**Erythromycin: Drug information**

Copyright 1978-2006 Lexi-Comp, Inc. All rights reserved.

(For additional information see \"Erythromycin: Patient drug
information\" and see \"Erythromycin: Pediatric drug information\")

**U.S. BRAND NAMES** --- A/T/S®; Akne-Mycin®; E.E.S.®; Ery-Tab®; Eryc®;
Eryderm®; Erygel®; EryPed®; Erythrocin®; PCE®; Romycin®; Staticin®
\[DSC\]; T-Stat® \[DSC\]; Theramycin Z®

**PHARMACOLOGIC CATEGORY**\
Acne Products\
Antibiotic, Macrolide\
Antibiotic, Ophthalmic\
Antibiotic, Topical\
Topical Skin Product\
Topical Skin Product, Acne

**DOSING: ADULTS**\
Usual dosage range:\
  Ophthalmic: Instill 1/2\" (1.25 cm) 2-6 times/day depending on the
severity of the infection\
  Topical: Apply over the affected area twice daily after the skin has
been thoroughly washed and patted dry\
  Oral:\
    Base: 250-500 mg every 6-12 hours\
    Ethylsuccinate: 400-800 mg every 6-12 hours\
  I.V.: Lactobionate: 15-20 mg/kg/day divided every 6 hours or 500 mg to
1 g every 6 hours, or given as a continuous infusion over 24 hours
(maximum: 4 g/24 hours)

Dermatologic infection: Topical: Apply over the affected area twice
daily after the skin has been thoroughly washed and patted dry

Indication-specific dosing:\
  Cervicitis: Oral: 500 mg 4 times/day for 7 days\
  Chancroid (unlabeled use; not a preferred agent): Oral: 500 mg 4
times/day for 7 days\
  Community-acquired pneumonia, bronchitis: Oral, I.V.: 500-1000 mg 4
times/day for 10-14 days. If Legionella is suspected/confirmed, 750-1000
mg 4 times/day for 21 days or more may be recommended. Note: Other
macrolides and/or fluoroquinolones may be preferred and better
tolerated.\
  Lymphogranuloma venereum: Oral: 500 mg 4 times/day for 21 days\
  Nongonococcal urethritis (recurrent): Oral: CDC Guidelines for the
Treatment of Sexually Transmitted Diseases recommendation: Metronidazole
(2 g as a single dose) plus 7 days of erythromycin base (500 mg 4
times/day) or erythromycin ethylsuccinate (800 mg 4 times/day)\
  Pertussis (CDC guidelines): Oral: 500 mg every 6 hours for 14 days\
  Preop bowel preparation (unlabeled use): Oral: 1 g erythromycin base
at 1, 2, and 11 PM on the day before surgery combined with mechanical
cleansing of the large intestine and oral neomycin\
  Gastrointestinal prokinetic (unlabeled use): Oral: Erythromycin has
been used as a prokinetic agent to improve gastric emptying time and
intestinal motility. In adults, 200 mg was infused I.V. initially
followed by 250 mg orally 3 times/day 30 minutes before meals. Lower
dosages have been used in some trials.

**DOSING: PEDIATRIC**

(For additional information see \"Erythromycin: Pediatric drug
information\")\
Usual dosage range: Infants and Children:\
  Oral: Note: Due to differences in absorption, 400 mg erythromycin
ethylsuccinate produces the same serum levels as 250 mg erythromycin
base, stearate or estolate).\
    Base: 30-50 mg/kg/day in 2-4 divided doses; do not exceed 2 g/day\
    Estolate: 30-50 mg/kg/day in 2-4 divided doses; do not exceed 2
g/day\
    Ethylsuccinate: 30-50 mg/kg/day in 2-4 divided doses; do not exceed
3.2 g/day\
    Stearate: 30-50 mg/kg/day in 2-4 divided doses; do not exceed 2
g/day\
  I.V. (as lactobionate): 15-50 mg/kg/day divided every 6 hours, not to
exceed 4 g/day\
  Ophthalmic: Refer to adult dosing.\
  Topical: Refer to adult dosing.

