ERYTHROMYCIN

Indications & Dose:

INDICATIONS AND USES:

Systemic: diabetic gastroparesis ; as an alternative to penicillins in anthrax ; Vincent’s gingivitis ; actinomycosis ; Nocardia infections (with a sulfonamide) ; Eikenella corrodens infections ; lforrelid infections (including early Lyme disease) ; campylobacter enteritis ; Lymphogranuloma venereum ; chancroid

DOSE

Adults: 250-500mg 3-4 times daily. Gonorrhoea: 500mg 6 hourly for 6-7 days. Syphillis: 1gm 6 hourly for 10-15 days (30 days in late Syphillis). Prophylaxis against streptococci: 250mg 12 hourly.

Children: 30-50mg/kg/24 hour div. every 6 hours.

Infusion, adult and child severe infections 50mg/ kg daily by continuous infusion or in divided doses every 6 hours, mild infections (oral treatment not possible) 25mg/kg daily.

Contraindications:

Systemic: preexisting liver disease (estolate);

Side Effects:

CV: Ventricular dysrhythmias (rare)

EENT: Hearing loss, overgrowth of nonsusceptible organisms (ophth), poor corneal wound healing, temporary visual haze, tinnitus

GI: Abdominal cramping and discomfort, anorexia, cholestatic hepatitis (most common with estolate), diarrhea, heartburn, nausea, pruritus ani, stomatitis, vomiting

GU: Moniliasis, vaginitis

SKIN: Pruritus, rash, thrombophlebitis, urticaria (IV site), burning; dry, scaly, oily skin; pruritus, rash, stinging; urticaria (top) 

Cautions:

Precautions:

Systemic: hepatic disease, prolonged or repeated therapy; ophthalmic: antibiotic hypersensitivity; topical: child < 12 yr

Interaction:

Drugs

Alfentanil: Prolonged anesthesia and respiratory depression

Alprazolam: Increased plasma alprazolam concentration

Amprenavir: Plasma concentrations of erythromycin may be increased by amprenavir; plasma concentrations of amprenavir may be increased by erythromycin

Astemizole: QT prolongation and life-threatening dysrhythmia

Atorvastatin: Increased plasma atorvastatin concentration with risk of rhabdomyolysis

Bromocriptine: Increased bromocriptine concentration with toxicity

Buspirone: Increased plasma buspirone concentration

Carbamazepine: Markedly increased plasma carbamazepine concentrations

Cisapride: QT prolongation and dysrhythmia

Clozapine: Increased plasma clozapine concentrations

Colchicine: Potential colchicine toxicity

Cyclosporine: Increased plasma cyclosporine concentrations

Diazepam: Increased plasma concentration of diazepam

Digoxin: Reduced bacterial flora may increase plasma digoxin concentrations

Disopyramide: Increased plasma disopyramide concentrations

Ergotamine: Potential for ergotism

Ethanol: Ethanol reduces plasma erythromycin concentration

Felodipine: Increased plasma felodipine concentrations

Food: Food may increase or decrease the bioBrands Available with Cost of erythromycin

Indinavir: Plasma concentrations of erythromycin may be increased by indinavir; plasma concentrations of -indinavir may be increased by erythromycin

Itraconazole: Increased plasma itraconazole concentration

Lovastatin: Increased plasma lovastatin concentration with risk of rhabdomyolysis

Methylprednisolone: Increased plasma rnethyl  prednisolone concentrations

Midazolam: Increased plasma concentration of midazolam

Nelfinavir: Plasma concentrations of erythromycin may be increased by nelfinavir; plasma concentrations of nelfinavir may be increased by erythromycin

Penicillin: Decreased activity of penicillin

Quinidine: Increased plasma concentration of quinidine

Ritonavir: Plasma concentrations of erythromycin may be increased by ritonavir; plasma concentrations of ritonavir may be increased by erythromycin

Saquinavir: Plasma concentrations of erythromycin may be increased by saquinavir; plasma concentrations of saquinavir may be increased by erythromycin

Sildenafil: Increased plasma sildenafil concentration

Simvastatin: Increased plasma simvastatin concentration with risk of rhabdomyolysis

Tacrolimus: Increased plasma tacrolimus

concentration

Terfenadine: QT prolongation and life-threatening dysrhythmia

Theophylline: Increased plasma theophylline concentration

Triazolam: Increased plasma triazolam concentration

Valproic acid: Increased plasma valproic acid concentration

Warfarin: Markedly increased hypoprothrombinemic response to warfarin

Zafirlukast: Reduced plasma zafirlukast concentration probably by reducing bioBrands Available with Cost Zopiclone: Increased plasma zopiclone concentration  

Warnings:

Adverse Effects:

Lactations:

 Compatible with breast feeding 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: