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Erythromycin (macrolide, antibiotic agent)

Know the basics|Know the precautions & warnings|Know the side effects|Know the interactions|Understand the dosage

Erythromycin is a generic antibiotic that treats a wide variety of bacterial infections. Erythromycin is known as a macrolide antibiotic. It works by stopping the growth of bacteria.

Erythromycin is only effective against bacterial infections. It will not work for viral infections. Do not use antibiotics unless they your doctor prescribes it to you.

erythromycin

Know the basics

What is erythromycin used for?

  • Acne
  • Prophylaxis for surgery
  • Respiratory tract infections
  • Skin and soft tissue infections
  • Susceptible gram-negative and gram-positive infections
  • Neonatal conjunctivitis
  • Eye infections

How should I take erythromycin?

Read the directions on the packaging for complete information. Check the label and expiration date.

Swallow oral dosage forms without chewing or crushing it. Oral suspensions need to be reconstituted (mixed) with water. Follow the directions on the packaging and only use a medical-grade measuring cup. Do not use a household spoon.

For topical dosage forms, wash your hands before and after handing the product. Avoid touching the tip of the dropper or nozzle. Use a clean cotton swab if necessary.

Parenteral dosage forms should be administered by a licensed healthcare professional.

How do I store erythromycin?

This product is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer.

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using erythromycin?

Before using this drug, tell your doctor if you are/have:

  • Pregnant or breastfeeding.
  • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
  • An allergy to any of the ingredients of this product.
  • Any other illnesses, disorders, or medical conditions.

Is it safe to take erythromycin during pregnancy or breast-feeding?

Unfortunately, there isn’t enough information about the safety of using this drug during pregnancy and breastfeeding. However, it is likely safe to use the topical dosage forms. Please always consult with your doctor to weigh the potential benefits and risks before taking any medication.

This medication is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Know the side effects

What are the side effects of erythromycin?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

  • Allergic reaction
  • Skin peeling, itching, or burning
  • Hypotension
  • GI upset
  • Loss of appetite
  • Diarrhea
  • Fever
  • Malaise
  • Tinnitus
  • Loss of hearing

Seek medical attention immediately if you experience any serious adverse effects:

  • QT prolongation, ventricular arrhythmias **potentially fatal
  • Pseudomembranous colitis
  • Superinfection
  • Myasthenia gravis
  • Infantile hypertrophic pyloric stenosis
  • Severe liver damage

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with erythromycin?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects.

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Drugs with known interactions:

  • Antivirals
  • Antifungals
  • Other antibiotics
  • Anitneoplastic drugs
  • Statins
  • Antimalarials
  • Antihypertensives
  • Immunosuppressants
  • Antidepressants
  • Corticosteroids

If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with erythromycin?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. To avoid stomach upset, it is best to take it on an empty stomach. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with erythromycin?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Bradycardia (slow heartbeat)
  • Heart rhythm problems (e.g., QT prolongation)
  • Hypokalemia (low potassium in the blood)
  • Hypomagnesemia (low magnesium in the blood)
  • Congestive heart failure
  • Liver disease
  • Myasthenia gravis

Understand the dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Prophylaxis of surgical infections, Respiratory tract infections, Skin and soft tissue infections, Susceptible Gram-negative infections, Susceptible Gram-positive infections

Via IV, initially give 1 to 2 g as erythromycin lactobionate per day, equivalent to 25 mg per kg of body weight in 2 to 4 divided doses. Maximum dose is 4 g per day, equal to 50 mg per kg a day, for severe infections. Switch to oral doses after 2 to 7 days of IV therapy.

For oral doses, take 1 to 2 g per day in 2 to 4 divided doses. Increase the dose up to 4 g per day for severe infections. Do not exceed 1 g in a single dose.

Superficial ocular infections

Apply a 1 cm ribbon of ointment to the affected eye(s) every 4 hours or more, depending on the severity of the infection.

Acne

Apply a thin layer of the topical product to the affected areas 1 to 2 times a day. Stop treatment if there is no improvement after 6 to 8 weeks.

What is the dose for a child?

Prophylaxis of surgical infections, Respiratory tract infections, Skin and soft tissue infections, Susceptible Gram-negative infections, Susceptible Gram-positive infections

Via IV, give 15 to 20 mg per kg of body weight in 4 divided doses. Maximum dose is 4 g per day for severe infections. Switch to oral doses after 2 to 7 days of IV therapy.

For oral doses, give 30 to 50 mg per kg in 2 to 4 divided doses. Double the dose for severe infections.

Prophylaxis of neonatal conjunctivitis

Carefully, apply a 1 cm ribbon of ointment to the lower conjunctival sac of both eyes.

Superficial ocular infections

Carefully, apply a 1 cm ribbon of ointment to the affected eye(s) every 4 hours or more, depending on the severity of the infection.

Acne

Apply a thin layer of the topical product to the affected areas 1 to 2 times a day. However, stop treatment if there is no improvement after 6 to 8 weeks.

How is erythromycin available?

Erythromycin is available in the following dosage forms and strengths:

  • Eye ointment: 5 mg/g
  • Oral capsule: 500 mg
  • Powder for oral suspension: 125 mg/5 mL, 200 mg/5 mL, 250 mg/5 mL
  • Oral drops: 100 mg/mL

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Erythromycin https://www.mims.com/philippines/drug/info/erythromycin?mtype=generic Accessed June 29, 2021

Erythromycin (Oral Route) https://www.mayoclinic.org/drugs-supplements/erythromycin-oral-route/proper-use/drg-20075495 Accessed June 29, 2021

Erythromycin https://www.nhs.uk/medicines/erythromycin/ Accessed June 29, 2021

Erythromycin (Topical). Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed June 29, 2021. http://online.lexi.com

Erythromycin (Systemic). Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed June 29, 2021. http://online.lexi.com

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Written by Stephanie Nicole Nera, RPh, PharmD Updated Jun 29
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