Indication-specific dosing:\
  Acne vulgaris (unlabeled use): Adolescents: Oral: 250-1500 mg/day in 2
divided doses; therapy may be continued for 4-6 weeks at lowest possible
dose\
  Pharyngitis: Oral: 40 mg/kg/day in 2 doses; maximum: 1600 mg/day;
short-course therapy for 5 days may be considered\
  Pertussis (CDC guidelines): Oral: 40-50 mg/kg/day in 4 divided doses
for 14 days; maximum 2 g/day (not preferred agent for infants \<1 month\
  Preop bowel preparation: Oral: 20 mg/kg erythromycin base at 1, 2, and
11 PM on the day before surgery combined with mechanical cleansing of
the large intestine and oral neomycin\
  Prophylaxis of neonatal gonococcal or chlamydial conjunctivitis:
Neonates: Ophthalmic: 0.5-1 cm ribbon of ointment should be instilled
into each conjunctival sac

**DOSING: ELDERLY** --- Refer to adult dosing.

**DOSING: RENAL IMPAIRMENT** --- Slightly dialyzable (5% to 20%);
supplemental dose is not necessary in hemo- or peritoneal dialysis or in
continuous arteriovenous or venovenous hemofiltration.

**DOSAGE FORMS** --- \[DSC\] = Discontinued product; \[CAN\] = Canadian
brand name

Capsule, delayed release, enteric-coated pellets, as base (Eryc®): 250
mg

Gel, topical: 2% (30 g, 60 g)\
  A/T/S®: 2% (30 g) \[contains alcohol 92%\]\
  Erygel®: 2% (30 g, 60 g) \[contains alcohol 92%\]

Granules for oral suspension, as ethylsuccinate (E.E.S.®): 200 mg/5 mL
(100 mL, 200 mL) \[cherry flavor\]

Injection, powder for reconstitution, as lactobionate (Erythrocin®): 500
mg, 1 g

Ointment, ophthalmic: 0.5% \[5 mg/g\] (1 g, 3.5 g)\
  Romycin®: 0.5% \[5 mg/g\] (3.5 g)

Ointment, topical (Akne-Mycin®): 2% (25 g)

Powder for oral suspension, as ethylsuccinate (EryPed®): 200 mg/5 mL
(100 mL, 200 mL) \[fruit flavor\]; 400 mg/5 mL (100 mL, 200 mL) \[banana
flavor\]

Powder for oral suspension, as ethylsuccinate \[drops\] (EryPed®): 100
mg/2.5 mL (50 mL) \[fruit flavor\]

Solution, topical: 2% (60 mL)\
  A/T/S®: 2% (60 mL) \[contains alcohol 66%\]\
  Eryderm®, T-Stat® \[DSC\], Theramycin Z®: 2% (60 mL) \[contain
alcohol\]\
  Sans Acne® \[CAN\]: 2% (60 mL) \[contains ethyl alcohol 44%; not
available in U.S.\]\
  Staticin®: 1.5% (60 mL) \[DSC\]

Suspension, oral, as estolate: 125 mg/5 mL (480 mL); 250 mg/5 mL (480
mL)

Suspension, oral, as ethylsuccinate: 200 mg/5 mL (480 mL); 400 mg/5 mL
(480 mL)\
  E.E.S.®: 200 mg/5 mL (100 mL, 480 mL) \[fruit flavor\]; 400 mg/5 mL
(100 mL, 480 mL) \[orange flavor\]

Swab (T-Stat® \[DSC\]): 2% (60s)

Tablet, chewable, as ethylsuccinate (EryPed®): 200 mg \[fruit flavor\]
\[DSC\]

Tablet, delayed release, enteric coated, as base (Ery-Tab®): 250 mg, 333
mg, 500 mg

Tablet, as base: 250 mg, 500 mg

Tablet, as ethylsuccinate (E.E.S.®): 400 mg

Tablet, as stearate: 250 mg\
  Erythrocin®: 250 mg, 500 mg

Tablet \[polymer-coated particles\], as base (PCE®): 333 mg, 500 mg

**DOSAGE FORMS: CONCISE** --- \[CAN\] = Canadian brand name

Capsule, delayed release, enteric-coated pellets: 250 mg\
  Eryc®: 250 mg

Gel, topical: 2% (30 g, 60 g)\
  A/T/S®: 2% (30 g)\
  Erygel®: 2% (30 g, 60 g)

Granules for oral suspension: 200 mg/5 mL\
  E.E.S.®: 200 mg/5 mL

Injection, powder for reconstitution: 500 mg, 1 g\
  Erythrocin®: 500 mg, 1 g

Ointment, ophthalmic: 0.5% \[5 mg/g\] (1 g, 3.5 g)\
  Romycin®: 0.5% \[5 mg/g\] (3.5 g)

