Erythromycin

Erythromycin base: Should be taken on an empty stomach. Best taken on an empty stomach at least 30 min & preferably 2 hr before meals.

Hypersensitivity. History of QT prolongation (congenital or documented acquired QT prolongation) or ventricular cardiac arrhythmia, including torsades de pointes; electrolyte disturbances (e.g. hypokalaemia, hypomagnesaemia). Concomitant use with amisulpride, astemizole, simvastatin, lovastatin, tolterodine, mizolastine, terfenadine, domperidone, pimozide, cisapride, ergotamine, dihydroergotamine, class IA (e.g. quinidine, procainamide) and class III (e.g. dofetilide, amiodarone, sotalol) antiarrhythmic agents.

Patient with CAD, severe cardiac insufficiency, conduction disturbances, clinically relevant bradycardia, myasthenia gravis. Hepatic impairment. Neonates, children, and elderly. Pregnancy and lactation. Monitoring Parameters Perform culture and susceptibility tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Monitor liver and renal function (prolonged use); blood pressure, heart rate. Observe for changes in frequency of bowel movements.

Significant: Hepatic dysfunction including increased liver enzymes and/or cholestatic hepatitis, with or without jaundice; exacerbation or new onset of symptoms of myasthenia gravis; infantile hypertrophic pyloric stenosis; overgrowth of non-susceptible bacteria or fungi (prolonged or repeated therapy). Rarely, serious allergic reactions (including acute generalised exanthematous pustulosis). Blood and lymphatic system disorders: Eosinophilia. Cardiac disorders: Chest pain. Ear and labyrinth disorders: Tinnitus, deafness. Eye disorders: Mitochondrial optic neuropathy; minor ocular irritation (ophthalmic). Gastrointestinal disorders: Nausea, vomiting, diarrhoea, pancreatitis, upper abdominal pain. General disorders and administration site conditions: Fever, malaise. Topical: Application site irritation (e.g. local dryness, localised burning, erythema or tenderness, stinging of the skin). Metabolism and nutrition disorders: Anorexia. Nervous system disorders: Seizures, vertigo. Psychiatric disorders: Confusion, hallucinations. Renal and urinary disorders: Interstitial nephritis. Skin and subcutaneous tissue disorders: Pruritus, urticaria. Vascular disorders: Hypotension.
Potentially Fatal: Pseudomembranous colitis, Clostridium difficile-associated diarrhoea, QT interval prolongation, torsades de pointes, severe skin reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme), angioneurotic oedema, anaphylaxis.

May increase serum concentration of acenocoumarol, alfentanil, bromocriptine, carbamazepine, cilostazol, ciclosporin, digoxin, dihydroergotamine, disopyramide, ergotamine, hexobarbitone, methylprednisolone, midazolam, omeprazole, phenytoin, quinidine, rifabutin, sildenafil, tacrolimus, domperidone, theophylline, tolterodine, triazolam, valproic acid, vinblastine, antifungals (e.g. ketoconazole, itraconazole, fluconazole), zopiclone. Increased serum concentration with cimetidine. Decreased serum concentration resulting in decreased effect with CYP3A4 inducers (e.g. rifampicin, phenytoin, carbamazepine, phenobarbital). Increased risk for CV events with hydroxychloroquine or chloroquine. Increased risk for rhabdomyolysis with HMG-CoA reductase inhibitors (e.g. lovastatin, simvastatin). Increased anticoagulant effects with oral anticoagulants (e.g. rivaroxaban, warfarin). May increase the pharmacological effect of triazolam, midazolam and related benzodiazepines. Increased risk for acute ergot toxicity (characterised by vasospasm and ischaemia of the CNS, extremities and other tissues) with ergotamine or dihydroergotamine. May increase serum concentrations of theophylline which may result in theophylline toxicity. Increased risk for hypotension, bradyarrhythmias, and lactic acidosis with Ca channel blockers.

Acne Treatment Preparations / Eye Anti-Infectives & Antiseptics / Macrolides / Topical Antibiotics

D10AF02 - erythromycin ; Belongs to the class of topical antiinfective preparations used in the treatment of acne.
J01FA01 - erythromycin ; Belongs to the class of macrolides. Used in the systemic treatment of infections.
S01AA17 - erythromycin ; Belongs to the class of antibiotics. Used in the treatment of eye infections.