occurs, rinse thoroughly with water. Do not apply on large areas of the body unless directed by your healthcare provider. Inform your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding before using this ointment.

Can I use cosmetics or other skincare products on the treated area?

Wait until the medication has fully absorbed into the skin before applying cosmetics or other skincare products. Discuss with your healthcare provider about the appropriate wait time before applying other substances over the treated area.

What should I do if there is no improvement in my condition?

If you do not notice improvement in your condition after using the ointment for the prescribed period, contact your healthcare provider. Do not continue using the ointment for longer than advised, as prolonged use without medical supervision may not be beneficial and could lead to unwanted side effects.

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Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.