Drug Interactions between erythromycin and tetracycline
This report displays the potential drug interactions for the following 2 drugs:
- erythromycin
- tetracycline
Interactions between your drugs
No interactions were found between erythromycin and tetracycline. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
erythromycin
A total of 641 drugs are known to interact with erythromycin.
- Erythromycin is in the drug class macrolides.
-
Erythromycin is used to treat the following conditions:
- Bacterial Endocarditis Prevention
- Bartonellosis
- Bowel Preparation
- Bronchitis
- Bullous Pemphigoid
- Campylobacter Gastroenteritis
- Chancroid
- Chlamydia Infection
- Dental Abscess
- Legionella Pneumonia
- Lyme Disease
- Lymphogranuloma Venereum
- Mycoplasma Pneumonia
- Nongonococcal Urethritis
- Ocular Rosacea
- Otitis Media
- Pemphigoid
- Pertussis
- Pharyngitis
- Pneumonia
- Rheumatic Fever Prophylaxis
- Skin and Structure Infection
- Skin or Soft Tissue Infection
- Strep Throat
- Syphilis, Early
- Upper Respiratory Tract Infection
tetracycline
A total of 197 drugs are known to interact with tetracycline.
- Tetracycline is in the drug class tetracyclines.
-
Tetracycline is used to treat the following conditions:
- Acne
- Bacterial Infection
- Bladder Infection
- Bronchitis
- Brucellosis
- Bullous Pemphigoid
- Chlamydia Infection
- Ehrlichiosis
- Epididymitis, Sexually Transmitted
- Gonococcal Infection, Uncomplicated
- Helicobacter Pylori Infection
- Lyme Disease, Arthritis
- Lyme Disease, Carditis
- Lyme Disease, Erythema Chronicum Migrans
- Lyme Disease, Neurologic
- Lymphogranuloma Venereum
- Nongonococcal Urethritis
- Ocular Rosacea
- Ornithosis
- Pelvic Inflammatory Disease
- Pemphigoid
- Pemphigus (off-label)
- Pneumonia
- Psittacosis
- Rheumatoid Arthritis (off-label)
- Rickettsial Infection
- Syphilis, Early
- Syphilis, Latent
- Tertiary Syphilis
- Upper Respiratory Tract Infection
Drug and food interactions
tetracycline food
Applies to: tetracycline
ADJUST DOSING INTERVAL: Administration with food, particularly dairy products, significantly reduces tetracycline absorption. The calcium content of these foods forms nonabsorbable chelates with tetracycline.
MANAGEMENT: Tetracycline should be administered one hour before or two hours after meals.
References
- "Product Information. Achromycin (tetracycline)." Lederle Laboratories PROD (2001):
- "Product Information. Declomycin (demeclocycline)." Lederle Laboratories PROD (2001):
erythromycin food
Applies to: erythromycin
ADJUST DOSING INTERVAL: Food may variably affect the bioavailability of different oral formulations and salt forms of erythromycin. The individual product package labeling should be consulted regarding the appropriate time of administration in relation to food ingestion. Grapefruit juice may increase the plasma concentrations of orally administered erythromycin. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. In an open-label, crossover study consisting of six healthy subjects, the coadministration with double-strength grapefruit juice increased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of a single dose of erythromycin (400 mg) by 52% and 49%, respectively, compared to water. The half-life was not affected. The clinical significance of this potential interaction is unknown.
MANAGEMENT: In general, optimal serum levels are achieved when erythromycin is taken in the fasting state, one-half to two hours before meals. However, some erythromycin products may be taken without regard to meals.
