- Side Effects
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
Generic Name: erythromycin
Brand Names: Ery-Tab, PCE
Drug Class: macrolide antibiotics
What is erythromycin, and what is it used for?
Erythromycin is an antibiotic in the class of antibiotics known as macrolide antibiotics which also includes azithromycin (Zithromax, Zmax) and clarithromycin (Biaxin).
Erythromycin, like all macrolide antibiotics, prevents bacterial cells from growing and multiplying by interfering with their ability to make proteins while not affecting human cells. Bacteria such as Haemophilus influenzae are resistant to erythromycin alone and must be treated with a combination of erythromycin and adequate doses of sulfonamides.
Erythromycin is used to treat:
- Streptococcal infections of the throat ("strep throat") and skin
- Lung infections, for example, pneumonia caused by streptococcal pneumoniae, mycoplasma pneumoniae, and legionella pneumophila (legionnaires disease)
- Pelvic inflammatory disease
- Whooping cough
- Intestinal amebiasis
It is used for the treatment of staphylococcal infections of the skin and as an alternative antibiotic for the treatment of syphilis, gonorrhea, and chlamydia.
Erythromycin is used in patients who are allergic to penicillin for the prevention of recurrent rheumatic fever and infections of the hearts' valves (endocarditis) in patients with valvular abnormalities of the heart before they undergo dental treatments.
The non-FDA approved uses for erythromycin include acne, Lyme disease, and tetanus.
The FDA approved E.E.S in April 1965.
What are the side effects of erythromycin?
The most frequent side effects of erythromycin are
These gastrointestinal side effects are usually dose-related, i.e., more pronounced with higher doses.
Allergic reactions such as
- rash, or
- anaphylaxis (a severe allergic reaction which can lead to shock and death) have been reported rarely.
What is the dosage for erythromycin?
- The usual dosage for adults is 250 mg every 6 hours, 333 mg every 8 hours or 500 mg every 12 hours. Doses may be increased up to 4 g/day according to the severity of the infection.
- In children, the usual dosage is 30 to 50 mg/kg/day with age, weight, and severity of the infection being taken into consideration to determine the appropriate dosage.
- Erythromycin may be taken with or without food; however optimal blood levels of erythromycin are obtained when taken on an empty stomach (at least 30 minutes and preferably 2 hours before or after meals).
What drugs interact with erythromycin?
- Erythromycin when used with antiarrhythmic drugs such as, amiodarone (Cordarone), bretylium (Bretylol), disopyramide (Norpace), dofetilide (Tikosyn), procainamide (Pronestyl), quinidine (Quinaglute, Quinidex, Quinora) and sotalol (Betapace) exaggerates the effect of the antiarrhythmic drugs which may give rise to abnormal heart rhythms such as torsades de pointes.
- Theophyllines such as theophylline (Theo-Dur), oxtriphylline (Choledyl SA), and aminophylline (Phyllocontin) reduce erythromycin blood levels by increasing elimination of erythromycin by the kidneys, which may reduce the effectiveness of erythromycin. Conversely, erythromycin inhibits the metabolism (breakdown) of theophyllines by the liver and causes an increase in blood levels of theophylline. High theophylline levels may give rise to side effects such as seizures and disturbances in heart rhythm. Therefore, the dose of theophyllines should be reduced or theophylline levels in the blood should be measured in patients taking erythromycin.
- Combining erythromycin with ergotamine or ydroergotamine has been associated with acute ergot toxicity. This combination should be avoided.
- Erythromycin prevents digoxin (Lanoxin) from being eliminated by the kidneys; this in turn causes increased levels of digoxin in the blood. Increased levels of digoxin can cause disturbances in heart rhythm. Therefore, it is important to monitor and adjust digoxin doses when treating with erythromycin.
- Erythromycin prevents the elimination of warfarin (Coumadin) from the body which can raise the levels of warfarin in the blood. Warfarin is an anticoagulant or blood thinner, and an increase in its level in blood can increase the risk of bleeding. It is important to monitor the effects of warfarin and adjust warfarin doses when treating with erythromycin.
- Erythromycin inhibits the breakdown of HMG-CoA reductase inhibitors (statins) such as atorvastatin (Lipitor), lovastatin (Mevacor) and simvastatin (Zocor) by the liver leading to increased levels of statins in the blood.
- High levels of statins could result in severe myopathy (muscle damage) with rhabdomyolysis (rapid breakdown of skeletal muscle) that may damage the kidneys or even lead to death.
