Description

Simple

An antibiotic used to treat and prevent various infections caused by bacteria.

Clinical

A macrolide antibiotic used to treat and prevent a variety of bacterial infections.

Overview

Erythromycin is a bacteriostatic antibiotic drug produced by a strain of Saccharopolyspora erythraea (formerly Streptomyces erythraeus) and belongs to the macrolide group of antibiotics which consists of [Azithromycin], [Clarithromycin], [Spiramycin] and others. It was originally discovered in 1952.[20] Erythromycin is widely used for treating a variety of infections, including those caused by gram-positive and gram-negative bacteria.[20,21] It is available for administration in various forms, including intravenous, topical, and eye drop preparations.[20]

Pharmacology

Indication


Erythromycin is indicated in the treatment of infections caused by susceptible strains of various bacteria.[21] The indications for erythromyc... Read more

Pharmacodynamic

Macrolides, such as erythromycin, stop bacterial growth by inhibiting protein synthesis and translation, treating bacterial infections.[ Read more

Mechanism of action

In order to replicate, bacteria require a specific process of protein synthesis, enabled by ribosomal proteins.[ Read more

Absorption

Orally administered erythromycin is readily absorbed. Food intake does not appear to exert effects on serum concentrations of erythromycin.[21]... Read more

Protein binding

Erythromycin demonstrates 93% serum protein binding in the erythromycin propionate form.[7] Another r... Read more

Volume of distribution

Erythromycin is found in most body fluids and accumulates in leucocytes and inflammatory liquid.[21, Read more

Clearance

The clearance of erythromycin in healthy subjects was 0.53 ± 0.13 l/h/kg after a 125mg intravenous dose.[ Read more

Half life

The elimination half-life of oral erythromycin was 3.5 hours according to one study[6] and ranged be... Read more

Route of elimination

In patients with normal liver function, erythromycin concentrates in the liver and is then excreted in the bile.[22]Under 5% of the orally administered dose of erythromycin is found exc... Read more

Toxicity

LD50

The oral LD50 of erythromycin in rats is 9272 mg/kg.[23]

Overdose information

Symptoms of overdose may include diarrhea, nausea, stomach cramps, and vomiting. Erythromycin should immediately be disco... Read more

Adverse Effects

Contraindications

  • Regions: Canada
  • With Drugs:
      • Name: Dihydroergotamine
      • Drugbank Id: DB00320
  • Regions: Canada
  • With Drugs:
      • Name: Ergotamine
      • Drugbank Id: DB00696
  • Recommended Actions:
    • Do not administer erythromycin estolate in pregnancy
    • Administer other forms of erythromycin
  • Regions: Canada
  • Patient Conditions:
      • Name: Pregnancy
      • Drugbank Id: DBCOND0018394
  • Regions: US
  • Patient Conditions:
      • Name: Patients taking statins which are extensively metabolized by CYP3A4
      • Drugbank Id: DBCOND0117376
  • With Drugs:
      • Name: Lovastatin
      • Drugbank Id: DB00227
      • Name: Simvastatin
      • Drugbank Id: DB00641
  • With Categories Coadmin:
      • Name: Hydroxymethylglutaryl-CoA Reductase Inhibitors
      • Drugbank Id: DBCAT000391
      • Mesh Id: D019161
  • Regions: US
  • With Drugs:
      • Name: Cisapride
      • Drugbank Id: DB00604
  • Regions: US
  • With Drugs:
      • Name: Pimozide
      • Drugbank Id: DB01100
  • Regions: US
  • With Drugs:
      • Name: Astemizole
      • Drugbank Id: DB00637
  • Regions: US
  • With Drugs:
      • Name: Terfenadine
      • Drugbank Id: DB00342
  • Regions: US
  • Patient Conditions:
      • Name: Known hypersensitivity to erythromycin
      • Drugbank Id: DBCOND0117157

Food Interactions

  • Avoid grapefruit products.
  • Take on an empty stomach. Allow approximately 30 minutes to 2 hours before meals, as this increases erythromycin absorption.
  • Take with a full glass of water.