Ointment, topical: 2% (25 g)\
  Akne-Mycin®: 2% (25 g)

Powder for oral suspension: 200 mg/5 mL, 400 mg/5 mL\
  EryPed®: 200 mg/5 mL, 400 mg/5 mL

Powder for oral suspension \[drops\]: 100 mg/2.5 mL\
  EryPed®: 100 mg/2.5 mL

Solution, topical: 2% (60 mL)\
  A/T/S®, Eryderm®, Theramycin Z®: 2% (60 mL)\
  Sans Acne® \[CAN\]: 2% (60 mL) \[not available in the U.S.\]

Suspension, oral: 125 mg/5 mL, 200 mg/5 mL, 250 mg/5 mL, 400 mg/5 mL\
  E.E.S.®: 200 mg/5 mL, 400 mg/5 mL

Tablet: 250 mg, 400 mg, 500 mg\
  E.E.S.®: 400 mg\
  Erythrocin®: 250 mg, 500 mg

Tablet, delayed release, enteric coated: 250 mg, 333 mg, 500 mg\
  Ery-Tab®: 250 mg, 333 mg, 500 mg

Tablet \[polymer-coated particles\]: 333 mg, 500 mg\
  PCE®: 333 mg, 500 mg

**GENERIC EQUIVALENT AVAILABLE** --- Yes

**ADMINISTRATION**\
Oral: Do not crush enteric coated drug product. GI upset, including
diarrhea, is common. May be administered with food to decrease GI upset.
Do not give with milk or acidic beverages.

I.V.: Infuse 1 g over 20-60 minutes. I.V. infusion may be very
irritating to the vein. If phlebitis/pain occurs with used dilution,
consider diluting further (eg, 1:5) if fluid status of the patient will
tolerate, or consider administering in larger available vein. The
addition of lidocaine or bicarbonate does not decrease the irritation of
erythromycin infusions.

Ophthalmic: Avoid contact of tip of ophthalmic ointment tube with
affected eye

**COMPATIBILITY**\
Erythromycin lactobionate: Stable in NS; incompatible with D5LR, D10W;
variable stability (consult detailed reference) in D5NS, D5W, LR.

Y-site administration: Compatible: Acyclovir, amiodarone,
cyclophosphamide, diltiazem, enalaprilat, esmolol, famotidine,
foscarnet, heparin, hydromorphone, idarubicin, labetalol, lorazepam,
magnesium sulfate, meperidine, midazolam, morphine, multivitamins,
perphenazine, tacrolimus, theophylline, vitamin B complex with C,
zidovudine. Incompatible: Fluconazole.

Compatibility in syringe: Incompatible: Ampicillin, heparin.

Compatibility when admixed: Compatible: Aminophylline, ampicillin,
cimetidine, diphenhydramine, hydrocortisone sodium succinate, lidocaine,
penicillin G potassium, penicillin G sodium, pentobarbital, polymyxin B
sulfate, potassium chloride, prochlorperazine edisylate, promazine,
ranitidine, sodium bicarbonate, verapamil. Incompatible: Colistimethate,
floxacillin, furosemide, heparin, metaraminol, metoclopramide,
riboflavin, vitamin B complex with C. Variable (consult detailed
reference): Ascorbic acid injection.

**USE**\
Systemic: Treatment of susceptible bacterial infections including S.
pyogenes, some S. pneumoniae, some S. aureus, M. pneumoniae, Legionella
pneumophila, diphtheria, pertussis, chancroid, Chlamydia, erythrasma, N.
gonorrhoeae, E. histolytica, syphilis and nongonococcal urethritis, and
Campylobacter gastroenteritis; used in conjunction with neomycin for
decontaminating the bowel

Ophthalmic: Treatment of superficial eye infections involving the
conjunctiva or cornea; neonatal ophthalmia

