Know the basics

What is erythromycin used for?

Erythromycin is used to treat a wide variety of bacterial infections. Erythromycin may also be used to prevent certain bacterial infections. Erythromycin is known as a macrolide antibiotic. It works by stopping the growth of bacteria.

Erythromycin treats or prevents only bacterial infections. Erythromycin will not work for viral infections (such as common cold, flu). Unnecessary use or misuse of any antibiotic can lead to its decreased effectiveness.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by yourhealth care professional. Use erythromycin for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Erythromycin may also be used to treat a certain type of stomach condition involving slowed digestion (gastroparesis).

How should I take erythromycin?

Take erythromycin by mouth as directed by your doctor, usually before a meal. Erythromycin is best absorbed when taken on an empty stomach. If nausea occurs, you may take erythromycin with food or milk.

This medication has a bitter taste if crushed. Swallow the medication whole. Do not chew or crush.

The dosage and length of treatment are based on your medical condition and response to treatment. In children, the dosage is also based on age and weight.

Antibiotics work best when the amount of medicine in your body is kept at a constant level. Therefore, take erythromycin at evenly spaced intervals. To help you remember, take it at the same time(s) each day.

If you are using erythromycin to treat an infection, continue to take erythromycin until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping erythromycin too early may result in a return of the infection. Tell your doctor if your condition persists or worsens.

If you are taking erythromycin to prevent certain bacterial infections, take it exactly as directed by your doctor. Do not stop taking the medication without your doctor’s approval

How do I store erythromycin?

Erythromycin is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store erythromycin in the bathroom or the freezer. There may be different brands of erythromycin that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush erythromycin down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using erythromycin?

Before taking erythromycin,

Tell your doctor and pharmacist if you are allergic to erythromycin, azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac), or any other drugs.
Tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other antibiotics, anticoagulants (‘blood thinners’), astemizole (Hismanal), carbamazepine (Tegretol), cisapride (Propulsid), clozapine (clozaril), cyclosporine (Neoral, Sandimmune), digoxin (Lanoxin), disopyramide (Norpace), ergotamine, felodipine (Plendil), lovastatin (Mevacor), phenytoin (Dilantin), pimozide (Orap), terfenadine (Seldane), theophylline (Theo-Dur), triazolam (Halcion), and vitamins.
Tell your doctor if you have or have ever had liver disease, yellowing of the skin or eyes, colitis, or stomach problems.
Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking erythromycin, call your doctor.
If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking erythromycin.

Is it safe to take erythromycin during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this medication during pregnancy. During breastfeeding, studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding

Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

A=No risk,
B=No risk in some studies,
C=There may be some risk,
D=Positive evidence of risk,
X=Contraindicated,
N=Unknown

Know the side effects

What are the side effects of erythromycin?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using erythromycin topical and call your doctor at once if you have any of these serious side effects:severe burning, stinging, or redness; oozing or other signs of skin infection; worsening of your skin condition; or diarrhea that is watery or bloody.

Less serious side effects may include: mild skin irritation or tenderness; dry or oily skin; itching; peeling; or mild eye irritation.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with erythromycin?

Erythromycin may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval, especially:

Antiviral medicine (drugs to treat hepatitis, or HIV/AIDS);
Antifungal medicine;
Any other antibiotic medicines;
Cancer medicine;
Drugs that lower cholesterol or triglycerides;
Drugs to treat or prevent malaria;
Drugs to treat pulmonary arterial hypertension;
Heart or blood pressure medication;
Medicine to prevent organ transplant rejection; or
Medicine to treat depression or mental illness.

This list is not complete and many other drugs can interact with erythromycin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Does food or alcohol interact with erythromycin?

Erythromycin may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with erythromycin?

Erythromycin may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

Bradycardia (slow heartbeat) ;
Heart rhythm problems (e.g., QT prolongation);
Hypokalemia (low potassium in the blood), uncorrected;
Hypomagnesemia (low magnesium in the blood), uncorrected—Use is not recommended in patients with these conditions;
Congestive heart failure—The granules and tablet dosage forms of this medicine contains sodium, which can make this condition worse;
Elevated liver enzymes;
Liver disease (including cholestatic hepatitis);
Myasthenia gravis (severe muscle weakness)—Use with caution. May make these conditions worse;

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using erythromycin.

What is the dose of erythromycin for an adult?

Usual Adult Dose for Campylobacter Gastroenteritis:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Chancroid:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Lymphogranuloma Venereum:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Mycoplasma Pneumonia:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Nongonococcal Urethritis:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Otitis Media:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Pharyngitis:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Pneumonia:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Skin or Soft Tissue Infection:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Syphilis – Early:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Upper Respiratory Tract Infection:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Bronchitis:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Chlamydia Infection:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Lyme Disease:

Mild to moderate infection: 250 to 500 mg (base, estolate, stearate) or 400 to 800 mg (ethylsuccinate) orally every 6 hours.
Severe infection: 1 to 4 g/day IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Legionella Pneumonia: Although the dosage has not been established, clinical trials have used 1 to 4 g/day orally or IV in divided doses every 6 hours or by continuous infusion.

Usual Adult Dose for Bacterial Endocarditis Prophylaxis: 1 g (stearate) or 800 mg (ethylsuccinate) orally two hours before procedure, then one-half the amount six hours after initial dose.

Usual Adult Dose for Bowel Preparation: 1 g (base) orally at 1, 2, and 11 PM the day before surgery (assuming 8 a.m. surgery time); given with oral neomycin 1 g and bowel evacuants.

Usual Adult Dose for Rheumatic Fever Prophylaxis: 250 mg orally twice a day.

What is the dose of erythromycin for a child?

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis: 20 mg/kg (ethylsuccinate or stearate) orally two hours before procedure, then one-half the amount six hours after initial dose.

Usual Pediatric Dose for Bowel Preparation: 20 mg/kg (base) orally at 1, 2, and 11 PM the day before surgery (assuming 8 a.m. surgery time); given with oral neomycin and bowel evacuants.

Usual Pediatric Dose for Pneumonia: Neonatal chlamydial conjunctivitis and pneumonia: 50 mg/kg/day orally in divided doses every 6 hours for at least 2 weeks.

Usual Pediatric Dose for Chlamydia Infection: Neonatal chlamydial conjunctivitis and pneumonia: 50 mg/kg/day orally in divided doses every 6 hours for at least 2 weeks.

Usual Pediatric Dose for Rheumatic Fever Prophylaxis: 250 mg orally twice a day.

Usual Pediatric Dose for Pertussis: 40-50 mg/kg/day, orally, divided every 6 hours for 14 days; maximum dose: 2 g/day (not preferred agent for infants less than 1 month of age).

How is erythromycin available?

Erythromycin is available in the following dosage forms and strengths:

Capsule Delayed Release Particles, Oral, as base: 250 mg
Solution Reconstituted, Intravenous, as lactobionate: 500 mg, 1000 mg
Suspension Reconsituted, Oral, as ethylsuccinate: 200 mg/5 mL (100 mL); 400 mg/5 mL (100 mL)
Tablet, Oral, as base: 250 mg, 500 mg
Tablet, Oral, as ethylsuccinate: 400 mg
Tablet, Oral, as stearate: 250 mg
Tablet, Delayed Release, Oral, as base: 250 mg, 333mg, 500 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of erythromycin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

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Erythromycin