Interactions

Type in a drug name to check for interaction with Erythromycin
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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
(R)-warfarin
The risk or severity of bleeding can be increased when Erythromycin is combined with (R)-warfarin.
(S)-Warfarin
The risk or severity of bleeding can be increased when Erythromycin is combined with (S)-Warfarin.
3-isobutyl-1-methyl-7H-xanthine
The metabolism of 3-isobutyl-1-methyl-7H-xanthine can be decreased when combined with Erythromycin.
4-hydroxycoumarin
The risk or severity of bleeding can be increased when Erythromycin is combined with 4-hydroxycoumarin.
6-O-benzylguanine
The metabolism of 6-O-benzylguanine can be decreased when combined with Erythromycin.
7-Deazaguanine
The metabolism of 7-Deazaguanine can be decreased when combined with Erythromycin.
7,9-Dimethylguanine
The metabolism of 7,9-Dimethylguanine can be decreased when combined with Erythromycin.
8-azaguanine
The metabolism of 8-azaguanine can be decreased when combined with Erythromycin.
8-chlorotheophylline
The metabolism of 8-chlorotheophylline can be decreased when combined with Erythromycin.
9-aminocamptothecin
The metabolism of 9-aminocamptothecin can be decreased when combined with Erythromycin.
9-Deazaguanine
The metabolism of 9-Deazaguanine can be decreased when combined with Erythromycin.
9-Methylguanine
The metabolism of 9-Methylguanine can be decreased when combined with Erythromycin.
Abatacept
The metabolism of Erythromycin can be increased when combined with Abatacept.
Abciximab
The risk or severity of bleeding can be increased when Erythromycin is combined with Abciximab.
Abexinostat
The risk or severity of QTc prolongation can be increased when Erythromycin is combined with Abexinostat.
Acalabrutinib
The metabolism of Erythromycin can be decreased when combined with Acalabrutinib.
Acefylline
The metabolism of Acefylline can be decreased when combined with Erythromycin.
Acenocoumarol
The risk or severity of bleeding can be increased when Erythromycin is combined with Acenocoumarol.
Aceprometazine
The risk or severity of QTc prolongation can be increased when Erythromycin is combined with Aceprometazine.
Acetylcysteine
The excretion of Erythromycin can be decreased when combined with Acetylcysteine.
24 References
  1. 1 . Kanazawa S, Ohkubo T, Sugawara K: The effects of grapefruit juice on the pharmacokinetics of erythromycin. Eur J Clin Pharmacol. 2001 Jan-Feb;56(11):799-803.PubMed: 11294369
  2. 2 . Ogwal S, Xide TU: Bioavailability and stability of erythromycin delayed release tablets. Afr Health Sci. 2001 Dec;1(2):90-6.PubMed: 12789122
  3. 3 . Okudaira T, Kotegawa T, Imai H, Tsutsumi K, Nakano S, Ohashi K: Effect of the treatment period with erythromycin on cytochrome P450 3A activity in humans. J Clin Pharmacol. 2007 Jul;47(7):871-6.PubMed: 17585116
  4. 4 . Houin G, Tillement JP, Lhoste F, Rapin M, Soussy CJ, Duval J: Erythromycin pharmacokinetics in man. J Int Med Res. 1980;8 Suppl 2:9-14.PubMed: 7429008
  5. 5 . Krasniqi S, Matzneller P, Kinzig M, Sorgel F, Huttner S, Lackner E, Muller M, Zeitlinger M: Blood, tissue, and intracellular concentrations of erythromycin and its metabolite anhydroerythromycin during and after therapy. Antimicrob Agents Chemother. 2012 Feb;56(2):1059-64. doi: 10.1128/AAC.05490-11. Epub 2011 Nov 14.PubMed: 22083477