Topical: Treatment of acne vulgaris

**USE - UNLABELED / INVESTIGATIONAL** --- Systemic: Treatment of
gastroparesis

**ADVERSE REACTIONS SIGNIFICANT**\
Systemic:\
  Cardiovascular: Ventricular arrhythmia, QTc prolongation, torsade de
pointes (rare), ventricular tachycardia (rare)\
  Central nervous system: Headache (8%), pain (2%), fever, seizure\
  Dermatitis: Rash (3%), pruritus (1%)\
  Gastrointestinal: Abdominal pain (8%), cramping, nausea (8%), oral
candidiasis, vomiting (3%), diarrhea (7%), dyspepsia (2%), flatulence
(2%), anorexia, pseudomembranous colitis, hypertrophic pyloric stenosis
(including cases in infants or IHPS), pancreatitis\
  Hematologic: Eosinophilia (1%)\
  Hepatic: Cholestatic jaundice (most common with estolate), increased
liver function tests (2%)\
  Local: Phlebitis at the injection site, thrombophlebitis\
  Neuromuscular & skeletal: Weakness (2%)\
  Respiratory: Dyspnea (1%), cough (3%)\
  Miscellaneous: Hypersensitivity reactions, allergic reactions

Topical: 1% to 10%: Dermatologic: Erythema, desquamation, dryness,
pruritus

**CONTRAINDICATIONS** --- Hypersensitivity to erythromycin or any
component of the formulation

Systemic: Pre-existing liver disease (erythromycin estolate);
concomitant use with ergot derivatives, pimozide, or cisapride

**WARNINGS / PRECAUTIONS** --- Systemic: Use caution with hepatic
impairment with or without jaundice has occurred, it may be accompanied
by malaise, nausea, vomiting, abdominal colic, and fever; discontinue
use if these occur; avoid using erythromycin lactobionate in neonates
since formulations may contain benzyl alcohol which is associated with
toxicity in neonates; observe for superinfections. Use in infants has
been associated with infantile hypertrophic pyloric stenosis (IHPS).
Macrolides have been associated with rare QT prolongation and
ventricular arrhythmias, including torsade de pointes. Elderly may be at
increased risk of adverse events, including hearing loss and/or torsade
de pointes when dosage 4 g/day, particularly if concurrent renal/hepatic
impairment.

**DRUG INTERACTIONS** --- Substrate of CYP2B6 (minor), 3A4 (major);
Inhibits CYP1A2 (weak), 3A4 (moderate)

Alfentanil (and possibly other narcotic analgesics): Serum levels may be
increased by erythromycin; monitor for increased effect.

Antipsychotic agents (particularly mesoridazine and thioridazine): Risk
of QTc prolongation and malignant arrhythmias may be increased.

Benzodiazepines (those metabolized by CYP3A4, including alprazolam and
triazolam): Serum levels may be increased by erythromycin; somnolence
and confusion have been reported.

Bromocriptine: Serum levels may be increased by erythromycin; monitor
for increased effect.

Buspirone: Serum levels may be increased by erythromycin; monitor.

Calcium channel blockers (felodipine, verapamil, and potentially others
metabolized by CYP3A4): Serum levels may be increased by erythromycin;
monitor.

Carbamazepine: Serum levels may be increased by erythromycin; monitor.

Cilostazol: Serum levels may be increased by erythromycin.

Cisapride: Serum levels may be increased by erythromycin; serious
arrhythmias have occurred; concurrent use contraindicated.

Clindamycin (and lincomycin): Use with erythromycin may result in
pharmacologic antagonism; manufacturer recommends avoiding this
combination.

Clozapine: Serum levels may be increased by erythromycin; monitor.

Colchicine: serum levels/toxicity may be increased by erythromycin;
monitor. Avoid use, if possible.

Cyclosporine: Serum levels may be increased by erythromycin; monitor
serum levels.

CYP3A4 inducers: CYP3A4 inducers may decrease the levels/effects of
erythromycin. Example inducers include aminoglutethimide, carbamazepine,
nafcillin, nevirapine, phenobarbital, phenytoin, and rifamycins.

CYP3A4 inhibitors: May increase the levels/effects of erythromycin.
Example inhibitors include azole antifungals, clarithromycin,
diclofenac, doxycycline, imatinib, isoniazid, nefazodone, nicardipine,
propofol, protease inhibitors, quinidine, telithromycin, and verapamil.

CYP3A4 substrates: Erythromycin may increase the levels/effects of
CYP3A4 substrates. Example substrates include benzodiazepines, calcium
channel blockers, cyclosporine, mirtazapine, nateglinide, nefazodone,
sildenafil (and other PDE-5 inhibitors), tacrolimus, and venlafaxine.
Selected benzodiazepines (midazolam and triazolam), cisapride, ergot
alkaloids, selected HMG-CoA reductase inhibitors (lovastatin and
simvastatin), and pimozide are generally contraindicated with strong
CYP3A4 inhibitors.

