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Erythromycin Oral Products

Last Updated: April 1, 2011
Status: Resolved

Products Affected - Description

Erythromycin stearate, Abbott
Erythrocin Stearate Filmtab, 250 mg tablets, 500 count (NDC 00074-6346-53) - discontinued

 
Erythromycin base, Abbott
Erythromycin Base Filmtab, 250 mg tablets, 500 count (NDC 00074-6326-53) - discontinued
Erythromycin Delayed-Release, 250 mg capsules, 500 count (NDC 00074-6301-53) - discontinued
Ery-Tab (erythromycin delayed-release), 250 mg tablets, 500 count (NDC 00074-6304-53) - discontinued
Ery-Tab (erythromycin delayed-release), 333 mg tablets, 500 count (NDC 00074-6320-53) - discontinued
 
Erythromycin ethylsuccinate, Abbott
EES 400 mg Filmtab, 500 count (NDC 00074-5729-53) - discontinued
EES 400 mg Filmtab, 1000 count (NDC 00074-5729-19) - discontinued
EES 400 mg Filmtab, 100 count, unit dose (NDC 00074-5729-11) - discontinued
EES 200 Liquid, 1 pint (NDC 00074-6306-16) - discontinued
EES 200 Liquid, 100 mL (NDC 00074-6306-13) - discontinued
EES 400 Liquid, 1 pint, (NDC 00074-6373-16) - discontinued
EES 400 Liquid, 100 mL (NDC 00074-6373-13) - discontinued
EryPed for oral suspension, 200 mg/5 mL, 5 mL unit dose, 100 count (NDC 00074-6302-05) - discontinued
EryPed oral suspension, 200 mg/5 mL, 200 mL (NDC 00074-6302-53) - discontinued
EryPed for oral suspension, 400 mg/5 mL, 5 mL unit dose, 100 count (NDC 00074-6305-05) - discontinued
EryPed for oral suspension, 400 mg/5 mL, 60mL (NDC 00074-6305-60) - discontinued
EryPed for oral suspension, 400 mg/5 mL, 200mL (NDC 00074-6305-53) - discontinued
EryPed Drops for oral suspension, 100 mg/2.5 mL, 50 mL (NDC 00074-6303-50) - discontinued

Reason for the Shortage

  • Abbott discontinued several oral erythromycin presentations by mid-December 2010. The rest of the oral erythromycin products were previously sold to Arbor Pharmaceuticals in late-November, 2010.1,2
  • Consolidated Midland and Actavis discontinued all erythromycin preparations.3,4

Estimated Resupply Dates

Arbor Pharmaceuticals is the sole supplier of all oral erythromycin products.


Erythromycin stearate
Arbor Pharmaceuticals available has Erythrocin Stearate 250 mg Filmtab 100 count (NDC 00074-6346-20).
 
Erythromycin base
  • Arbor Pharmaceuticals has available Erythromycin Base Filmtab 250 mg (NDC 00074-6326-13) and 500 mg (NDC 00074-6227-13) 100 count tablets.
  • Arbor Pharmaceuticals has available erythromycin 250 mg (NDC 00074-6301-13) 100 count delayed-release capsules.
  • Arbor Pharmaceuticals has available Ery-Tab 250 mg (NDC 00074-6304-13), 333 mg (NDC 00074-6320-13), and 500 mg (NDC 00074-6321-13) 100 count delayed-release tablets.
  • Arbor Pharmaceuticals has available PCE Dispertab 333 mg 60 count (NDC 00074-6290-60) and 500 mg 100 count (NDC 00074-3389-13) particles in tablets.

Erythromycin ethylsuccinate
  • Arbor Pharmaceuticals has available erythromycin ethylsuccinate 400 mg tablets 100 count (NDC 00074-2589-13) and E.E.S. 400 mg Filmtab 100 count (NDC 00074-5729-13).
  • Arbor Pharmaceuticals has available E.E.S. (erythromycin ethylsuccinate) 200 mg/5 mL 100 mL (NDC 00074-6369-02) and 200 mL (NDC 00074-6369-10) granules for oral suspension.
  • Arbor Pharmaceuticals has available EryPed (erythromycin ethylsuccinate) 400 mg/5mL 100 mL (NDC 00074-6305-13) and 200 mg/5 mL 100 mL (NDC 00074-6302-13) granules for oral suspension.

