E.E.S. Granules Side Effects

Generic Name: erythromycin

Note: This page contains information about the side effects of erythromycin. Some of the dosage forms included on this document may not apply to the brand name E.E.S. Granules.

Not all side effects for E.E.S. Granules may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to erythromycin: oral capsule, oral capsule delayed release, oral powder for suspension, oral suspension, oral tablet, oral tablet chewable, oral tablet delayed release, oral tablet enteric coated

Along with its needed effects, erythromycin (the active ingredient contained in E.E.S. Granules) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking erythromycin:

Rare
  • Blistering, peeling, or loosening of the skin
  • chills
  • cough
  • diarrhea
  • difficulty with swallowing
  • dizziness
  • fast heartbeat
  • hives or welts
  • joint or muscle pain
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red, irritated eyes
  • red skin lesions, often with a purple center
  • redness of the skin
  • skin rash
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • tightness in the chest
  • unusual tiredness or weakness
  • wheezing
Incidence not known
  • Abdominal or stomach cramps or tenderness
  • bloating
  • bloody or cloudy urine
  • chest pain or discomfort
  • dark urine
  • diarrhea, watery and severe, which may also be bloody
  • fainting
  • fever
  • general tiredness and weakness
  • greatly decreased frequency of urination or amount of urine
  • hearing loss
  • increased thirst
  • irregular heartbeat recurrent
  • irregular or slow heart rate
  • light-colored stools
  • nausea and vomiting
  • pain
  • swelling of the feet or lower legs
  • unusual weight loss
  • upper right abdominal or stomach pain
  • yellow eyes and skin

Some side effects of erythromycin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
  • Abdominal or stomach pain
  • diarrhea (mild)
  • loss of appetite
  • weight loss

For Healthcare Professionals

Applies to erythromycin: compounding powder, injectable powder for injection, oral capsule, oral delayed release capsule, oral delayed release tablet, oral granule for reconstitution, oral suspension, oral tablet, oral tablet chewable, oral tablet coated particles

General

The most common side effects associated with oral erythromycin (the active ingredient contained in E.E.S. Granules) were gastrointestinal and were dose-related.

Gastrointestinal

Rare (less than 0.1%): Pancreatitis, pancreatitis without biliary obstruction
Frequency not reported: Nausea, abdominal pain, diarrhea, vomiting, anorexia, infantile hypertrophic pyloric stenosis, pseudomembranous colitis, Clostridium difficile associated diarrhea (ranging from mild diarrhea to fatal colitis)

Onset of pseudomembranous colitis symptoms has been reported during or after antibacterial therapy.

Cardiovascular

Frequency not reported: QT prolongation, ventricular arrhythmias, ventricular tachycardia, torsades de pointes, arrhythmias, hypotension, polymorphous ventricular tachycardia
Postmarketing reports: Torsades de pointes

Life-threatening episodes of ventricular tachycardia associated with prolonged QT interval (torsades de pointes) have been reported following IV administration of erythromycin lactobionate.

QT prolongation has been reported both in otherwise healthy patients and in patients with a history of heart disease or who were on other potentially arrhythmogenic drugs. Most affected patients were receiving erythromycin intravenously. In a recent retrospective study of 278 consecutive patients who had received IV erythromycin lactobionate, 39% of 49 evaluable patients developed moderate to severe delay in ventricular repolarization (QTc interval greater than or equal to 500 msec) during treatment. Of the 278 patients, torsade de pointes was observed in one patient (less than 0.4%).

Arrhythmias and hypotension have been reported following IV administration.

One case of erythromycin-related polymorphous ventricular tachycardia reported in a patient treated for pneumonia was characterized by a normal QT interval.

Hepatic

Rare (less than 0.1%): Hepatotoxicity, fulminant hepatic necrosis, false isolated elevations of serum glutamic oxaloacetic transaminase (SGOT) enzymes
Frequency not reported: Hepatic dysfunction (including increased liver enzymes), hepatocellular and/or cholestatic hepatitis (with or without jaundice), transient elevations of liver function tests, hepatitis, abnormal liver function test results, intrahepatic cholestasis

Hepatic dysfunction (including increased liver enzymes) and hepatocellular and/or cholestatic hepatitis (with or without jaundice) have been reported with oral erythromycin.

Hypersensitivity

Frequency not reported: Allergic reactions (ranging from urticaria to anaphylaxis), hypersensitivity reactions (presented as rash, eosinophilia, fever), hypersensitivity with noninfectious hepatitis

Dermatologic

Rare (less than 0.1%): Skin rash, maculopapular rashes (generalized, pruritic)
Frequency not reported: Skin reactions (ranging from mild eruptions to erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis)

Nervous system

Reversible hearing loss was reported primarily in patients with renal dysfunction and in patients receiving high doses of erythromycin (the active ingredient contained in E.E.S. Granules)

Several published reviews have indicated that ototoxicity was associated with erythromycin dosages greater than 4 grams per day, preexisting liver or kidney disease, and advanced age. Recovery generally occurred within two weeks.

Rare (less than 0.1%): Convulsions, reversible hearing loss, reversible ototoxicity
Frequency not reported: Exacerbation of myasthenia gravis symptoms, new onset of myasthenic syndrome

Hematologic

A case of hemolytic anemia has been reported in a patient with severe underlying diseases and erythromycin-associated hepatitis.

Rare (less than 0.1%): Reversible agranulocytosis
Frequency not reported: Hemolytic anemia

Renal

Frequency not reported: Interstitial nephritis

Psychiatric

Rare (less than 0.1%): Recurrent nightmares

Local

Slow infusion of diluted erythromycin (the active ingredient contained in E.E.S. Granules) (continuously or intermittently over no less than 20 to 60 minutes) almost invariably alleviated venous irritation.

Rare (less than 0.1%): Venous irritation with IV administration

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