Delavirdine: Serum levels of erythromycin may be increased; also, serum
levels of delavirdine may increased by erythromycin (low risk); monitor.

Digoxin: Serum levels may be increased by erythromycin; monitor digoxin
levels.

Disopyramide: Serum levels may be increased by erythromycin; in
addition, QTc prolongation and risk of malignant arrhythmia may be
increased; avoid combination.

Ergot alkaloids: Concurrent use may lead to acute ergot toxicity (severe
peripheral vasospasm and dysesthesia).

HMG-CoA reductase inhibitors (atorvastatin, lovastatin, and
simvastatin); Erythromycin may increase serum levels of \"statins\"
metabolized by CYP3A4, increasing the risk of myopathy/rhabdomyolysis
(does not include fluvastatin and pravastatin). Switch to
pravastatin/fluvastatin or suspend treatment during course of
erythromycin therapy.

Loratadine: Serum levels may be increased by erythromycin; monitor.

Methylprednisolone: Serum levels may be increased by erythromycin;
monitor.

Neuromuscular-blocking agents: May be potentiated by erythromycin (case
reports).

Phenytoin: Serum levels may be increased by erythromycin; other evidence
suggested phenytoin levels may be decreased in some patients; monitor.

Pimozide: Serum levels may be increased, leading to malignant
arrhythmias; concomitant use is contraindicated.

Protease inhibitors (amprenavir, nelfinavir, and ritonavir): May
increase serum levels of erythromycin.

QTc-prolonging agents: Concomitant use may increase the risk of
malignant arrhythmias.

Quinidine: Serum levels may be increased by erythromycin; in addition,
the risk of QTc prolongation and malignant arrhythmias may be increased
during concurrent use.

Quinolone antibiotics (sparfloxacin, gatifloxacin, and moxifloxacin):
Concurrent use may increase the risk of malignant arrhythmias.

Rifabutin: Serum levels may be increased by erythromycin; monitor.

Sildenafil, tadalafil, vardenafil: Serum concentration may be
substantially increased by erythromycin. Do not exceed single sildenafil
doses of 25 mg in 48 hours, a single tadalafil dose of 10 mg in 72
hours, or a single vardenafil dose of 2.5 mg in 24 hours.

Tacrolimus: Serum levels may be increased by erythromycin; monitor serum
concentration.

Theophylline: Serum levels may be increased by erythromycin; monitor.

Valproic acid (and derivatives): Serum levels may be increased by
erythromycin; monitor.

Vinblastine (and vincristine): Serum levels may be increased by
erythromycin.

Warfarin: Effects may be potentiated; monitor INR closely and adjust
warfarin dose as needed or choose another antibiotic.

Zafirlukast: Serum levels may be decreased by erythromycin; monitor.

Zopiclone: Serum levels may be increased by erythromycin; monitor.

**ETHANOL / NUTRITION / HERB INTERACTIONS**\
Ethanol: Avoid ethanol (may decrease absorption of erythromycin or
enhance ethanol effects).

Food: Increased drug absorption with meals; erythromycin serum levels
may be altered if taken with food.

Herb/Nutraceutical: St John\'s wort may decrease erythromycin levels.

**PREGNANCY RISK FACTOR** --- B ([show
table](http://www.utdol.com/utd/content/image.do?imageKey=requ_pix/drug_r13.htm&title=Drug ratings in pregnancy))

**LACTATION** --- Enters breast milk/use caution (AAP considers
\"compatible\")

**DIETARY CONSIDERATIONS** --- Systemic: Drug may cause GI upset; may
take with food.

**PRICING** --- (data from drugstore.com)\
Capsule, enteric pellets (Erythromycin Base)\
  250 mg (30): \$9.38

Gel (Erythromycin)\
  2% (30): \$18.65\
  2% (60): \$38.65

Ointment (Akne-Mycin)\
  2% (25): \$58.70

Ointment (Erythromycin)\
  5 mg/g (3.5): \$7.99

Solution (Eryderm)\
  2% (60): \$21.57

Solution (Erythromycin)\
  2% (59): \$7.99

Solution (Theramycin Z)\
  2% (60): \$24.69

Suspension (E.E.S. 200)\
  200 mg/5 mL (200): \$12.91

Suspension (E.E.S. 400)\
  400 mg/5 mL (100): \$12.82

Suspension (Erythromycin Ethylsuccinate)\
  200 mg/5 mL (200): \$9.04\
  400 mg/5 mL (100): \$10.91

