- What is erythromycin, and how does it work (mechanism of action)?
- What are the uses for erythromycin?
- What are the side effects of erythromycin?
- What is the dosage for erythromycin? Should I take it with food?
- Which drugs or supplements interact with erythromycin?
- Is erythromycin safe to take if I'm pregnant or breastfeeding?
- What else should I know about erythromycin?
What is erythromycin, and how does it work (mechanism of action)?
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.
The FDA approved E.E.S in April 1965.
What are the uses for erythromycin?
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
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.
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:
What is the dosage for erythromycin? Should I take it with food?
- 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).
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Which drugs or supplements 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 (r (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 treating 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.
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Erythromycin (Ery-Tab, PCE) is an antibiotic prescribed to treat a variety of infections. Side effects, drug interactions, dosage, storage, and pregnancy safety information should be reviewed prior to taking this medication.
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Staph Infection (Staphylococcus Aureus)
Staphylococcus or staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness directly by infection or indirectly by the toxins they produce. Symptoms and signs of a staph infection include redness, swelling, pain, and drainage of pus. Minor skin infections are treated with an antibiotic ointment, while more serious infections are treated with intravenous antibiotics.
Acne is a localized skin inflammation as a result of overactivity of oil glands at the base of hair follicles. This inflammation, depending on its location, can take the form of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Urinary Tract Infection (UTI)
A urinary tract infection (UTI) is an infection of the bladder, kidneys, ureters, or urethra. E. coli, a type of bacteria that lives in the bowel and near the anus, causes most UTIs. UTI symptoms include pain, abdominal pain, mild fever, urinary urgency and frequency. Treatment involves a course of antibiotics.
Intestinal Gas (Belching, Bloating, Flatulence)
Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus. Causes of belching or burping include drinking too rapidly, anxiety, carbonated drinks, habit, and swallowing air. Learn about causes of intestinal gas, foods that cause gas and bloating, treatments that reduce excessive gas and soothe gas pain, and much more.
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Indigestion (Dyspepsia, Upset Stomach Pain)
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Syphilis in Women
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Clostridium Difficile Colitis (Antibiotic-Associated Colitis, C. difficile colitis)
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Vancomycin-Resistant Enterococci (VRE)
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Aortic Valve Stenosis (Symptoms, Causes, Surgery)
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Whooping Cough (Pertussis)
Whooping cough (pertussis) is highly contagious respiratory infection that is caused by the bacteria Bordetella pertussis. There are an estimated 300,000 plus deaths annually from whooping cough (pertussis). Whooping cough commonly affects infants and young children but can be prevented with immunization with the vaccine. First stage whooping cough symptoms are a runny nose, sneezing, low-grade fever, a mild cough with the cough gradually becoming more severe. After one to two weeks, the second stage of whooping cough begins.
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Abnormal Heart Rhythms (Heart Rhythm Disorders)
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Diphtheria is a disease that causes symptoms and signs such as fever, enlarged lymph nodes, and swallowing problems. Erythromycin is the primary treatment for diphtheria. Vaccines that prevent diphtheria include the DTaP, Tdap, DT, and Td.
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Hailey-Hailey Disease (Familial Benign Pemphigus)
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Heart Attack Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back. Women experience the same symptoms as men; however, they also may experience: Extreme fatigue Pain in the upper abdomen Dizziness Fainting Leading a healthy lifestyle with a heart healthy low-fat diet, and exercise can help prevent heart disease and heart attack.
Sexually Transmitted Diseases and Pregnancy (STDs)
When you are pregnant, many sexually transmitted diseases (STDs) can be especially harmful to you and your baby. These STDs include herpes, HIV/AIDS, genital warts (HPV), hepatitis B, chlamydia, syphilis, gonorrhea, and trichomoniasis. Symptoms include bumps, sores, warts, swelling, itching, or redness in the genital region. Treatment of STDs while pregnant depends on how far along you are in the pregnancy and the progression of the infection.
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