Erythromycin belongs in a group of drugs called macrolide antibiotics. Macrolide antibiotics slow the growth of, or sometimes kill, sensitive bacteria by reducing the production of important proteins needed by the bacteria to survive.
Erythromycin is used to treat or prevent many different types of infections caused by bacteria.
Erythromycin may also be used for purposes not listed in this medication guide.
Important information
Some medicines can cause unwanted or dangerous effects when used with erythromycin. Your doctor may need to change your treatment plan if you use cisapride, pimozide, ergotamine, or dihydroergotamine.
Before you take erythromycin, tell your doctor if you have liver disease, myasthenia gravis, a heart rhythm disorder, a history of Long QT syndrome, or low levels of potassium or magnesium in your blood.
Take this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Erythromycin will not treat a viral infection such as the common cold or flu.
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking erythromycin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Before taking this medicine
You should not take erythromycin if you are allergic to it.
Some medicines can cause unwanted or dangerous effects when used with erythromycin. Your doctor may need to change your treatment plan if you use any of the following drugs:
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cisapride;
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pimozide;
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ergotamine; or
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dihydroergotamine.
To make sure erythromycin is safe for you, tell your doctor if you have:
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liver or kidney disease;
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myasthenia gravis;
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a heart rhythm disorder;
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an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
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a history of Long QT syndrome; or
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if you take medicine to treat a heart rhythm disorder.
FDA pregnancy category B. Erythromycin is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
See also: Pregnancy and breastfeeding warnings (in more detail)
Erythromycin can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Do not give this medicine to a child without a doctor"s advice.
How should I take erythromycin?
Take erythromycin exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.
If a child is using this medicine, tell your doctor if the child has any changes in weight. Erythromycin doses are based on weight in children.
Do not crush, chew, or break a delayed-release capsule or tablet. Swallow it whole.
Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Erythromycin will not treat a viral infection such as the common cold or flu.
This medicine can cause unusual results with certain lab tests of the urine. Tell any doctor who treats you that you are using erythromycin.
Store at room temperature away from moisture, heat, and light.
You may need to store liquid medicine in a refrigerator. Carefully follow the storage directions on your medicine label. Liquid medicine expires after a short period of time. Throw away any unused liquid as directed.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking erythromycin?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking erythromycin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Erythromycin side effects
Get emergency medical help if you have any of these signs of an allergic reaction to erythromycin: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
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diarrhea that is watery or bloody;
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headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
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hearing problems (rare);
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liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
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severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Older adults may be more likely to have serious side effects from erythromycin, including hearing loss, or a life-threatening fast heart rate.
Common erythromycin side effects may include:
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Erythromycin dosing information
Usual Adult Dose of Erythromycin 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 of Erythromycin 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 of Erythromycin 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.
Erythromycin was previously recommended by the American Heart Association for prophylaxis prior to dental, oral and upper respiratory tract procedures in at-risk, penicillin-allergic patients. It is no longer recommended because of the high incidence of gastrointestinal adverse effects and complicated pharmacokinetics of the various formulations. However, patients who have successfully received erythromycin for prophylaxis in the past may continue with this regimen if desired. Currently, clindamycin, first-generation cephalosporins (in patients who have not had an IgE-mediated anaphylactic reaction to penicillin), azithromycin or clarithromycin are drugs of choice for prophylaxis in penicillin-allergic patients undergoing oral, dental, respiratory tract or esophageal procedures.
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.
Erythromycin is recommended by the American Heart Association for long-term prophylaxis of streptococcal upper respiratory tract infections in the prevention of recurrences of rheumatic fever in patients allergic to penicillin and sulfonamides.
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.
Erythromycin was previously recommended by the American Heart Association for prophylaxis prior to dental, oral and upper respiratory tract procedures in at-risk, penicillin-allergic patients. It is no longer recommended because of the high incidence of gastrointestinal adverse effects and complicated pharmacokinetics of the various formulations. However, patients who have successfully received erythromycin for prophylaxis in the past may continue with this regimen if desired. Currently, clindamycin, first-generation cephalosporins (in patients who have not had an IgE-mediated anaphylactic reaction to penicillin), azithromycin or clarithromycin are drugs of choice for prophylaxis in penicillin-allergic patients undergoing oral, dental, respiratory tract or esophageal procedures.
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.
Erythromycin is recommended by the American Heart Association for long-term prophylaxis of streptococcal upper respiratory tract infections in the prevention of recurrences of rheumatic fever in patients allergic to penicillin and sulfonamides.
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).
What other drugs will affect erythromycin?
Many drugs can interact with erythromycin. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with erythromycin, especially:
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antiviral medicine (drugs to treat hepatitis, or HIV/AIDS);
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antifungal medicine;
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any other antibiotic medicines;
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cancer medicine;
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drugs that lower cholesterol or triglycerides;
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drugs to treat or prevent malaria;
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drugs to treat pulmonary arterial hypertension;
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heart or blood pressure medication;
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medicine to prevent organ transplant rejection; or
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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.