  6. 6 . Amsden GW: Erythromycin, clarithromycin, and azithromycin: are the differences real? Clin Ther. 1996 Jan-Feb;18(1):56-72; discussion 55.PubMed: 8851453
  7. 7 . Gordon RC, Regamey C, Kirby WM: Serum protein binding of erythromycin, lincomycin, and clindamycin. J Pharm Sci. 1973 Jul;62(7):1074-7.PubMed: 4714113
  8. 8 . Fohner AE, Sparreboom A, Altman RB, Klein TE: PharmGKB summary: Macrolide antibiotic pathway, pharmacokinetics/pharmacodynamics. Pharmacogenet Genomics. 2017 Apr;27(4):164-167. doi: 10.1097/FPC.0000000000000270.PubMed: 28146011
  9. 9 . Champney WS, Burdine R: Macrolide antibiotics inhibit 50S ribosomal subunit assembly in Bacillus subtilis and Staphylococcus aureus. Antimicrob Agents Chemother. 1995 Sep;39(9):2141-4.PubMed: 8540733
  10. 10 . Champney WS, Miller M: Inhibition of 50S ribosomal subunit assembly in Haemophilus influenzae cells by azithromycin and erythromycin. Curr Microbiol. 2002 Jun;44(6):418-24.PubMed: 12000992
  11. 11 . Sun H, Frassetto LA, Huang Y, Benet LZ: Hepatic clearance, but not gut availability, of erythromycin is altered in patients with end-stage renal disease. Clin Pharmacol Ther. 2010 Apr;87(4):465-72. doi: 10.1038/clpt.2009.247. Epub 2010 Jan 20.PubMed: 20090676
  12. 12 . Franke RM, Lancaster CS, Peer CJ, Gibson AA, Kosloske AM, Orwick SJ, Mathijssen RH, Figg WD, Baker SD, Sparreboom A: Effect of ABCC2 (MRP2) transport function on erythromycin metabolism. Clin Pharmacol Ther. 2011 May;89(5):693-701. doi: 10.1038/clpt.2011.25. Epub 2011 Mar 30.PubMed: 21451505
  13. 13 . Dinos GP: The macrolide antibiotic renaissance. Br J Pharmacol. 2017 Sep;174(18):2967-2983. doi: 10.1111/bph.13936. Epub 2017 Aug 10.PubMed: 28664582
  14. 14 . Mather LE, Austin KL, Philpot CR, McDonald PJ: Absorption and bioavailability of oral erythromycin. Br J Clin Pharmacol. 1981 Aug;12(2):131-40. doi: 10.1111/j.1365-2125.1981.tb01191.x.PubMed: 7306427
  15. 15 . Wang LQ, Hu ZY, Yu Q, Guo X, Xiong J, Huang ZZ, Cheng ZN: [Pharmacokinetics of erythromycin stinoprate capsule]. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2005 Apr;30(2):197-201.PubMed: 15898434
  16. 16 . Colburn WA, Di Santo AR, Gibaldi M: Pharmacokinetics of erythromycin on repetitive dosing. J Clin Pharmacol. 1977 Oct;17(10 Pt 1):592-600.PubMed: 915023
  17. 17 . Barre J, Mallat A, Rosenbaum J, Deforges L, Houin G, Dhumeaux D, Tillement JP: Pharmacokinetics of erythromycin in patients with severe cirrhosis. Respective influence of decreased serum binding and impaired liver metabolic capacity. Br J Clin Pharmacol. 1987 Jun;23(6):753-7. doi: 10.1111/j.1365-2125.1987.tb03111.x.PubMed: 3606934
  18. 18 . Periti P, Mazzei T, Mini E, Novelli A: Clinical pharmacokinetic properties of the macrolide antibiotics. Effects of age and various pathophysiological states (Part I). Clin Pharmacokinet. 1989 Apr;16(4):193-214. doi: 10.2165/00003088-198916040-00001.PubMed: 2656049
  19. 19 . Kavi J, Webberley JM, Andrews JM, Wise R: A comparison of the pharmacokinetics and tissue penetration of spiramycin and erythromycin. J Antimicrob Chemother. 1988 Jul;22 Suppl B:105-10. doi: 10.1093/jac/22.supplement_b.105.PubMed: 3182434
  20. 20 . NIH StatPearls: Erythromycin Link
  21. 21 . FDA Approved Drug Products: Ery-Ped (erythromycin ethylsuccinate) granules for oral suspension Link
  22. 22 . MedSafe NZ: ERA (erythromycin stearate) oral filmtabs Link
  23. 23 . Pfizer: Erythromycin MSDS Link
  24. 24 . Erythromycin estolate monograph File