Erythromycins (Systemic)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For erythromycins, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to erythromycins, or any related medicines, such as azithromycin or clarithromycin. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Erythromycin estolate has caused side effects involving the liver in some pregnant women. However, none of the erythromycins has been shown to cause birth defects or other problems in human babies.

Breast-feeding - Erythromycins pass into the breast milk. However, erythromycins have not been shown to cause problems in nursing babies.

Children - This medicine has been tested in children and, in effective doses, has not been shown to cause different side effects or problems in children than it does in adults.

Older adults - This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, older adults may be at increased risk of hearing loss, especially if they are taking high doses of erythromycin and/or have kidney or liver disease.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking or receiving erythromycins, it is especially important that your health care professional know if you are taking any of the following:

• Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or
• Amiodarone (e.g., Cordarone) or
• Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
• Androgens (male hormones) or
• Antithyroid agents (medicine for overactive thyroid) or
• Carmustine (e.g., BiCNU) or
• Chloroquine (e.g., Aralen) or
• Dantrolene (e.g., Dantrium) or
• Daunorubicin (e.g., Cerubidine) or
• Disulfiram (e.g., Antabuse) or
• Divalproex (e.g., Depakote) or
• Estrogens (female hormones) or
• Etretinate (e.g., Tegison) or
• Gold salts (medicine for arthritis) or
• Hydroxychloroquine (e.g., Plaquenil) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Methyldopa (e.g., Aldomet) or
• Naltrexone (e.g., Trexan) (with long-term, high-dose use) or
• Oral contraceptives (birth control pills) containing estrogen or
• Other anti-infectives by mouth or by injection (medicine for infection) or
• Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
• Phenytoin (e.g., Dilantin) or
• Plicamycin (e.g., Mithracin) or
• Valproic acid (e.g., Depakene) - Use of these medicines with erythromycins, especially erythromycin estolate, may increase the chance of liver problems

• Aminophylline (e.g., Somophyllin) or
• Caffeine (e.g., NoDoz) or
• Oxtriphylline (e.g., Choledyl) or
• Theophylline (e.g., Somophyllin-T, Theo-Dur) - Use of these medicines with erythromycins may increase the chance of side effects from aminophylline, caffeine, oxtriphylline, or theophylline

• Astemizole (e.g., Hismanal) or
• Terfenadine (e.g., Seldane) - Use of astemizole or terfenadine with erythromycins may cause heart problems, such as an irregular heartbeat; these medicines should not be used together

• Carbamazepine (e.g., Tegretol) - Use of carbamazepine with erythromycin may increase the side effects of carbamazepine or increase the chance of liver problems

• Chloramphenicol (e.g., Chloromycetin) or
• Clindamycin (e.g., Cleocin) or
• Lincomycin (e.g., Lincocin) - Use of these medicines with erythromycins may decrease the effectiveness of these other antibiotics

• Cyclosporine (e.g., Sandimmune) or
• Warfarin (e.g., Coumadin) - Use of any of these medicines with erythromycins may increase the side effects of these medicines

Other medical problems - The presence of other medical problems may affect the use of erythromycins. Make sure you tell your doctor if you have any other medical problems, especially:

• Heart disease - High doses of erythromycin may increase the chance of side effects in patients with a history of an irregular heartbeat

• Liver disease - Erythromycins, especially erythromycin estolate, may increase the chance of side effects involving the liver

• Loss of hearing - High doses of erythromycins may, on rare occasion, cause hearing loss, especially if you have kidney or liver disease