Increased risk of cholestatic hepatitis when treatment is >10 days or in patients with previous history of erythromycin usage. History of hepatic disorders; arrhythmias; prolonged QT interval; lactation. Monitor liver function. Avoid estolate in liver impairment. Caution when using lactobionate in patients with severe renal impairment. May aggravate muscle weakness in patients with myasthenia gravis.
Lactation: Unknown if excreted in breast milk; use with caution
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
Mode of Action
Erythromycin inhibits protein synthesis by irreversibly binding to the 50S ribosomal subunit thus blocking the transpeptidation or translocation reactions of susceptible organisms resulting in stunted cell growth.
Interaction
Rhabdomyolysis w/ or w/o renal impairment w/ HMG-CoA reductase inhibitors (e.g. simvastatin). Increased risk of colchicine toxicity. Increased sedation w/ triazolobenzodiazepines and related benzodiazepines (e.g. alprazolam, midazolam). Theophylline may decrease and cimetidine may increase erythromycin concentration. Hypotension, bradyarrhythmia and lactic acidosis w/ Ca channel blockers (e.g. verapamil, amlodipine, diltiazem). Increased systemic exposure of sildenafil. Increased or prolonged adverse effects w/ ciclosporin, carbamazepine, tacrolimus, alfentanil, disopyramide, rifabutin, quinidine, methylprednisolone, cilostazol, vinblastine and bromocriptine. Increased risk of digoxin toxicity. Increased bleeding w/ oral anticoagulants.
Potentially Fatal: QT prolongation, cardiac arrhythmias, ventricular tachycardia, ventricular fibrillation, torsades de pointes w/ cisapride, pimozide, astemizole or terfenadine. Acute ergot toxicity w/ ergotamine and dihydroergotamine.
Pregnancy Category Note
Pregnancy Category: B
Lactation: Unknown if excreted in breast milk; use with caution
Adult Dose
Topical/Cutaneous
Acne
Adult: Apply onto affected areas 1-2 times daily. Discontinue treatment if condition worsens or if there is no improvement after 6-8 wk of continuous usage.
Max duration: 6 mth.
Child Dose
Safety and efficacy not established
Renal Dose
N/A
Administration
Apply to affected areas after skin is thoroughly washed and patted dry
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