Erythromycin: Uses, Dosage, Side Effects & Antibiotic Interactions

Summary of Key Points

Erythromycin is an antibiotic commonly used to treat a variety of bacterial infections, including respiratory infections, skin conditions, and sexually transmitted diseases. It works by preventing the growth of bacteria. Erythromycin is available in different forms and strengths, and it’s important to follow the prescribed dosage carefully. Common side effects include stomach upset and diarrhea. Always consult your healthcare provider before making any changes to your dose.

Names of Erythromycin Medication

US Brand Names: Ery-Tab, Erythrocin, E.E.S., PCE

Generic Name: Erythromycin

The generic name is the standard name of the medication, while brand names are assigned by manufacturers. In this article, the generic name is listed in parentheses.

Pharmacologic Category: Macrolide Antibiotics

Erythromycin belongs to the macrolide class of antibiotics, which work by inhibiting protein synthesis in bacteria, thereby stopping their growth.

Erythromycin Dosage and Treatment Duration

Erythromycin is prescribed for a range of infections, and the dosage and duration of treatment depend on the specific condition being treated. Always consult your healthcare provider before adjusting your dose. If you need to speak with a doctor, you can schedule a telemedicine appointment with one of our providers at your convenience.

1. Pneumonia: 250 mg every 6 hours or 500 mg every 12 hours for 7-10 days.
2. Bronchitis: 250 mg every 6 hours or 500 mg every 12 hours for 7-14 days.
3. Sinusitis: 250 mg every 6 hours or 500 mg every 12 hours for 10-14 days.
4. Chlamydia: 500 mg every 6 hours for 7 days.
5. Whooping Cough (Pertussis): 500 mg every 6 hours for 7-14 days.
6. Skin Infections: 250 mg every 6 hours or 500 mg every 12 hours for 7-10 days.
7. Strep Throat: 250 mg every 6 hours or 500 mg every 12 hours for 10 days.
8. Legionnaires’ Disease: 500 mg every 6 hours for 14-21 days.
9. Acne: 250 mg twice daily. Duration varies based on response to treatment.
10. Otitis Media (Ear Infection): 250 mg every 6 hours or 500 mg every 12 hours for 7-10 days.

Dosage Forms and Strengths of Erythromycin

Erythromycin is available in several forms and strengths, providing flexibility in treatment options:

1. Tablets: 250 mg, 500 mg
2. Capsules: 250 mg, 333 mg
3. Oral Suspension: 200 mg/5 mL, 400 mg/5 mL
4. Topical Gel: 2%
5. Ophthalmic Ointment: 0.5%
6. Injectable: 500 mg per vial

Administration Instructions for Erythromycin

Take erythromycin exactly as prescribed by your healthcare provider. It is typically taken with a full glass of water. You may take it with or without food, but if you experience stomach discomfort, taking it with food may help. Do not crush or chew extended-release tablets. If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Never take two doses at once.

Erythromycin Side Effects and Adverse Reactions

As with all medications, erythromycin can cause side effects. While most are mild, some may be more serious. If you experience any severe side effects, contact your healthcare provider immediately or seek emergency medical attention.

Common Side Effects (may affect 1 in 10 people):

1. Stomach upset: Nausea, vomiting, or diarrhea are common and usually mild.
2. Abdominal pain: Some patients may experience cramping or discomfort.

Less Common Side Effects (may affect 1 in 100 people):

1. Rash: Skin irritation or redness may occur.
2. Loss of appetite: Some patients may notice a decrease in hunger.

Serious Side Effects (rare, but seek medical attention):

1. Severe allergic reaction: Symptoms may include difficulty breathing, swelling of the face, lips, or throat, and hives.
2. Liver problems: Yellowing of the skin or eyes (jaundice) may indicate liver issues.
3. Hearing loss: In rare cases, erythromycin can cause temporary hearing problems, particularly in older adults.

Contraindications for Erythromycin Use

A contraindication is a specific condition or situation where a medication should not be used because it may cause harm. Several contraindications apply to erythromycin, as these conditions can increase the risk of serious side effects or reduce the medication’s effectiveness.

1. Allergy to Erythromycin or other macrolide antibiotics: If you have a known allergy to erythromycin or similar antibiotics (such as azithromycin or clarithromycin), taking this medication could result in a severe allergic reaction, including life-threatening anaphylaxis.
2. Severe liver disease: Erythromycin is metabolized by the liver. If you have severe liver disease, your body may not process the medication properly, leading to higher drug levels and an increased risk of side effects.
3. History of QT prolongation or heart rhythm disorders: Erythromycin can affect the heart’s electrical activity, potentially causing dangerous arrhythmias. If you have a history of heart rhythm problems, this medication could increase your risk of a life-threatening condition called torsades de pointes.
4. Concurrent use of certain medications: Some medications, when taken with erythromycin, can increase the risk of serious side effects such as heart rhythm problems or liver damage. These include drugs like cisapride, pimozide, and ergotamine (see the Drug to Drug Interactions section below).

