Fusidic Acid

Know the basics

What is fusidic acid used for?

Fusidic acid is prescribed for skin infections caused by staphylococcal bacteria. Such infections include impetigo, angular cheilitis (an infection around the mouth), and infected dermatitis. It works by stopping the growth of the bacteria causing the infection. Sodium fusidate is a salt of fusidic acid and it works in the same way. You may find this name being given as the ingredient if you have been prescribed an ointment to use.

Fusidic acid cream and sodium fusidate ointment are antibacterial preparations which usually clear skin infection quickly, particularly where the infection only covers a small area. If the infection is more widespread, antibiotic tablets or a liquid medicine may be needed (see separate medicine leaflet called Sodium fusidate for infections for more information about this).

If the area of skin is inflamed as well as infected, your doctor may prescribe a cream which combines fusidic acid with an anti-inflammatory agent, such as hydrocortisone (brand name Fucidin® H) or betamethasone (brand name Fucibet®).

How should I take fusidic acid?

Before you start this treatment, read the manufacturer’s printed information leaflet from inside your pack. The leaflet will give you more information about the cream or ointment, and how to use it.

Use the preparation exactly as your doctor tells you to. Apply a thin layer of cream/ointment to the infected area and rub it in gently. Unless you have been told otherwise, use it 3-4 times a day. Remember to wash your hands well after you have finished using it (unless you are using it to treat your hands).

Only use it for as long as your doctor has instructed you to. A course of treatment for impetigo typically lasts for around 7-10 days.

How do I store fusidic acid?

Fusidic acid is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store fusidic acid in the bathroom or the freezer. There may be different brands of fusidic acid that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush fusidic acid down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using fusidic acid?

Before taking this medication, tell your doctor if you:

• If you are pregnant or breast-feeding. (Although fusidic acid is not known to be harmful to an unborn baby, you should let your doctor know if you think you are pregnant).
• If you have ever had an allergic reaction to a medicine, or to a skin preparation.

Is it safe to take fusidic acid during pregnancy or breast-feeding?

There isn’t enough information about the safety of using this medication during pregnancy and breast-feeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication.

Know the side effects

What are the side effects of fusidic acid?

Fusidic acid eye drops:

• Stinging or burning for a short time after use;
• Allergic reaction (hypersensitivity).

Fusidic acid cream:

• Rash;
• Stinging and irritation;
• Itchy rash and inflammation.

Fusidic acid suspension:

• Stomach upsets.

If any of these persist or you consider them severe then you should inform your doctor or pharmacist.

Tell your doctor immediately if you develop any of the following symptoms while you are using fusidic acid eye drops or cream:

• Difficulty breathing;
• Your face swells, particularly around your eyes or your eyelids;
• A severe rash;
• Burning or stinging in your eye that does not go away.

Tell your doctor immediately if you develop any of the following symptoms while you are using fusidic acid suspension:

• Your skin or the whites of your eyes become yellow;
• You are not passing water (anuria);
• You start to bruise easily or have unexplained bleeding;
• Repeated and persistent mouth ulcers, sore throat or other infections.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with fusidic acid?

Fusidic acid may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Using fusidic acid with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Atorvastatin, Pravastatin, Ritonavir, Saquinavir, Simvastatin.

Does food or alcohol interact with fusidic acid?

Fusidic acid may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with fusidic acid?

Fusidic acid may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

• Liver disease—May be worsened by fusidic acid.

Understand the Dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before using this medication.

What is the dose of Fusidic Acid for an adult?

Susceptible infections

Adult: 500 mg orally three times a day. May increase to 1 g three times a day in fulminating infections.

Susceptible infections

Adult: greater than 50 kg: 500 mg three times a day; may increase to 1 g three times a day in fulminating infections. Greater than 50 kg: 6-7 mg/kg three times a day. To be given by slow intravenous infusion over at least 2 hr; should be given via a large vein with good blood flow.

Conjunctivitis

Adult: As 1% eye drops, ophthalmic: Instill 1 drop into the affected eye every 12 hr for 7 days.

Skin infections

Adult: As a 2% ointment/cream/gel, Topical/Cutaneous: Apply onto affected area 3-4 times daily until there is improvement. If gauze dressing is used, then frequency of application may be reduced to 1-2 times daily.

Reconstitution: Each 500 mg dose is given as a buffered solution (pH 7.4-7.6) diluted to 500 ml with sodium chloride or other suitable IV solution.

Incompatibility: Incompatible with amino acid solutions or whole blood. Admixture incompatibility: Carbenicillin, kanamycin, gentamicin, calcium solutions.

What is the dose of Fusidic Acid for a child?

Susceptible infections

Child: less than 1 year: orally, About 15 mg/kg; 1-5 year: 250 mg; 5-12 year: 500 mg. Doses to be taken three times a day.

Susceptible infections

Child:  20 mg/kg intravenous daily in 3 divided doses. To be given by slow intravenous infusion over at least 2 hr; should be given via a large vein with good blood flow.

Conjunctivitis

Child: ≥2 yr: As 1% eye drops, ophthalmic: Instill 1 drop into the affected eye every 12 hr for 7 days.

Skin infections

Child: As a 2% ointment/cream/gel, Topical/Cutaneous: Apply onto affected area 3-4 times daily until there is improvement. If gauze dressing is used, then frequency of application may be reduced to 1-2 times daily.

How is fusidic acid available?

Fusidic acid is available in the following dosage forms and strengths:

Each 5ml of Suspension contains 250mg Fusidic Acid, Ph.Eur. (therapeutically equivalent to 175mg Sodium Fusidate

Fucidin suspension contains 2mg sodium in every 1ml).

Fusidic Acid 20mg/g Cream

Fucidin Tablet: 250 mg

Fucidin Powder for Injection: 500 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of fusidic acid, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.