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erythromycin

Pronunciation

Generic Name: erythromycin (er ITH roe MYE sin)
Brand Name: E.E.S. Granules, E.E.S.-200, E.E.S.-400, E.E.S.-400 Filmtab, Ery-Tab, Eryc, EryPed, EryPed 200, EryPed 400, Erythrocin Stearate Filmtab, PCE Dispertab, ...show all 19 brand names

What is erythromycin?

Erythromycin is a macrolide antibiotic. Erythromycin fights bacteria in the body.

Erythromycin is used to treat many different types of infections caused by bacteria.

Erythromycin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about erythromycin?

You should not take erythromycin if you are allergic to it, or if you are also using cisapride (Propulsid), dihydroergotamine (D.H.E. 45, Migranal), ergotamine (Ergomar, Cafergot, Migergot), or pimozide (Orap). Erythromycin may interact with these medicines and could cause dangerous or life-threatening heart rhythm disorders.

Video: Asthma

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Before you take erythromycin, tell your doctor if you have liver disease, myasthenia gravis, a heart rhythm disorder, a history of Long QT syndrome, or low levels of potassium or magnesium in your blood.

Take this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Erythromycin will not treat a viral infection such as the common cold or flu.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking erythromycin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

What should I discuss with my healthcare provider before taking erythromycin?

You should not take erythromycin if you are allergic to it, or if you are taking any of the following medicines. Erythromycin may interact with these medicines and could cause dangerous or life-threatening heart rhythm disorders.

  • cisapride (Propulsid);

  • pimozide (Orap); or

  • dihydroergotamine (D.H.E. 45, Migranal) or ergotamine (Ergomar, Cafergot, Migergot).

To make sure you can safely take erythromycin, tell your doctor if you have any of these other conditions:

  • liver disease;

  • myasthenia gravis;

  • a heart rhythm disorder;

  • a history of Long QT syndrome; or

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood).

FDA pregnancy category B. Erythromycin is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Erythromycin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects on heart rhythm, including a life-threatening fast heart rate.

How should I take erythromycin?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

You may take erythromycin with or without food.

Do not crush, chew, break, or open an erythromycin tablet or capsule. Swallow it whole.

Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using erythromycin.

Take this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Erythromycin will not treat a viral infection such as the common cold or flu.

Store at room temperature away from moisture and heat, unless otherwise directed on the medicine label.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking erythromycin?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking erythromycin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Erythromycin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • severe dizziness, fainting, fast or pounding heartbeats;

  • diarrhea that is watery or bloody;

  • hearing problems;

  • vomiting or fussiness after eating (in a child taking erythromycin);

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:

  • mild nausea, vomiting, diarrhea, or stomach pain;

  • dizziness, headache, feeling tired;

  • vaginal itching or discharge; or

  • mild itching or skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Erythromycin Dosing Information

Usual Adult Dose for Campylobacter Gastroenteritis:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Chancroid:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Lymphogranuloma Venereum:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Mycoplasma Pneumonia:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Nongonococcal Urethritis:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Otitis Media:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Pharyngitis:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Pneumonia:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Skin or Soft Tissue Infection:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Syphilis -- Early:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Upper Respiratory Tract Infection:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Bronchitis:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Chlamydia Infection:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Lyme Disease:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.

Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Legionella Pneumonia:

Although the dosage has not been established, clinical trials have used 1 to 4 g/day orally or IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Bacterial Endocarditis Prophylaxis:

1 g (stearate) or 800 mg (ethylsuccinate) orally two hours before procedure, then one-half the amount six hours after initial dose.

Erythromycin was previously recommended by the American Heart Association for prophylaxis prior to dental, oral and upper respiratory tract procedures in at-risk, penicillin-allergic patients. It is no longer recommended because of the high incidence of gastrointestinal adverse effects and complicated pharmacokinetics of the various formulations. However, patients who have successfully received erythromycin for prophylaxis in the past may continue with this regimen if desired. Currently, clindamycin, first-generation cephalosporins (in patients who have not had an IgE-mediated anaphylactic reaction to penicillin), azithromycin or clarithromycin are drugs of choice for prophylaxis in penicillin-allergic patients undergoing oral, dental, respiratory tract or esophageal procedures.

