Erythromycin, Inj/Oral

Macrolide & similar types · Macrolide

Indications

Erythromycin-sensitive infections. Acne.

Dosage

ORAL: Adults: 250-500 mg every 6 hr or 500 mg-1 gm every 12 hr taken before or with meals; up to 4 gm daily in divided doses in severe infections. Children: Neonate: 12.5 mg/kg every 6 hr; 1 mth-2 yr, 125 mg every 6 hr; 2-8 yr, 250 mg every 6 hr. The dosage doubled for severe infection. Lower Respiratory Infection: Adults: Usual: 250 mg every 6 hr or 500 mg every 12 hr. Children: Usual: 30-50 mg/kg/day in divided doses. Max: 4 gm/day. Upper Respiratory Infection: Adults: Usual: 250 mg every 6 hr or 500 mg every 12 hr. Children: Usual: 30-50 mg/kg/day in divided doses. Max: 4 gm/day. Skin Infections: Adults: Usual: 250 mg every 6 hr or 500 mg every 12 hr. Children: Usual: 30-50 mg/kg/day in divided doses. Max: 4 gm/day. Acne: Initially 250 mg twice daily; maintenance 250 mg once daily after one mth. Early syphilis: Adults: Usual: 500 mg every 6 hr for 14 days. Uncomplicated genital…

Administration

IV Infusion may be very irritating to the vein. If phlebitis/pain occurs with used dilution, consider diluting further (e.g. 1:5) if fluid states of the patient will tolerate, or consider administering in larger available vein. Reconstitution: Erythromycin lactobionate should be reconstituted with SWFI without preservatives to avoid gel formation. IV form has the longest stability in 0.9% sodium chloride (NS) and should be prepared in this base solution whenever possible. Do not use D5W as a diluent unless sodium bicarbonate is added to solution. If IV must be prepared in D5W, 0.5 mL of the 8.4% sodium bicarbonate solution should be added per each 100 mL of D5W. Standard diluent: 500 mg/250 mL D5W/NS; 750 mg/250 mL D5W/NS; 1 gm/250 mL D5W/NS. Compatibility: Stable in NS. Incompatible with D5LR, D10W. Y-site administration: Incompatible with fluconazole. Stability: The reconstituted…

Adverse Effects

GI upset, cholestatic jaundice, allergic reactions, reversible hearing loss, pancreatitis, cardiac effects, Myasthaenia-like syndrome, Stevens-Johnson syndrome, toxic epidermal necrolysis, hepatotoxicity, hypotension, interstitial nephritis, hallucinations, chest pain, fever, malaise, QT prolongation, infantile hypertrophic pyloric stenosis, C.difficile associated diarrhoea.

Risk Factor (Pregnancy/Lactation)

Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Contraindications: Porphyria. Precautions: Predisposition to prolonged QT interval, renal or hepatic impairment, Myasthaenia gravis.

Interactions

Amisulpride, tolterodine, astemizole, mizolastine, ergot derivatives, theophylline, carbamazepine, oral anticoagulants, digoxin, cisapride, alfentanil, bromocriptine, cyclosporin, disopyramide, amiodarone, hexobarbitone, midazolam, phenytoin, triazolam, valproate, statins, zopiclone, tacrolimus, pimozide, quinidine, rifabutin, amisulpride, domperidone, hepatotoxic agents, drugs that prolong QT interval, colchicine, protease inhibitors, verapamil, cimetidine, CYP3A4 inducers or substrates.

Advice to Patient

Take atleast 30 minutes or 2 hours before meals. Swallow whole with a glass of water. Do not chew or crush extended release preparations. Take erythromycin ethylsuccinate form with meals as it is better absorbed with food. Contact prescriber if there is unusual vomiting, nausea, abdominal pain, fever, skin rash or itching, easy bleeding or bruising, vaginal itching, vaginal discharge, blood in stool, severe diarrhoea that remains for 3 or more days, pale stool, yellowing of eyes or skin, dark colored urine, mouth sores, white plaques or fuzziness in mouth, hearing changes or if there is worsening of condition or no improvement. Watery or bloody stools can occur 2 or more months after therapy and can be serious, requiring immediate treatment. Complete full course of therapy even if you feel better. Avoid alcohol during therapy.

Pharmacokinetics

Absorption: Oral: Variable but better with salt forms than with base form; 18%-45%; ethylsuccinate may be better absorbed with food. Metabolism: Hepatic. Half-life elimination: Neonates (=15 days of age): 2.1 hrs. Adults: Peak: 1.5-2 hrs. End-stage renal disease: 5-6 hrs. Time to peak, serum: Base: 4 hrs. Ethylsuccinate: 0.5-2.5 hrs. Stearate: 3 hrs; delayed with food due to differences in absorption. Excretion: Primarily faeces. Urine.

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

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