Skip to Content

Erythromycin Lactobionate Injection

Last Updated: March 22, 2018
Status: Resolved

Erythromycin Lactobionate Injection

Products Affected - Description
  • Erythrocin powder for solution for injection, Pfizer
    500 mg, ADD-Vantage vial, 10 count (NDC 00409-6476-44)

500 mg, vial, 10 count (NDC 00409-6482-01)
Reason for the Shortage
  • Pfizer has Erythrocin on shortage due to manufacturing delays.

Available Products
  • There is insufficient supply for usual ordering

Estimated Resupply Dates

  • Pfizer has Erythrocin 500 mg vials and 500 mg ADD-Vantage vials on back order and the company estimates a release date of September 2018.

Alternative Agents & Management

  • Table 1. Alternatives to Erythromycin Lactobionate Injection in Selected Situations1-5 

    Situation

    Recommendation

    Comments

    Gastroparesis1-2

    Metoclopramide 5 mg 3 times daily initial dose. Dosage range 5 mg to 10 mg 2 to 3 times daily before meals (maximum dose 40 mg daily).
     
    Erythromycin 250 mg to 500 mg orally 3 times daily before meals.

    Metoclopramide - Liquid preferred to increase absorption. Use drug holidays or dose reductions when clinically possible.Side effects such as drowsiness and tardive dyskinesia may limit the utility of metoclopramide.

    Erythryomycin oral - Limit duration of therapy, tacyphylaxis may occur after 4 weeks.

    Gastroparesis following partial large or small bowel resection surgery with primary anastomosis 3

    Alvimopan 12 mg orally 30 minutes to 5 hours before surgery, then 12 mg orally twice daily for up to a maximum of 15 doses

    May only be used in hospitals. Hospitals must be enrolled in the Entereg Access Support and Education (EASE) program.

    Premature Rupture of Membranes (PROM)4-5

    Ampicillin 2 gram IV every 6 hours and erythromycin 250 mg IV every 6 hours for 48 hours followed by oral amoxicillin 250 mg every 8 hours and erythromycin 333 mg every 8 hours. 

     
     

    Azithromycin may be used as an alternative to erythromycin.

    A small retrospective study (N=168) found no difference in time of latency between patients who received ampicillin and azithromycin (9.4+10.4 days) and patients who received ampicillin and erythromycin (9.6+13.2 days, p=0.40). Azithromycin dose and route not specified in study. 5

References

    1. Camilleri M, Parkman HP, Shafi MA et al. Clinical Guideline: Management of Gastroparesis. Am J Gastroenterol. 2013;108 (1):18-38.
    2. Lexi-Drugs Online. Hudson, OH: Lexi-Comp, Inc; 2018.
    3. Entereg (alvimopan) capsules [product information]. Whitehouse Station, NJ: Merck; 2015.
    4. ACOG Practice Bulletin No. 188: Premature Rupture of Membranes. Clinical managment guidelines for obstetrician-gynecologists. Obstet Gynecol. Jan 2018; 131:e1-14.
    5. Pierson RC, Gordon SS, Haas DM. A Retrospective Comparison of Antibiotic Regimens for Preterm Premature Rupture of Membranes. Obstetrics and Gynecology. 2014;124 (3):515-519.

Updated

Updated March 22, 2018 by Leslie Jensen, PharmD, Drug Information Specialist. Created July 11, 2016 by Michelle Wheeler, PharmD, Drug Information Specialist. Copyright 2018, Drug Information Service, University of Utah, Salt Lake City, UT.

Hide