Erythromycin Side Effects
Not all side effects for erythromycin 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
Other dosage forms:
In addition to its needed effects, some unwanted effects may be caused by erythromycin. In the event that any of these side effects do occur, they may require medical attention.
You should check with your doctor immediately if any of these side effects occur when taking erythromycin:Rare
- Blistering, peeling, or loosening of the skin
- difficulty with swallowing
- 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
- Abdominal or stomach cramps or tenderness
- bloody or cloudy urine
- chest pain or discomfort
- dark urine
- diarrhea, watery and severe, which may also be bloody
- 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
- swelling of the feet or lower legs
- unusual weight loss
- upper right abdominal or stomach pain
- yellow eyes and skin
Some of the side effects that can occur with erythromycin may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional: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
The most common side effects associated with oral erythromycin were gastrointestinal and were dose-related.
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.
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.
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.
Frequency not reported: Allergic reactions (ranging from urticaria to anaphylaxis), hypersensitivity reactions (presented as rash, eosinophilia, fever), hypersensitivity with noninfectious hepatitis
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)
Reversible hearing loss was reported primarily in patients with renal dysfunction and in patients receiving high doses of erythromycin.
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
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
Frequency not reported: Interstitial nephritis
Rare (less than 0.1%): Recurrent nightmares
Slow infusion of diluted erythromycin (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
More about erythromycin
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- Erythromycin delayed-release capsules
- Erythromycin delayed-release tablets
- Erythromycin ethylsuccinate
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