Mupirocin Nasal Ointment, Spray & Sinus Rinse

Mupirocin nasal preparations are compounded, prescription forms of mupirocin, an antibiotic, made to be used inside the nose. Bayview compounds a 2% nasal ointment, a 0.2% nasal spray, and capsules whose powder is mixed into a saline sinus rinse, each to your provider's prescription.

The FDA-approved mupirocin nasal ointment, Bactroban Nasal, is listed by the FDA as discontinued, and Drugs@FDA lists no other approved mupirocin product for the nose (Drugs@FDA). The mupirocin ointment sold for skin infections is a different product, and MedlinePlus advises not letting it get into the nose (MedlinePlus). Bayview compounds this as part of our ear, nose, and throat line.

How does it work?

Mupirocin is an antibiotic that stops bacteria from making the proteins they need, by binding to an enzyme called isoleucyl-tRNA synthetase (FDA label). In the nose it acts on the surface it touches. Its main target there is Staphylococcus aureus (staph), including methicillin-resistant S. aureus (MRSA), which can live in the front of the nostrils without causing symptoms (FDA label).

What is it used for?

The FDA-approved nasal ointment was labeled to clear MRSA carried in the nose in adults, children 12 and older, and health care workers, as part of an infection control program during hospital outbreaks (FDA label). World Health Organization guidelines recommend mupirocin 2% nasal ointment around the time of heart and orthopedic surgery for people known to carry staph in the nose, and suggest considering it for carriers having other surgeries (WHO). Some ear, nose, and throat specialists also prescribe mupirocin in a saline sinus rinse for long-lasting sinus inflammation (chronic rhinosinusitis) when staph is found in the sinuses, an off-label use studied in small trials (Kim and Kwon). Only a licensed provider can decide whether any of these fits your situation; Bayview Pharmacy does not provide consultations, and a valid prescription is required.

Ointment, spray, or sinus rinse?

All three forms put mupirocin inside the nose. The ointment coats the front of the nostrils, the spray delivers a fine mist, and a sinus rinse carries the medication through the nasal passages and into the sinuses. The table below is for education only.

Forms are described for education only and are not a statement that any form is better or more effective. Your provider sets the form, strength, and length of treatment.

How is it used?

Use it exactly as your label directs. For the FDA-approved nasal ointment, the directions were about half of a single-use tube in each nostril twice a day, morning and evening, for 5 days, then pressing the nostrils together and releasing them for about a minute to spread the ointment (FDA label). For the spray, blow your nose gently, then spray the number of times your label says into each nostril. For a sinus rinse, open one capsule, empty the powder into your saline rinse bottle, mix, and rinse as directed. Mix a fresh rinse each time, use distilled, sterile, or previously boiled and cooled water (never untreated tap water), and lean over a sink and breathe through your mouth while you rinse. Keep mupirocin away from your eyes (FDA label). The FDA label advised against using other nose products at the same time, so ask your provider how to time any other nasal medicines (FDA label).

Side effects & safety

In clinical trials of the FDA-approved nasal ointment, the most common side effects were headache (9%), a runny or stuffy nose (6%), congestion (5%), sore throat (4%), a change in taste (3%), burning or stinging (2%), cough (2%), and itching (1%) (FDA label). Serious allergic reactions, including swelling and trouble breathing, have been reported. Diarrhea caused by Clostridioides difficile has been reported with nearly all antibiotics, and long use can let germs that mupirocin does not act on, such as fungi, overgrow (FDA label). Side effect data for compounded sprays and rinses are limited.

Who should not use it?

Do not use mupirocin if you are allergic to mupirocin or any ingredient in the preparation (FDA label). The safety of the FDA-approved nasal ointment was not established in children younger than 12, and there are not enough human data to know whether it carries a risk in pregnancy (FDA label). Tell your provider if you are pregnant or breastfeeding, and about all of your conditions and medicines, before starting.

How should it be stored?

Store as directed on your label. The FDA-approved nasal ointment was stored at room temperature and not refrigerated (FDA label). Keep rinse capsules in their closed container, dry and at room temperature. Keep all forms out of reach of children, and do not use them after the beyond-use date.

Why is this compounded?

The FDA-approved mupirocin nasal ointment is discontinued, and Drugs@FDA lists the remaining approved mupirocin products as ointments and creams for the skin (Drugs@FDA). There is no manufactured mupirocin nasal spray or sinus rinse. Compounding lets a licensed pharmacy prepare a 2% nasal ointment, a 0.2% nasal spray, or measured rinse capsules to an individual prescription. As a 503A compounding pharmacy, Bayview prepares each order under USP <795> standards. Compounded preparations are not FDA-approved. Related preparations include Povidone-Iodine Nasal Spray, Budesonide Sinus Rinse Capsules, and Amphotericin B. The full list is in our compounded medications catalog.