Suspension (reconstituted) (E.E.S. Granules)\
  200 mg/5 mL (100): \$12.62\
  200 mg/5 mL (200): \$20.83

Tablet, EC (Ery-Tab)\
  333 mg (30): \$10.91\
  500 mg (20): \$8.69

Tablet, EC (PCE)\
  333 mg (30): \$63.17\
  500 mg (20): \$55.39

Tablets (E.E.S. 400)\
  400 mg (40): \$12.64

Tablets (Erythrocin Stearate)\
  250 mg (30): \$7.56\
  500 mg (20): \$9.92

Tablets (Erythromycin Base)\
  500 mg (40): \$11.39

Tablets (Erythromycin Ethylsuccinate)\
  400 mg (40): \$11.38

**TOXICOLOGY / OVERDOSE COMPREHENSIVE** --- Symptoms include nausea,
vomiting, and diarrhea. Treatment consists of general and supportive
care only.

**CANADIAN BRAND NAMES** --- Apo-Erythro Base®; Apo-Erythro E-C®;
Apo-Erythro-ES®; Apo-Erythro-S®; Diomycin®; EES®; Erybid™; Eryc®;
Novo-Rythro Estolate; Novo-Rythro Ethylsuccinate; Nu-Erythromycin-S;
PCE®; PMS-Erythromycin; Sans Acne®

