Drug/Small Molecule:
erythromycin

Overview

Generic Names: EM; Erythrocin; Erythrocin Stearate; Erythromycin Stearate; Erythromycin estolate; Erythromycin ethylsuccinate; Erythromycin glucoheptonate; Erythromycin lactobionate; Erythromycin oxime
Trade Names: Abboticin; Abomacetin; Ak-mycin; Akne-Mycin; Aknin; Benzamycin; Benzamycin Pak; Bristamycin; Dotycin; Dumotrycin; E-Base; E-Glades; E-Mycin; E-Solve 2; EMU; ETS; Emgel; Eritrocina; Ermycin; Ery-Sol; Ery-Tab; Eryc; Eryc 125; Eryc Sprinkles; Erycen; Erycette; Erycin; Erycinum; Eryderm; Erygel; Erymax; Erypar; Erythra-Derm; Erythro; Erythro-Statin; Erythrogran; Erythroguent; Erythromast 36; Erythromid; Erythromycin A; Erythromycin B; Ethril 250; Ilocaps; Ilosone; Ilotycin; Ilotycin Gluceptate; IndermRetcin; Kesso-Mycin; Mephamycin; Pantomicina; Pce; Pfizer-e; Propiocine; R-P Mycin; Robimycin; Sansac; Serp-AFD; Stiemycin; Taimoxin-F; Theramycin Z; Torlamicina; Wemid; Wyamycin S
Brand Mixtures: Sans-Acne Solution (Alcohol Anhydrous + Erythromycin); Staticin Lot (Alcohol Anhydrous + Erythromycin + Laureth 4); Stievamycin Forte Gel (Erythromycin + Tretinoin); Stievamycin Gel (Erythromycin + Tretinoin); T-Stat Lot (Alcohol Anhydrous + Erythromycin); T-Stat Pad-Lot (Alcohol Anhydrous + Erythromycin)
PharmGKB Accession Id: PA449493

Description

Erythromycin is a bacteriostatic antibiotic macrolide produced by <i>Streptomyces erythreus</i>. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. PubChem (source: Drug Bank)

Indication

For use in the treatment of infections caused by susceptible strains of microorganisms in the following diseases: respiratory tract infections (upper and lower) of mild to moderate degree, pertussis (whooping cough), as adjunct to antitoxin in infections due to <i>Corynebacterium diphtheriae</i>, in the treatment of infections due to <i>Corynebacterium minutissimum</i>, intestinal amebiasis caused by <i>Entamoeba histolytica</i>, acute pelvic inflammatory disease caused by <i>Neisseria gonorrhoeae</i>, skin and soft tissue infections of mild to moderate severity caused by <i>Streptococcus pyogenes</i> and <i>Staphylococcus aureus</i>, primary syphilis caused by <i>Treponema pallidum</i>, infections caused by <i>Chlamydia trachomatis</i>, nongonococcal urethritis caused by <i>Ureaplasma urealyticum</i>, and Legionnaires' disease caused by <i>Legionella pneumophila</i>. (source: Drug Bank)

ATC Therapeutic Categories

  • D10AF:Antiinfectives for treatment of acne
  • J01FA:Macrolides
  • S01AA:Antibiotics

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

Erythromycin acts by penetrating the bacterial cell membrane and reversibly binding to the 50 S subunit of bacterial ribosomes or near the “P” or donor site so that binding of tRNA (transfer RNA) to the donor site is blocked. Translocation of peptides from the “A” or acceptor site to the “P” or donor site is prevented, and subsequent protein synthesis is inhibited. Erythromycin is effective only against actively dividing organisms. The exact mechanism by which erythmromycin reduces lesions of acne vulgaris is not fully known: however, the effect appears to be due in part to the antibacterial activity of the drug. (source: Drug Bank)

Pharmacology

Erythromycin is produced by a strain of <i>Streptomyces erythraeus</i> and belongs to the macrolide group of antibiotics. After absorption, erythromycin diffuses readily into most body fluids. In the absence of meningeal inflammation, low concentrations are normally achieved in the spinal fluid, but the passage of the drug across the blood-brain barrier increases in meningitis. Erythromycin is excreted in breast milk. The drug crosses the placental barrier, but fetal plasma levels are low. Erythromycin is not removed by peritoneal dialysis or hemodialysis. (source: Drug Bank)

Food Interactions

Avoid alcohol.
Take on empty stomach: 1 hour before or 2 hours after meals.
Take with a full glass of water Avoid taking with grapefruit juice. (source: Drug Bank)

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic. Extensively metabolized - after oral administration, less than 5% of the administered dose can be recovered in the active form in the urine. (source: Drug Bank)

Protein Binding

Erythromycin is largely bound to plasma proteins, and the freely dissociating bound fraction after administration of erythromycin base represents 90% of the total erythromycin absorbed. (source: Drug Bank)

Absorption

Orally administered erythromycin base and its salts are readily absorbed in the microbiologically active form. Topical application of the ophthalmic ointment to the eye may result in absorption into the cornea and aqueous humor. (source: Drug Bank)

Toxicity

Symptoms of overdose include diarrhea, nausea, stomach cramps, and vomiting. (source: Drug Bank)

Isomeric SMILES Code:

CC[C@@H]1[C@@]([C@H]([C@H](C(=O)[C@@H](C[C@@]([C@@H]([C@@H]([C@@H]([C@H](C(=O)O1)C)O[C@H]2C[C@@]([C@H]([C@@H](O2)C)O)(C)OC)C)O[C@H]3[C@@H]([C@H](C[C@H](O3)C)N(C)C)O)(C)O)C)C)O)(C)O (source: Drug Bank)

The following genes are in curated knowledge about this drug.