References
- Welling PG, Huang H, Hewitt PF, Lyons LL "Bioavailability of erythromycin stearate: influence of food and fluid volume." J Pharm Sci 67 (1978): 764-6
- Welling PG, Elliott RL, Pitterle ME, et al. "Plasma levels following single and repeated doses of erythromycin estolate and erythromycin stearate." J Pharm Sci 68 (1979): 150-5
- Welling PG "Influence of food and diet on gastrointestinal drug absorption: a review." J Pharmacokinet Biopharm 5 (1977): 291-334
- Coyne TC, Shum S, Chun AH, Jeansonne L, Shirkey HC "Bioavailability of erythromycin ethylsuccinate in pediatric patients." J Clin Pharmacol 18 (1978): 194-202
- Malmborg AS "Effect of food on absorption of erythromycin. A study of two derivatives, the stearate and the base." J Antimicrob Chemother 5 (1979): 591-9
- Randinitis EJ, Sedman AJ, Welling PG, Kinkel AW "Effect of a high-fat meal on the bioavailability of a polymer-coated erythromycin particle tablet formulation." J Clin Pharmacol 29 (1989): 79-84
- Kanazawa S, Ohkubo T, Sugawara K "The effects of grapefruit juice on the pharmacokinetics of erythromycin." Eur J Clin Pharmacol 56 (2001): 799-803
tetracycline food
Applies to: tetracycline
GENERALLY AVOID: The bioavailability of oral tetracyclines and iron salts may be significantly decreased during concurrent administration. Therapeutic failure may result. The proposed mechanism is chelation of tetracyclines by the iron cation, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. In ten healthy volunteers, simultaneous oral administration of ferrous sulfate 200 mg and single doses of various tetracyclines (200 mg to 500 mg) resulted in reductions in the serum levels of methacycline and doxycycline by 80% to 90%, oxytetracycline by 50% to 60%, and tetracycline by 40% to 50%. In another study, 300 mg of ferrous sulfate reduced the absorption of tetracycline by 81% and that of minocycline by 77%. Conversely, the absorption of iron has been shown to be decreased by up to 78% in healthy subjects and up to 65% in patients with iron depletion when ferrous sulfate 250 mg was administered with tetracycline 500 mg. Available data suggest that administration of iron 3 hours before or 2 hours after a tetracycline largely prevents the interaction with most tetracyclines except doxycycline. Due to extensive enterohepatic cycling, iron binding may occur with doxycycline even when it is given parenterally. It has also been shown that when iron is administered up to 11 hours after doxycycline, serum concentrations of doxycycline may still be reduced by 20% to 45%.
MANAGEMENT: Coadministration of a tetracycline with any iron-containing product should be avoided if possible. Otherwise, patients should be advised to stagger the times of administration by at least three to four hours, although separating the doses may not prevent the interaction with doxycycline.
References
- Neuvonen PJ "Interactions with the absorption of tetracyclines." Drugs 11 (1976): 45-54
- Gothoni G, Neuvonen PJ, Mattila M, Hackman R "Iron-tetracycline interaction: effect of time interval between the drugs." Acta Med Scand 191 (1972): 409-11
- Venho VM, Salonen RO, Mattila MJ "Modification of the pharmacokinetics of doxycycline in man by ferrous sulphate or charcoal." Eur J Clin Pharmacol 14 (1978): 277-80
- "Product Information. Minocin (minocycline)." Lederle Laboratories PROD (2002):
- Campbell NR, Hasinoff BB "Iron supplements: a common cause of drug interactions." Br J Clin Pharmacol 31 (1991): 251-5
- Bateman FJ "Effects of tetracyclines." Br Med J 4 (1970): 802
- Neuvonen PJ, Gothoni G, Hackman R, Bjorksten K "Interference of iron with the absorption of tetracyclines in man." Br Med J 4 (1970): 532-4
- Greenberger NJ "Absorption of tetracyclines: interference by iron." Ann Intern Med 74 (1971): 792-3
- Neuvonen PJ, Penttila O "Effect of oral ferrous sulphate on the half-life of doxycycline in man." Eur J Clin Pharmacol 7 (1974): 361-3
- "Product Information. Seysara (sarecycline)." Allergan Inc (2018):
- "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc. (2018):
erythromycin food
Applies to: erythromycin
Ethanol, when combined with erythromycin, may delay absorption and therefore the clinical effects of the antibiotic. The mechanism appears to be due to slowed gastric emptying by ethanol. Data is available only for erythromycin ethylsuccinate. Patients should be advised to avoid ethanol while taking erythromycin salts.
References
- Morasso MI, Chavez J, Gai MN, Arancibia A "Influence of alcohol consumption on erythromycin ethylsuccinate kinetics." Int J Clin Pharmacol 28 (1990): 426-9
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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