Erythromycin Base

The active ingredient is erythromycin, provided in a tablet that is not enteric-coated. It is a macrolide antibiotic, in the same class as azithromycin and clarithromycin. Macrolides work by slowing the growth of bacteria through preventing protein synthesis. This class of antibacterials works on a wide range of gram-positive and gram-negative bacteria.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using erythromycin. However, the following is a synopsis of the general guidelines for the use of erythromycin:

• It can be taken by mouth with or without food, but is best absorbed when taken 30 minutes before or 2 hours after food.
• It should not be taken with alcohol.
• You should avoid grapefruit or grapefruit juice while on this medication.

The most common side effects of erythromycin seen in clinical trials as compared to placebo include nausea, vomiting, diarrhea, stomach pain, appetite loss, and mild skin rashes.

Some individuals may experience serious side effects while using erythromycin. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Symptoms of liver problems such as unexplained stomach pain on the upper right side, unexplained nausea/ vomiting, dark urine, pale stool, and jaundice (yellowing of the skin or eyes).
• Severe skin rashes presenting with painful blisters or peeling skin.
• Signs of an irregular heart rate/ rhythm (QT prolongation, Torsades de Pointes): dizziness, heart palpitations, chest pain.
• Severe diarrhea (Clostridium Difficile Associated Diarrhea - CDAD) presenting with fever, stomach pain, and/or watery/bloody stool.
• Symptoms of a serious allergic reaction such as swelling of the face/lips/tongue, difficulty breathing, severe and widespread rash (hives), fainting, or heart palpitations.

These are not all of the possible side effects of erythromycin. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting erythromycin, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• A known hypersensitivity (allergy) to erythromycin.
• Heart rhythm problems, such as a prolonged QT interval, long QT syndrome (LQTS).
• Heart rate problems, such as a slow heartbeat (bradycardia), or Torsades de Pointes arrhythmia.
• Low potassium or magnesium.

Severe muscle weakness due to myasthenia gravis.

Heart failure.

Liver disease.

You should not take erythromycin if you are currently taking terfenadine (Triludan, Teldan), astemizole (Hismanal), cisapride (Propulsid), domperidone (Motilium), pimozide (Orap), ergotamine (Ergomar), theophylline, dihydroergotamine (D.H.E. 45, Migranal), vincristine, topotecan, fluconazole, posaconazole, or lemborexant (Dayvigo).

Since erythromycin is used for many types of infections, its onset depends on the reason you’re taking it. It is usually taken anywhere between 5 to 14 days, and you should start to feel better within the first few days.

When erythromycin is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Drugs containing theophylline or one of its derivatives (proxyphylline) - in combination with erythromycin can lead to a lower level of erythromycin in the blood, and a higher level of theophylline.
• Chemotherapy drugs such as vincristine or topotecan.
• Azole antifungal medications, such as ketoconazole, fluconazole, and posaconazole - these drugs may increase the level of erythromycin in your body and put you more at risk for serious side effects.
• Antiarrhythmic medications such as dronedarone, amiodarone, verapimil, digoxin, and diltiazem - these drugs may increase the level of erythromycin in your body and put you more at risk for serious side effects.
• Lipid-lowering agents (statins) such as simvastatin, atorvastatin, or lovastatin - using one of these drugs with erythromycin can put you at an increased risk of muscle pain or breakdown.
• Anti-inflammatory medications such as colchicine - in combination with erythromycin could lead to colchicine toxicity (nausea, abdominal pain, vomiting).
• Benzodiazepines such as triazolam or alprazolam - erythromycin may increase levels of these drugs and increase side effects from them (weakness, fatigue).
• Drugs used for erectile dysfunction, such as sildenafil (Viagra) - erythromycin may increase levels of this drug and put you at risk of increased side effects (indigestion, dizziness, headaches).
• Antihistamines such as terfenadine and astemizole, and the GI stimulant drug cisapride - in combination with erythromycin could lead to serious cardiovascular side effects.
• Certain medications that treat or prevent blood clots like warfarin.

It is available in two strengths: 250mg or 500mg.

This drug should be stored at room temperature in a tightly closed container, away from the reach of children or pets.

There is a brand name version of erythromycin made by Pfizer (Eryc), available in a capsule form. Alternate formulations include an oral suspension and a topical ointment.

This is the generic version.

It is important to complete the entire course of any antibiotic, as prescribed by your physician, even if you start to feel better before the full course is completed.

Erythromycin is not associated with toxicity to a growing fetus when taken at any stage of pregnancy. However, talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

This drug is excreted in human milk, but not in substantial amounts to cause harm to an infant. It is considered compatible with breastfeeding. Infants of breastfeeding parents should be monitored for oral thrush, loss of appetite, and diarrhea while the parent is taking erythromycin.