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Erythromycin

Rycin (Used for Skin Infection, Urinary Tract Infection, Bacterial Infection, Upper Respiratory Infection, Lower Respiratory Infection, Pneumonia, Amoebiasis)

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Written by R. Author | Reviewed by Uche Ruth

Updated on June 10, 2024

Overview

Erythromycin is an antibiotic that's used to treat a variety of infections caused by bacteria, including certain skin and respiratory infections. The dosage depends on the specific infection you're using it for. The most common side effects are related to the stomach, like nausea, vomiting, and diarrhea. Erythromycin comes in two forms that are taken by mouth: oral tablets and an oral suspension.

What is Erythromycin used for?

How Erythromycin works

Erythromycin belongs to a group of antibiotics called macrolide antibiotics. It treats your infection by preventing the bacteria from making important proteins they need to survive.

Pros and cons of Erythromycin

pros and cons of erythromycin
Pharmacist tips for Erythromycin

  • Erythromycin is best taken on an empty stomach (30 minutes before or 2 hours after a meal), but not everyone can tolerate taking it this way. If you have a lot of stomach-related side effects, like nausea or vomiting, taking your dose with food can help lessen them.
  • Erythromycin ethylsuccinate (EES) oral suspension and tablets can be taken with or without meals because food doesn't affect how your body absorbs the medication.
  • Erythromycin should only be used to treat infections caused by bacteria. It doesn't treat infections caused by viruses like the common cold or the flu.
  • Finish all of the erythromycin your healthcare provider prescribed for you, even if you start to feel better. Stopping the medication too soon can cause your infection to come back and become harder to treat.
  • Diarrhea is a common side effect of erythromycin, and it usually goes away after you stop treatment. Let your healthcare provider know right away if you have watery and bloody stools, with or without stomach cramps and fever, because this might lead to other serious problems.
  • Erythromycin interacts with several medications, such as digoxin (Lanoxin), colchicine (Colcrys), and a group of cholesterol medications called statins. Let your healthcare provider and pharmacist know about all the medications you're taking, including ones that are available over the counter, vitamins, and herbal supplements.
  • If you are taking erythromycin for an STI, make sure your sexual partner(s) also get treated. If they don't, they could reinfect you. Most states allow you to ask your healthcare provider for a prescription for your partner(s) without them present. This is called expedited partner therapy. Ask your healthcare provider if this is an option where you live.

What are the risks and warnings for Erythromycin?

Erythromycin can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Liver damage

  • Risk factors: History of liver problems

erythromycin can cause severe or life-threatening liver damage. Your risk is higher if you have or have had liver problems. If you experience unexplained stomach pain, nausea, vomiting, dark urine, pale stools, or yellowing of your skin or eyes, contact your healthcare provider right away. Blood tests will need to be done to check that your liver is healthy.

Life-threatening changes in your heart rhythm (QT prolongation)

  • Risk factors: History of QT prolongation | History of irregular heart rhythm (arrhythmias) | Current slow heart rate | History of low potassium or magnesium in the blood | Taking other medications that affect your heart rhythm | Age 65 or older

Rarely, erythromycin can cause a serious heart rhythm problem called QT prolongation. This can cause your heart to stop and lead to death. Those with certain heart conditions and those older than age 65 have a higher risk of this problem. You shouldn't take erythromycin if you also use other medications that also cause QT prolongation. Before taking this medication, let your healthcare provider know about any heart conditions you have and provide a list of all the medications you're taking, including over-the-counter items, vitamins, and herbal supplements.

Syphilis in infants

  • Risk factors: Women who were treated for syphilis while pregnant

Using erythromycin to treat syphilis during pregnancy might not completely prevent the baby from getting infected with syphilis when born. That's because the medication might not reach the baby effectively. Be sure to let your healthcare provider and your child's healthcare provider know if you took erythromycin for syphilis while you were pregnant. Your baby will need to take antibiotics after they are born.

Severe diarrhea

  • Risk factors: Use of multiple antibiotics | Long-term use of antibiotics | Age 65 or older | Recent hospital stay | People with weakened immune systems

Like all antibiotics, erythromycin can put you at a higher risk for getting Clostridioides difficile (C. difficile) associated diarrhea (CDAD), a life-threatening side effect. Like many other bacteria, C. diff naturally lives in your gut. These bacteria normally don’t cause any problems. But taking erythromycin or other antibiotics can cause certain bacteria to grow out of control. When C. diff grows out of control, it can cause fatal diarrhea due to dehydration and swelling of the colon. Stop erythromycin and contact your healthcare provider right away if you experience bloody or watery stool, as this might be a sign of CDAD.

Interactions with other medications

Erythromycin is known to interact with many medications, some of which can be life-threatening. To avoid problems with your heart rhythm, don't take erythromycin with other medications that also affect the heart rhythm.

Taking Erythromycin with certain medications can cause the body to absorb too much of these medications, raising the risk for side effects. For example, if erythromycin is taken with colchicine (Colcrys), it can lead to a dangerous condition called colchicine-related toxicity. In addition, erythromycin shouldn't be taken with certain statins, such as lovastatin or simvastatin (Zocor), because it raises the risk of serious muscle damage.

