A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Pce 333 Side Effects, and Drug Interactions - Erythromycin PCE
Pce 333 Side Effects, and Drug Interactions - Erythromycin PCE
SIDE EFFECTS
The most frequent side
effects of oral erythromycin
preparations are gastrointestinal and are dose-related. They include
nausea, vomiting,
abdominal pain, diarrhea
and anorexia. Symptoms of hepatitis,
hepatic dysfunction
and/or abnormal liver
function test
results may occur. (See WARNINGS.)
Onset of pseudomembranous colitis
symptoms may occur during or after antibacterial treatment. (See
WARNINGS.)
Rarely, erythromycin
has been associated with the production
of ventricular arrhythmias, including ventricular
tachycardia and
torsades de pointes, in individuals with prolonged QT interval.
Allergic reactions ranging from urticaria
to anaphylaxis have
occurred. Skin reactions ranging from mild eruptions to erythema
multi-forme, Stevens-Johnson syndrome, and toxic
epidermal necrolysis
have been reported rarely.
There have been isolated reports of reversible
hearing loss
occurring chiefly in patients with renal
insufficiency
and in patients receiving high doses of erythromycin.
DRUG INTERACTIONS
Erythromycin use in patients who are receiving high doses of theophylline
may be associated with an increase in serum
theophylline levels
and potential theophylline toxicity. In
case of theophylline
toxicity and/or elevated
serum theophylline
levels, the dose of theophylline
should be reduced while the patient
is receiving concomitant
erythromycin therapy.
Concomitant administration
of erythromycin
and digoxin has been
reported to result in elevated digoxin
serum levels.
There have been reports of increased anticoagulant
effects when erythromycin and oral
anticoagulants were used concomitantly. Increased anticoagulation
effects due to interactions of erythromycin
with oral anticoagulants
may be more pronounced in the elderly.
Concurrent use of erythromycin
and ergotamine or
dihydroergotamine has been associated in some patients with acute
ergot toxicity
characterized by severe peripheral
vasospasm and dysesthesia.
Erythromycin has been reported to decrease the clearance
of triazolam and midazolam and
thus, may increase the pharmacologic effect
of these benzodiazepines.
The use of erythromycin
in patients concurrently taking drugs metabolized by the cytochrome
P450 system may be associated
with elevations in serum levels of these other drugs. There have
been reports of interactions of erythromycin with carbamazepine,
cyclosporine, tacrolimus, hexobarbital, phenytoin, alfentanil, cisapride,
disopyramide, lovastatin, bromocriptine, valproate, terfenadine,
and astemizole. Serum concentrations of drugs metabolized by the
cytochrome P450 system
should be monitored closely in patients concurrently receiving erythromycin.
Erythromycin has been reported to significantly alter the metabolism
of the nonsedating antihistamines terfenadine and astemizole when
taken concomitantly. Rare cases of serious cardiovascular
adverse events, including electro-cardiographic QT/QTc interval
prolongation, cardiac
arrest, torsades de pointes, and other ventricular
arrhythmias have been observed. (See CONTRAINDICATIONS.)
In addition, deaths have
been reported rarely with concomitant
administration
of terfenadine and erythromycin.
There have been post-marketing reports of drug
interactions when erythromycin was coadministered with cisapride,
resulting in QT prolongation, cardiac arrhythmias, ventricular
tachycardia, ventricular
fibrillation, and
torsades de pointes, most likely due to the inhibition
of hepatic metabolism
of cisapride by erythromycin. Fatalities have been reported. (See
CONTRAINDICATIONS).
Drug/Laboratory Test interactions
Erythromycin interferes with the fluorometric determination
of urinary catecholamines.
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