- Erythromycin also can elevate blood levels of some anti-seizure drugs such as carbamazepine (Tegretol) by preventing the breakdown of the anti-seizure drug by the liver. Therefore, doses of the anti-seizure drugs may need to be reduced during treatment with erythromycin.
- Erythromycin also increases blood levels of sildenafil (Viagra). The dose of sildenafil should be reduced when treated with erythromycin.
- Grapefruit juice may prevent the breakdown of erythromycin, resulting in elevated levels of erythromycin in the blood. Therefore, it is important to avoid eating grapefruit or drinking grapefruit juice during treatment with erythromycin.
Is erythromycin safe to take if I'm pregnant or breastfeeding?
- Erythromycin crosses the placenta, but its level in the blood of the fetus is low. There are no adequate studies in pregnant women, hence pregnant women should only use erythromycin if it is felt that the benefits of treatment outweigh the potential but unknown risks.
- Erythromycin is excreted in breast milk; however, erythromycin is considered by the American Academy of Pediatrics to be compatible with breastfeeding. Caution should be exercised, however, when erythromycin is prescribed to women who are breastfeeding.
What else should I know about erythromycin?
What preparations of erythromycin are available?
Erythromycin is available as:
- Tablets: 250, 333, 400 and 500 mg.
- Suspension: 200 and, 400 mg/teaspoon.
- Tablet (Chewable): 200 mg. Powder: 100 mg/half-teaspoon and 200 mg/teaspoon.
- Granules: 200 and 400 mg/teaspoon.
- Powder for Injection: 500 mg and 1g.
How should I keep erythromycin stored?
Erythromycin should be stored at temperatures below 86 F (30 C). It is important to protect tablets from moisture and excessive heat.
Erythromycin is an antibiotic prescribed to treat a variety of infections. The most frequent side effects of erythromycin are nausea, vomiting, loss of appetite, diarrhea, and abdominal pain. Consult with your doctor about any medications or supplements you may be taking and if there is potential for drug interactions with erythromycin. Check with your doctor before taking erythromycin if pregnant or breastfeeding.
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Chlamydia is a sexually transmitted disease (STD) that poses risks for both men and women. Untreated chlamydia in women may cause pelvic inflammatory disease (PID) or may harm an unborn baby.
What Are the Symptoms and Signs of Syphilis?
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Treatment & Diagnosis
- Eye Discharge
- Strep Throat
- Drainage of Pus
- Pelvic Inflammatory Disease (PID)
- Sinus Infection (Sinusitis)
- Abscessed Tooth
- Rheumatic Fever
- Scarlet Fever
- Mitral Valve Prolapse
- Whooping Cough (Pertussis)
- Doctor: Checklist to Take To Your Doctor's Appointment
- Group B Strep Infection
- Aortic Stenosis
- Legionnaires' Disease
- Group A Streptococcus Infection
- Aortic Valve Stenosis
- Whooping Cough: On the Rise
- STD FAQs
- Rosacea FAQs
- Strep Streptococcal Throat Infection FAQs
- Pelvic Inflammatory Disease (PID) FAQs
- Medication Disposal
- Dangers of Mixing Medications
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Gonorrhea Treatment Recommendations Update
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Strep Throat Diagnosis & Treatment
- What Are the Side Effects of Taking Antibiotics Long-Term?
- How Long Does It Take Strep to Go Away?
- How Do You Treat Whooping Cough in Adults?
- Can You Get Chlamydia Any Way Other than Sex?
- Syphilis Symptoms in Women
- Listeriosis Incubation Period and Risk Factors
- Strep Throat Complications
- Chlamydia Diagnosis in Women
- Listeriosis Symptoms, Signs, and Diagnosis
- Listeriosis Treatment and Prevention
- Whooping Cough Symptoms
- Sore Throat: Is It Mono or Strep Throat?
- Oral Gonorrhea Symptoms
- Strep Throat Symptoms
- Sore Throat: Virus or Strep?
- Chlamydia Symptoms
- Antibiotics 101
- Strep Throat Natural Home Remedies
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- azithromycin (Zithromax): For COVID-19
- Drug Interactions
- erythromycin and benzoyl peroxide (gel or pak), Benzamycin
- Side Effects of Ery-Tab (erythromycin)
- Side Effects of Benzamycin (erythromycin and benzoyl peroxide)
- Eryped (erythromycin ethylsuccinate)
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