**INTERNATIONAL BRAND NAMES** --- A-Lennon-Erythromycin® (ZA); A-Mycin®
(BD); Acnecin® (PL); Acneryne® (BE, LU); Acnesol® (IN); Acnetrim® (IL);
Adco-Erythromycin® (ZA); Akne Cordes® (AT, DE); Akne-mycin® (CH, CN);
Akne-Mycin® (IL, LU, NL, SG); Aknefug-EL® (CZ, DE, HU); Aknemycin® (AT,
BE, CZ, DE, HU, LU, PL); Aknilox® (CH, TR); Algiderm® (AR); Althrocin®
(IN); Antibioxon® (AR); Apo-Erythro Base® (CA); Apo-Erythro E-C® (CA);
Apo-Erythro-ES® (CA); Apo-Erythro-S® (CA, PE); Arsitrocin® (ID); Baknyl®
(EC); Bestocin® (MX); Betamycin® (ZA); Biotril® (MX); Bonac® (CO);
Broncomultigen® (PE); Bronsema® (ES); Cetathrocin® (ID); Colitromin®
(MX); Corsatrocin® (ID); Cusi Erythromycin® (PL); Davercin® (PL); DBL
Erythromycin® (AU); Deripil® (ES); Diomycin® (CA); E-Mycin® (AU, HK, IN,
NZ); E-Trocima-P® (MX); E.S.E. (PT); EES® (AU, CA, SG); Egery® (FR);
Elocin® (TH); Eltocin® (IN); EMU VE® (CL); Era I.V.® (NZ); Erasis® (EG,
JO, KW, LB); Erathrom® (TH); Era® (NZ); Eribec® (MX); Eriber® (MX);
Ericin® (TH); Eridosis® (ES); Eriecu® (EC); Erigrand Pediatrica® (AR);
Erigrand® (AR); Erimit® (TH); Erimycin® (TH); Erios® (CH); Erisine®
(AR); Eritrex® (BR); Eritrocina® (IT, PT); Eritroderm® (AR);
Eritrofarmin® (MX); Eritrofarm® (AR); Eritrofar® (BR); Eritrogobens®
(ES); Eritromagis® (RO); Eritromec® (ID); Eritromed Gotas® (AR);
Eritromed Unguento® (AR); Eritromicina Bioquim® (AR); Eritromicina
Estearato® (PE); Eritromicina Estedi® (ES); Eritromicina Etilsuccinato
L.CH.® (CL); Eritromicina Etilsuccinato® (EC, IT); Eritromicina
Etilsuccinat® (RO); Eritromicina Fabra® (AR); Eritromicina Fmndtria®
(PE); Eritromicina Galderma® (IT); Eritromicina Gen-Far® (PE);
Eritromicina Genfar® (CO, EC); Eritromicina IDI® (IT); Eritromicina
Iqfarma® (PE); Eritromicina Klonal® (AR); Eritromicina Lactobionat®
(RO); Eritromicina Lafedar® (AR); Eritromicina lattobionato® (IT);
Eritromicina Lch® (PE); Eritromicina MK® (CO, CR, DO, GT, HN, PA, SV);
Eritromicina® (AR, BR, CL, CO, IT, PE, RO); Eritromicin® (HR, SI, YU);
Eritropharma® (MX); Eritrosif® (TR); Eritroveinte® (ES); Eritrovier®
(MX); Eritro® (RO, TR); Erixyl® (DO); Ermyced® (CY); Ermycin® (CY);
Ermysin® (FI); Eromel® (ZA); Eromycin® (BD); Eros® (ID); Erotab® (PE,
SG); Erphathrocin® (ID); Ery 1A Pharma® (DE); Ery-Diolan® (CY, DE, KW,
LB, SY); Ery-hameln® (DE); Ery-Hexal® (LU); Ery-Max® (NO, PH, SE);
Ery-Tab® (TH); Eryacnen® (BR, CL, CR, DO, GT, HN, MX, PA, SV); Eryacne®
(AR, AU, FR, GB, IT, NL, SG, TH, TR); Eryaknen® (AT, CH, DE); Erybeta
TS® (DE); Erybeta® (DE); Erybid™ (CA); ERYCINUM® (DE); Erycin® (DK, TH);
Erycoat® (ID); Eryc® (AU, CA, CZ, HK, HU, IL, RO); Erydermec® (DE);
Eryderm® (BE, CH, EG, ID, IL, JO, KW, LB, LU, MX, NL, SG, SY, ZA);
Eryfluid® (CZ, FR, LU, PT, RO, RU); Eryhexal® (AT, DE, LU, RO); Erylan®
(PE); Erymax® (GB, IE); Erymed® (ID); Erymin® (TH); Erymycin AF® (ZA);
Erypark® (CL); EryPed® (EG); Eryped® (HK); EryPed® (JO, KW, LB); Eryped®
(SG); EryPed® (SY); Erysafe® (IN); Erysanbe® (ID); Erysec® (DE); Erysil®
(TH); Erysol® (HK); Eryson® (SG); Erystad® (AT); Eryth-Mycin® (TH);
Erythran® (BG, HU); Erythrin® (ID); Erythro ethyl granules® (HK);
Erythro Suspensio (PE); Erythro-Hefa® (DE); Erythro-Teva® (IL);
Erythrocine-ES® (NL); Erythrocine® (BE, FR, HK, LU, NL); Erythrocin®
(DE, ZA); Erythrodar® (HK, JO, KW, LB, MT, MY, RO); Erythroforte® (BE);
Erythrogel® (FR); Erythrogenat TS® (DE); Erythrogenat® (DE); Erythrol®
(IL); Erythromid® (GB); Erythromil® (BG, JO, KW, LB, MA, MY, RO, SY);
Erythromycin acis® (DE); Erythromycin AL® (DE); Erythromycin curasan®
(DE); Erythromycin Estolate® (CY); Erythromycin Ethyl Succinate® (GB);
Erythromycin Genericon® (AT); Erythromycin Heumann® (DE); Erythromycin
Indo Farma® (ID); Erythromycin Lactobionate® (AU, GB, HU, NZ);
Erythromycin Lannacher® (AT); Erythromycin Merck 1G® (IL); Erythromycin
Rivo® (RO); Erythromycin Stada® (DE); Erythromycin-ratiopharm DB® (LU);
Erythromycin-ratiopharm® (DE); Erythromycin-Wolff® (DE); Erythromycine
Bailleul® (FR); Erythromycine Dakota® (FR); Erythromycine Faulding®
(BE); Erythromycine lactobionate Mayne® (NL); Erythromycine-Ethypharm®
(LU); Erythromycine® (NL); Erythromycinum Intravenosum® (PL);
Erythromycinum pro Suspensione® (PL); Erythromycinum® (PL); Erythroped
A® (GB); Erythroped® (GB, IE, IL); Erythroskid® (CZ); Erythrotrop® (HU);
Erythrox® (BD); Erytrarco® (CH); Erytro-Teva® (RO); Erytrociclin® (IT);
Erytromycine FNA® (NL); Erytromycine® (NL); Ery® (FR, LU); Escumycin®
(DK); Esinol® (JP); Etisux® (AR); Etrocin® (BD); Etrolate® (TH); Euskin®
(ES); Gelerit® (CL); Grunamycin® (RU); Hexabotin® (DK); Hydrodermed Ery®
(DE); Ikathrocin® (ID); Iliocin® (MX); Ilocin® (BR); Ilosin® (MX);
Ilosone® (BE, BR, GB, HK, LU, MX, PE, PH, RO, TH, ZA); Iloticina® (AR);
Inderm® (BE, DE, LU, NL, RO); Infectomycin Saft® (DE); Infectomycin®
(DE); Kanazima® (BR); Karex-Wolff® (DE); Karex® (CH); Kemothrocin® (ID);
Kitacne® (AR); Konithrocin® (ID); Labocne® (CL); Lactobionat
Eritromicina® (RO); Lagarmicin® (ES); Latotryd® (MX); Lauritran® (MX);
Lauromicina® (IT); Lederpax® (AR, ES); Loderm® (ES); Macromycine® (BE,
LU); Malocin® (TH); Mercina® (CL); Meromycin® (AT, CZ, HU); Monomycina®
(EC); Monomycin® (CH, DE, LU); Neo Iloticina® (ES); Novo-Rythro Estolate
(CA); Novo-Rythro Ethylsuccinate (CA, RO); Nu-Erythromycin-S (CA); Oft
Cusi Eritromicina® (ES); Oftalmolets® (AR); Oleogen F® (PE); Opithrocin®
(ID); Optomicin® (MX); Paediathrocin® (DE); Panamycin® (CO); Pantodrin®
(ES); Pantomicina® (AR, BR, CL, CO, ES, PE); Pantomucol® (PE); PCE® (CA,
HK); Pediazole® (PE); Pentoclave® (AR); Pharothrocin® (ID);
PMS-Erythromycin (CA); Pocin® (TH); Porphyrocin® (HK, RO, YU);
Primacine® (IE); Procephal® (MX); Propionat de Eritromicina® (RO);
Purmycin® (ZA); Ranthrocin® (SG); Redrocin® (TH); Rommix® (GB);
Rythinate® (EG, JO, KW, LB, SY); Sanasepton Gel® (DE); Sanasepton® (DE);
Sans Acne® (CA); Sans-Acne® (DO, MX); Selvicin® (PE); Servitrocin® (BD,
CH, HK, TH); Skid Gel E® (DE); Spectrasone® (ZA); Stacin® (TH);
Stiemycine® (AT, DE); Stiemycin® (AR, BR, CH, CO, CR, DO, EG, GB, GT,
HK, HN, IE, JO, KW, LB, LU, MX, NL, NZ, PA, SG, SV, SY, TH, ZA);
Stimycine® (BE, FR); T-Stat® (SG); Takasunon® (JP); Throcin® (BD);
Tiloryth® (GB); Tiprocin® (IE); Tomcin® (TH); Toperit® (AR); Trixne®
(AR); Wemid® (AR); Xeramel® (ZA)