Drug to Drug Interactions

It’s essential to be aware of potential drug interactions when taking Erythromycin, as certain medications can increase the risk of side effects or reduce the effectiveness of your treatment. Always inform your healthcare provider about all the medications you’re taking, including over-the-counter drugs and supplements.

1. Cisapride (Propulsid): Combining cisapride with Erythromycin can lead to serious heart rhythm disturbances.
2. Pimozide (Orap): This antipsychotic, when taken with Erythromycin, increases the risk of severe heart rhythm complications.
3. Warfarin (Coumadin): Erythromycin can enhance the effects of warfarin, a blood thinner, raising the risk of bleeding.
4. Simvastatin (Zocor): Erythromycin can elevate simvastatin levels in your body, increasing the risk of muscle damage (rhabdomyolysis).
5. Ergotamine (Ergomar): This migraine medication can cause dangerous blood vessel constriction when combined with Erythromycin, leading to severe side effects.
6. Theophylline (Theo-24): Erythromycin can raise the levels of theophylline, an asthma treatment, potentially leading to toxicity.

Erythromycin in Pregnancy

Is it Safe to Take Erythromycin When Pregnant?

Erythromycin is generally considered safe during pregnancy, especially when prescribed for bacterial infections that could pose risks to both the mother and baby if left untreated. It is classified as a Category B drug by the FDA, meaning animal studies have shown no harm to the fetus, though there are no well-controlled studies in pregnant women. Always consult your healthcare provider before taking any medication during pregnancy. If you need treatment while pregnant, our telemedicine providers can guide you through the safest options.

Erythromycin While Breastfeeding

Is it Safe to Take Erythromycin While Breastfeeding?

Erythromycin passes into breast milk in small amounts. While generally considered safe for breastfeeding mothers, there is a slight risk of side effects in the nursing infant, such as diarrhea or an upset stomach. If you’re breastfeeding, discuss the risks and benefits of taking Erythromycin with your healthcare provider. If you have concerns, our telemedicine providers are available to help you make an informed decision.

Estimated Cost of Erythromycin Medication

The cost of a 30-day supply of Erythromycin without insurance varies by pharmacy and location. However, using a GoodRX coupon, the estimated cost ranges from $15 to $25 for a 30-day supply of Erythromycin 250 mg tablets. Prices may vary, so it’s a good idea to check with your pharmacy or use a discount program like GoodRX to find the best price.

Possible Alternatives to Erythromycin

If Erythromycin isn’t the right choice for you, alternative treatments are available for the conditions it commonly treats. Always discuss any changes to your treatment plan with your healthcare provider. If you’re unsure, our telemedicine providers are available to assist you.

1. Pneumonia: Alternatives include antibiotics like amoxicillin, doxycycline, or azithromycin. Lifestyle changes, such as quitting smoking, can also help prevent pneumonia.
2. Bronchitis: Alternatives include doxycycline or azithromycin. For viral bronchitis, rest, fluids, and over-the-counter medications may be recommended.
3. Sinusitis: Alternatives include amoxicillin or doxycycline. Nasal saline rinses and decongestants can also help alleviate symptoms.
4. Chlamydia: Azithromycin or doxycycline are common alternatives. It’s important to inform your sexual partner(s) and ensure they are treated as well.
5. Whooping cough (Pertussis): Azithromycin or clarithromycin are alternative antibiotics. Vaccination is the best prevention method.
6. Skin infections: Depending on the type of infection, alternatives may include cephalexin or clindamycin. Good skin hygiene and proper wound care are essential.
7. Strep throat: Penicillin or amoxicillin are often used as alternatives. Gargling with salt water and staying hydrated can help relieve symptoms.
8. Legionnaires’ disease: Alternatives include levofloxacin or azithromycin. Avoiding exposure to contaminated water sources can help prevent infection.
9. Acne: Alternatives include topical treatments like benzoyl peroxide or retinoids. Maintaining a consistent skincare routine and avoiding oily products can also help.
10. Otitis media (ear infection): Amoxicillin or cefdinir are common alternatives. Ear drops or warm compresses can help relieve pain in some cases.

Recent Updates on Erythromycin Research

Recent studies have focused on the use of Erythromycin in treating respiratory infections and its role in combating antibiotic-resistant bacteria. Researchers are exploring how Erythromycin can be combined with other antibiotics to enhance its effectiveness against resistant strains. Additionally, ongoing research is investigating Erythromycin’s potential in treating chronic inflammatory conditions like rosacea, where its anti-inflammatory properties may offer benefits beyond its antibacterial effects. As new findings emerge, it’s important to stay informed and discuss any updates with your healthcare provider. Our telemedicine providers are also available to answer any questions you may have about the latest research.

James Kingsley

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