Symptoms of hepatitis, hepatic dysfunction and/or abnormal liver function test results may occur. (See Elderly patients may be more susceptible to development of torsades de pointes arrhythmias than younger patients. Cases of torsades de pointes have been spontaneously reported during postmarketing surveillance in patients receiving erythromycin. Rare cases of serious cardiovascular adverse events, including electrocardiographic QT/QTc interval prolongation, cardiac arrest, torsades de pointes, and other ventricular arrhythmias have been observed. (See Erythromycin Ethylsuccinate for Oral Suspension, USP, 200 mg/5 mL contains 58.75 mg (2.55 mEq) of sodium per individual dose.Erythromycin Ethylsuccinate for Oral Suspension, USP, 400 mg/5 mL contains 117.5 mg (5.1 mEq) of sodium per individual dose.Based on the 200 mg/5 mL strength, at the usual recommended doses, adult patients would receive a total of 470 mg/day (20.4 mEq) of sodium. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. Interactions with other drugs metabolized by the CYP3A isoform are also possible. (See In addition, there have been reports of interactions of erythromycin with drugs not thought to be metabolized by CYP3A, including hexobarbital, phenytoin, and valproate.Erythromycin has been reported to significantly alter the metabolism of the nonsedating antihistamines terfenadine and astemizole when taken concomitantly. Erythromycin should be avoided in patients with known prolongation of the QT interval, patients with ongoing proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, and in patients receiving Class IA (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmic agents. Erythromycin stearate did not show genotoxic potential in the Ames, and mouse lymphoma assays or induce chromosomal aberrations in CHO cells. Choose from the topics below to learn how you can safely use Advil to defy tough aches and pain. If superinfection occurs, erythromycin should be discontinued and appropriate therapy instituted.When indicated, incision and drainage or other surgical procedures should be performed in conjunction with antibiotic therapy. Less than 5 percent of the orally administered dose of erythromycin is excreted in active form in the urine.Erythromycin crosses the placental barrier, but fetal plasma levels are low. Advil is committed to delivering safe and effective pain relief. ������o��U�.�).Eu��}Q]��P�6�����JyPY)D�U�*�)��r(�TF����!�_� U��pAB�+��� �� ����P ��C.�3��d��ܢ�Cd(M@B�(x��! Dosage adjustments may be considered, and when possible, serum concentrations of drugs primarily metabolized by CYP3A should be monitored closely in patients concurrently receiving erythromycin.The following are examples of some clinically significant CYP3A based drug interactions. Action Date Submission Supplement Categories or Approval Type Letters, Reviews, Labels, Patient Package Insert Note Url; 04/10/2020: SUPPL-95: Labeling-Container/Carton Labels Increased anticoagulation effects due to interactions of erythromycin with various oral anticoagulants may be more pronounced in the elderly.Erythromycin is a substrate and inhibitor of the 3A isoform subfamily of the cytochrome p450 enzyme system (CYP3A). The Lancet 1999;354 (9196): 2101-5The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. The decrease in erythromycin concentrations due to coadministration of theophylline could result in subtherapeutic concentrations of erythromycin.Hypotension, bradyarrhythmias, and lactic acidosis have been observed in patients receiving concurrent verapamil, belonging to the calcium channel blockers drug class.Concomitant administration of erythromycin and digoxin has been reported to result in elevated digoxin serum levels.There have been reports of increased anticoagulant effects when erythromycin and oral anticoagulants were used concomitantly. Advil delivers relief that's fast with strength that lasts. endstream endobj 2250 0 obj <>stream Coadministration of erythromycin and a drug primarily metabolized by CYP3A may be associated with elevations in drug concentrations that could increase or prolong both the therapeutic and adverse effects of the concomitant drug. Infants born to women treated during pregnancy with oral erythromycin for early syphilis should be treated with an appropriate penicillin regimen.If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. The mechanism by which this interaction occurs is unknown.