**MECHANISM OF ACTION** --- Inhibits RNA-dependent protein synthesis at
the chain elongation step; binds to the 50S ribosomal subunit resulting
in blockage of transpeptidation

**PHARMACODYNAMICS / KINETICS**\
Absorption: Oral: Variable but better with salt forms than with base
form; 18% to 45%; ethylsuccinate may be better absorbed with food

Distribution: Crosses placenta; enters breast milk\
  Relative diffusion from blood into CSF: Minimal even with
inflammation\
  CSF:blood level ratio: Normal meninges: 1% to 12%; Inflamed meninges:
7% to 25%

Protein binding: 75% to 90%

Metabolism: Hepatic via demethylation

Half-life elimination: Peak: 1.5-2 hours; End-stage renal disease: 5-6
hours

Time to peak, serum: Base: 4 hours; Ethylsuccinate: 0.5-2.5 hours;
delayed with food due to differences in absorption

Excretion: Primarily feces; urine (2% to 15% as unchanged drug)

**PATIENT INFORMATION** --- Refrigerate after reconstitution; take
entire course of medication; chewable tablets should not be swallowed
whole; report if persistent diarrhea occurs; discard any unused portion
after 10 days; absorption of estolate, ethylsuccinate, and base in a
delayed release form are unaffected by food; take stearate salt and
nondelayed release base preparations 2 hours before or after meals

(For additional information see \"Erythromycin: Patient drug
information\")

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Agreement.](http://www.utdol.com/utd/content/license.do)

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