Usual Adult Dose for Bowel Preparation:

1 g (base) orally at 1, 2, and 11 PM the day before surgery (assuming 8 a.m. surgery time); given with oral neomycin 1 g and bowel evacuants.

Usual Adult Dose for Rheumatic Fever Prophylaxis:

250 mg orally twice a day.

Erythromycin is recommended by the American Heart Association for long-term prophylaxis of streptococcal upper respiratory tract infections in the prevention of recurrences of rheumatic fever in patients allergic to penicillin and sulfonamides.

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis:

20 mg/kg (ethylsuccinate or stearate) orally two hours before procedure, then one-half the amount six hours after initial dose.

Erythromycin was previously recommended by the American Heart Association for prophylaxis prior to dental, oral and upper respiratory tract procedures in at-risk, penicillin-allergic patients. It is no longer recommended because of the high incidence of gastrointestinal adverse effects and complicated pharmacokinetics of the various formulations. However, patients who have successfully received erythromycin for prophylaxis in the past may continue with this regimen if desired. Currently, clindamycin, first-generation cephalosporins (in patients who have not had an IgE-mediated anaphylactic reaction to penicillin), azithromycin or clarithromycin are drugs of choice for prophylaxis in penicillin-allergic patients undergoing oral, dental, respiratory tract or esophageal procedures.

Usual Pediatric Dose for Bowel Preparation:

20 mg/kg (base) orally at 1, 2, and 11 PM the day before surgery (assuming 8 a.m. surgery time); given with oral neomycin and bowel evacuants.

Usual Pediatric Dose for Pneumonia:

Neonatal chlamydial conjunctivitis and pneumonia: 50 mg/kg/day orally in divided doses every 6 hours for at least 2 weeks.

Usual Pediatric Dose for Chlamydia Infection:

Neonatal chlamydial conjunctivitis and pneumonia: 50 mg/kg/day orally in divided doses every 6 hours for at least 2 weeks.

Usual Pediatric Dose for Rheumatic Fever Prophylaxis:

250 mg orally twice a day.

Erythromycin is recommended by the American Heart Association for long-term prophylaxis of streptococcal upper respiratory tract infections in the prevention of recurrences of rheumatic fever in patients allergic to penicillin and sulfonamides.

Usual Pediatric Dose for Pertussis:

40-50 mg/kg/day, orally, divided every 6 hours for 14 days; maximum dose: 2 g/day (not preferred agent for infants less than 1 month of age).

What other drugs will affect erythromycin?

Many drugs can interact with erythromycin. Below is just a partial list. Tell your doctor if you are using:

  • alfentanil (Alfenta);

  • bromocriptine (Parlodel);

  • cilostazol (Pletal);

  • colchicine (Colcrys);

  • cyclosporine (Sandimmune, Gengraf, Neoral);

  • digoxin (Lanoxin);

  • methylprednisolone (Medrol);

  • sildenafil (Viagra);

  • tacrolimus (Prograf);

  • theophylline (Elixophyllin, Theo-24, Theochron, Uniphyl);

  • vinblastine (Velban);

  • alprazolam (Xanax) or triazolam (Halcion);

  • a blood thinner such as warfarin (Coumadin, Jantoven);

  • carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin), or valproic acid (Depakene, Stavzor);

  • atorvastatin (Lipitor, Caduet), lovastatin (Mevacor, Altoprev, Advicor), or simvastatin (Zocor, Simcor, Vytorin);

  • heart or blood pressure medicine such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), diltiazem (Cardizem, Cartia, Dilacor, Diltia, Diltzac, Taztia, Tiazac), or verapamil (Calan, Covera, Isoptin, Verelan);

  • a heart rhythm medication such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), flecainide (Tambocor), ibutilide (Corvert), mexiletine (Mexitil), procainamide (Procan, Pronestyl), propafenone, (Rythmol), quinidine (Quin-G), sotalol (Betapace), and others; or

  • any other antibiotics.

This list is not complete and there are many other drugs that can interact with erythromycin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about erythromycin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 11.02. Revision Date: 2012-08-29, 2:41:26 PM.

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