Implications for Patient Care

  • Oral erythromycin is an antiinfective medication used to treat a variety of bacteria and other infections.5-11 Usual dosing for the various erythromycin preparations are listed in the following table. Length of therapy and optimal dosing is based on patient specific characteristics along with type and severity of infection.
  • No single agent may be substituted for erythromycin for all patients. Base choice of therapy on specific patient characteristics.
  • Multiple preparations of erythromycin have been developed to improve absorption of erythromycin base.12
  • Erythromycin ethylsuccinate 400 mg is equivalent to erythromycin 250 mg as stearate or base.5-11

Table. Dosing for Erythromycin Preparations
5-11   

Drug

Adult Dose

Pediatric Dose

Erythromycin Stearate
 
Erythromycin Base
 
Erythromycin Base Delayed Release Tablets (Ery-Tab) and Capsules
 
PCE (erythromycin base as particles)
Usual Starting Dose
250 mg every 6 hours
 
OR
 
333 mg every 8 hours*
 
OR
 
500 mg every 12 hours
 
Maximum Dose
4 grams/day
 
Twice daily dosing not recommended in doses >1 gram/day
 
*333 mg presentation available as PCE and Ery-Tab only
 
Usual Starting Dose
30-50 mg/kg/day in divided doses
 
Maximum Dose
May double dose if needed not to exceed 4 grams/day

Erythromycin Ethylsuccinate including EryPed

Usual Starting Dose
400 mg every 6 hours*
 
Maximum Dose
4 grams of erythromycin base/day
 
*400 mg erythromycin ethylsuccinate = 250 mg erythromycin base or stearate
 
Twice daily dosing not recommended in doses >1 gram/day

Usual Starting Dose
 
(doses may be given every 6-12 hours)
 
Under 10 lbs: 30-50 mg/kg/day or 15-25 mg/lb/day
 
10-15 lbs: 200 mg/day
16-25 lbs: 400 mg/day
26-50 lbs: 800 mg/day
51-100 lbs: 1200 mg/day
>100 lbs: 1600 mg/day
 
Maximum Dose
May double dose if needed 

Safety

Avoid switching between products if possible to minimize potential underdosing or overdosing.

Alternative Agents & Management

No single agent may be substituted for erythromycin for all patients. Base choice of therapy on specific patient characteristics.

Related Shortages

References

  1. Abbott Laboratories (personal communications). March 11, 2011.
  2. Arbor Pharmaceuticals (personal communications). March 11, 14, 30, and April 1, 2011.
  3. Consolidated Midland, Corp. (personal communications). March 11, 2011.
  4. Actavis (personal communications). March 11, 2011.
  5. Erythromycin ethylsuccinate tablets (E.E.S. Filmtab) product information. North Chicago, IL: Abbott Laboratories, June 2009.
  6. Erythromycin ethylsuccinate for oral suspension (EryPed.) product information. North Chicago, IL: Abbott Laboratories, November 2008.
  7. Erythromycin base delayed-release tablets (Ery-Tab) product information. North Chicago, IL: Abbott Laboratories, April 2010.
  8. Erythromycin stearate tablets (Erythrocin Stearate Filmtab) product information. North Chicago, IL: Abbott Laboratories, June 2009.
  9. Erythromycin base tablets (Erythromycin Base Filmtab) product information. North Chicago, IL: Abbott Laboratories, June 2009.
  10. Erythromycin delayed-release capsules product information. North Chicago, IL: Abbott Laboratories, June 2009.
  11. Erythromycin particles in tablet (PCE Dispertab Tablets) product information. North Chicago, IL: Abbott Laboratories, April 2010.
  12. Sivapalasingam S, Steigbigel NH. Macrolides, clindamycin, and ketolides. In: Mandel, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Mandel GL, Bennett JE, Dolin R, Eds. Philadelphia, PA. Churchill Livingstone Elsevier. 2010: 427-448.

Updated

Updated April 1, 2011 by Jane Chandramouli, Pharm.D., Drug Information Specialist. Created March 11, 2011, by Michelle Wheeeler, Pharm.D., Drug Information Specialist. Copyright 2011, Drug Information Service, University of Utah, Salt Lake City, UT.

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