Make sure to tell both your healthcare provider and your pharmacist about all medications and over-the-counter products you are taking before you start erythromycin, even if you only take them once in a while or as needed. Your dose might even need to be adjusted to avoid these interactions.

Worsening of myasthenia gravis

  • Risk factors: History of myasthenia gravis

If you have myasthenia gravis, taking erythromycin can worsen symptoms like muscle weakness and difficulty breathing. Talk to your healthcare provider if you are concerned about this problem.

Intestinal blockage in babies

  • Risk factors: Infants taking erythromycin for a long time

Infants have developed a blockage between their stomach and small intestine after taking erythromycin. Infants are at higher risk of developing this problem the longer they take this medication. Typically, this medication isn't used for infants unless it's for a life-threatening illness. If a healthcare provider does prescribe erythromycin for your infant, watch for vomiting or fussiness while eating. and contact your child's healthcare provider right away.

Strengths

Tablet

  • 250mg
  • 333mg

Dosages

Erythromycin tablets:

  • Adults: The typical dose is 250 mg by mouth 4 times a day OR 500 mg by mouth every 12 hours. The maximum dose is 4,000 mg a day.
  • Children: The typical dose is 30 to 50 mg/kg by mouth a day. This dose should be split up into smaller doses and given either 2 or 4 times a day. The maximum dose is 4,000 mg a day.

Erythromycin ethylsuccinate (EES) (tablets or suspension):

  • Adults: The typical dose is 400 mg by mouth every 6 hours. The total dose can be adjusted to be taken 2 or 3 times a day. The maximum dose is 4,000 mg a day.
  • Children: The typical dose is 30 to 50 mg/kg by mouth per day. This dose should be split up into smaller doses and given either 2 or 4 times a day.

The dose and duration can be different depending on the specific type of infection.

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Interactions

Erythromycin may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Erythromycin. Please note that only the generic name of each medication is listed below.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Side-effects

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Nausea
  • Vomiting
  • Stomach pain
  • Diarrhea
  • Anorexia

Other Side Effects

  • Rash
  • Hives
  • Hearing loss

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.

  • Liver damage: fever, chills, fatigue, nausea, vomiting, yellowing of the skin or whites of the eyes, itching, clay-colored stool, and dark urine
  • Abnormal heart rhythm: Feeling like your heart is pounding out of your chest, feeling like you are about to faint, dizziness
  • Clostridioides difficile (C. diff)-associated diarrhea (CDAD): watery or bloody diarrhea, stomach pain, vomiting, fever, nausea
  • Serious allergic and skin reaction: fever, rash, body aches, itching, trouble breathing, peeling skin, painful blisters all over your body


The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

  • Blistering, peeling, or loosening of the skin
  • Chills
  • Cough
  • Diarrhea
  • Difficulty with swallowing
  • Dizziness
  • Fast heartbeat
  • Hives or welts, skin rash
  • Joint or muscle pain
  • Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • Red, irritated eyes
  • Red skin lesions, often with a purple center
  • Redness of the skin
  • Sore throat
  • Sores, ulcers, or white spots in the mouth or on the lips
  • Tightness in the chest
  • Unusual tiredness or weakness

Incidence not known

  • Bloating
  • Bloody or cloudy urine
  • Chest pain or discomfort
  • Dark urine
  • Diarrhea, watery and severe, which may also be bloody
  • Fainting
  • Fever
  • General tiredness and weakness
  • Greatly decreased frequency of urination or amount of urine
  • Hearing loss
  • Increased thirst
  • Irregular heartbeat recurrent
  • Irregular or slow heart rate
  • Light-colored stools
  • Nausea
  • Pain
  • Stomach cramp or tenderness
  • Swelling of the feet or lower legs
  • Unusual weight loss
  • Upper right abdominal or stomach pain
  • Vomiting
  • Yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Common Concerns

No. Erythromycin is not a penicillin medication. It's a macrolide antibiotic, which is a different type of antibiotic. If you're allergic to penicillin, your healthcare provider might prescribe erythromycin as an alternative to penicillin-type antibiotics.
No. Erythromycin is not a sulfa medication. It falls under a different group of antibiotics known as macrolide antibiotics.
It's not known whether erythromycin is safe to use in pregnancy. In animal studies, erythromycin didn’t cause harm to the baby. Talk with your healthcare provider if you’re pregnant or plan to get pregnant. They can make sure that erythromycin is safe for you and your baby.
The length of time you take erythromycin depends on the type of infection you have and how severe it is. Most infections can be treated in 7 days, but other infections might take 3 weeks or more to completely clear up. Follow the directions on your prescription label carefully and ask your healthcare provider if you're not sure how long you should be taking this medication.
Erythromycin comes in tablet form, whereas erythromycin ethylsuccinate (EES) is available in both oral suspension and tablet forms. EES isn't absorbed as much into the body compared to regular erythromycin. EES might also have fewer side effects, making it more tolerable than erythromycin. Speak to your healthcare provider to see which one might work better for you.
Erythromycin isn't FDA approved to treat gastroparesis, a condition where the movement of food in the gut is slowed down or even stopped. But because erythromycin is known to speed up gut muscle movement, some healthcare providers might prescribe it off-label for a short term to treat gastroparesis. Talk to your healthcare provider if you have questions about using this medication for gastroparesis.

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