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Erythrocin Stearate Filmtab (erythromycin) Disease Interactions

There are 5 disease interactions with Erythrocin Stearate Filmtab (erythromycin):

Major

Erythromycin (Includes Erythrocin Stearate Filmtab) ↔ Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Biliary Obstruction

The use of oral erythromycin, especially erythromycin estolate and erythromycin ethylsuccinate, has been associated with occasional cases of hepatic dysfunction, including elevated liver enzymes and hepatocellular and/or cholestatic hepatitis. Therapy with oral erythromycin should be administered cautiously in patients with liver disease. Additionally, erythromycin is primarily excreted by the liver into the bile. The effect of liver and/or biliary disease on erythromycin clearance is unknown. Empiric dosage adjustments may be appropriate in patients with impaired hepatic or biliary function.

References

  1. Diehl AM, Latham P, Boitnott JK, et al "Cholestatic hepatitis from erythromycin ethylsuccinate." Am J Med 76 (1984): 931-4
  2. Bachman BA, Boyd WP Jr, Brady PG "Erythromycin ethylsuccinate-induced cholestasis." Am J Gastroenterol 77 (1982): 397-400
  3. Kroboth PD, Brown A, Lyon JA, et al "Pharmacokinetics of single-dose erythromycin in normal and alcoholic liver disease subjects." Antimicrob Agents Chemother 21 (1982): 135-40
View all 12 references
Major

Macrolide Antibiotics (Includes Erythrocin Stearate Filmtab) ↔ Qt Prolongation

Severe Potential Hazard, High plausibility

Applies to: Long QT Syndrome, Hypokalemia, Magnesium Imbalance, Arrhythmias

Prolonged cardiac repolarization and QT interval have been reported in patients receiving treatment with macrolides. Providers should weight risks and benefits of using these drugs in patients with known prolongation of the QT interval, history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias, proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, or patients receiving other drugs that prolong the QT interval.

Major

Mdvs (Includes Erythrocin Stearate Filmtab) ↔ Prematurity

Severe Potential Hazard, Moderate plausibility

Applies to: Prematurity/Underweight in Infancy

Parenteral medications formulated in multidose vials often contain benzyl alcohol as a preservative. Their use is considered by drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. When used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, benzyl alcohol has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. Thus, single-dose formulations should always be used in infants whenever possible. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. However, the administration of high dosages of these medications must take into account the total amount of benzyl alcohol administered. The level at which toxicity may occur is unknown.

References

  1. ""Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs. Available from: URL: http://www.aap.org/policy/re9706.html." Pediatrics 99 (1997): 268-78
  2. "Product Information. Tracrium (atracurium)." Glaxo Wellcome, Research Triangle Park, NC.
  3. "Product Information. Fragmin (dalteparin)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 6 references
Moderate

Antibiotics (Includes Erythrocin Stearate Filmtab) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
View all 47 references
Moderate

Macrolide Antibiotics (Includes Erythrocin Stearate Filmtab) ↔ Myasthenia Gravis

Moderate Potential Hazard, Moderate plausibility

Applies to: Myasthenia Gravis

The use of macrolide antibiotics has been reported to exacerbate symptoms of myasthenia gravis and trigger new onset of symptoms of myasthenic syndrome. Limited data suggest presynaptic suppression of acetylcholine release. Therapy with these agents should be administered cautiously in patients with a history of myasthenia gravis.

References

  1. May EF, Calvert PC "Aggravation of myasthenia gravis by erythromycin." Ann Neurol 28 (1990): 577-9
  2. "Product Information. Ery-tab (erythromycin)." Abbott Pharmaceutical, Abbott Park, IL.

Erythrocin Stearate Filmtab (erythromycin) drug Interactions

There are 697 drug interactions with Erythrocin Stearate Filmtab (erythromycin)

Erythrocin Stearate Filmtab (erythromycin) alcohol/food Interactions

There are 2 alcohol/food interactions with Erythrocin Stearate Filmtab (erythromycin)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. 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.

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