Erythromycin

MEDICATION TYPE

Antibiotic

INDICATIONS

Treatment of community acquired respiratory infections, atypical infections, Staph. aureus prophylaxis and treatment of staph isolates or minor exacerbations. Possible anti-inflammatory agent. Can be used infrequently as a prokinetic for constipation.

DRUG INTERACTIONS

Amiodarone
Risk of ventricular arrythmias when administered with intravenous erythromycin.

Antiepileptics
Increased levels of carbamazepine, phenytoin and sodium valproate.

Cimetidine
Increases erythromycin levels, increases risk of toxicity.

Cisapride
Risk of arrythmias – avoid concomitant use.

Cyclosporin
Increases cyclosporin level.

Digoxin
May increase digoxin levels (no BNF black spot).

Itraconazole
May increase itraconazole levels. (No BNF black spot).

Midazolam
Increase plasma midazolam levels with profound sedation.

Sirolimus
Plasma concentration of both drugs increased. Avoid concomitant use.

Tacrolimus
Increases tacrolimus level.

Terfenadine
Risk of arrythmias – avoid concomitant use.

Theophylline
Increases theophylline level (takes approx 5/7 for interaction).

Warfarin
Increased INR.

NOTES

Multiple CYP3A4 interactions; consider azithromycin alternative.