  Gene Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Has annotations
ABCB1
  •   
  • PD
  • PK
  • FA
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
CYP2C8
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  •   
  • PK
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Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP2D6
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  • PK
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Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
CYP3A
  • CO
  •   
  • PK
  •   
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A4
  •   
  • PD
  • PK
  • FA
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A5
  •   
  •   
  • PK
  •   
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
KCNH2
  •   
  • PD
  •   
  • FA
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
NR1I2
  •   
  •   
  •   
  • FA
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
SCN5A
  •   
  • PD
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Publications
No phenotype data Genotype Data Available Literature annotations available Not annotated
SLCO1A2
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  •   
  • PK
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Publications
No phenotype data Genotype Data Available Literature annotations available Not annotated
SLCO1B3
  •   
  •   
  • PK
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Publications

A list of non-curated publications that mention this drug along with other genes is available.

The following drugs are in curated knowledge about this drug.

  Drug Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Not annotated
dexamethasone
  •   
  •   
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
digoxin
  • CO
  • PD
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
galantamine
  •   
  •   
  • PK
  •   
  •   
Publications

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Drug Description
acenocoumarol Uncurated Annotation The macrolide increases anticoagulant effect (source: Drug Bank)
alfentanil Uncurated Annotation The macrolide increases the effect and toxicity of alfentanil (source: Drug Bank)
alprazolam Uncurated Annotation The macrolide increases the effect of the benzodiazepine (source: Drug Bank)
amiodarone Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
astemizole Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
atorvastatin Uncurated Annotation The macrolide possibly increases the statin toxicity (source: Drug Bank)
bretylium Uncurated Annotation Increased risk of cardiotoxicity and arryhthmias (source: Drug Bank)
bromocriptine Uncurated Annotation Erythromycin increases serum levels of bromocriptine (source: Drug Bank)
buspirone Uncurated Annotation The macrolide increases the effect and toxicity of buspirone (source: Drug Bank)
cabergoline Uncurated Annotation Erythromycin increases serum levels and toxicity of cabergoline (source: Drug Bank)
carbamazepine Uncurated Annotation The macrolide increases the effect of carbamazepine (source: Drug Bank)
cerivastatin Uncurated Annotation The macrolide possibly increases the statin toxicity (source: Drug Bank)
cisapride Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
citalopram Uncurated Annotation Possible serotoninergic syndrome with this combination (source: Drug Bank)
clozapine Uncurated Annotation Erythromycin increases the effect of clozapine (source: Drug Bank)
colchicine Uncurated Annotation Severe colchicine toxicity can occur (source: Drug Bank)
cyclosporine Uncurated Annotation The macrolide increases the effect of cyclosporine (source: Drug Bank)
diazepam Uncurated Annotation The macrolide increases the effect of the benzodiazepine (source: Drug Bank)
dicumarol Uncurated Annotation The macrolide increases anticoagulant effect (source: Drug Bank)
digoxin Uncurated Annotation The macrolide increases the effect of digoxin in 10% of patients (source: Drug Bank)
disopyramide Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
docetaxel Uncurated Annotation The agent increases the serum levels and toxicity of docetaxel (source: Drug Bank)
dofetilide Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
eletriptan Uncurated Annotation The macrolide increases the effect and toxicity of eletriptan (source: Drug Bank)
ergonovine Uncurated Annotation Possible ergotism and severe ischemia with this combination (source: Drug Bank)
erlotinib Uncurated Annotation This CYP3A4 inhibitor increases levels/toxicity of erlotinib (source: Drug Bank)
felodipine Uncurated Annotation Erythromycin increases the effect of felodipine (source: Drug Bank)
fluoxetine Uncurated Annotation Possible serotoninergic syndrome with this combination (source: Drug Bank)
gefitinib Uncurated Annotation This CYP3A4 inhibitor increases levels/toxicity of gefitinib (source: Drug Bank)
grepafloxacin Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
imatinib Uncurated Annotation The macrolide increases levels of imatinib (source: Drug Bank)
itraconazole Uncurated Annotation The macrolide increases the effect and toxicity of itraconazole (source: Drug Bank)
levofloxacin Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
lovastatin Uncurated Annotation The macrolide possibly increases the statin toxicity (source: Drug Bank)
mesoridazine Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
methylergonovine Uncurated Annotation Possible ergotism and severe ischemia with this combination (source: Drug Bank)
methylprednisolone Uncurated Annotation The macrolide increases the effect of corticosteroid (source: Drug Bank)
midazolam Uncurated Annotation The macrolide increases the efect of the benzodiazepine (source: Drug Bank)
moxifloxacin Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
pimozide Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
quetiapine Uncurated Annotation This macrolide increases the effect/toxicity of quetiapine (source: Drug Bank)
quinidine Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
repaglinide Uncurated Annotation This macrolide increases effect of repaglinide (source: Drug Bank)
rifabutin Uncurated Annotation The rifamycin decreases the effect of the macrolide (source: Drug Bank)
rifampin Uncurated Annotation The rifamycin decreases the effect of the macrolide (source: Drug Bank)
ritonavir Uncurated Annotation Increased toxicity of both agents (source: Drug Bank)
sertraline Uncurated Annotation Possible serotoninergic syndrome with this combination (source: Drug Bank)
sibutramine Uncurated Annotation Erythromycin increases the effect and toxicity of sibutramine (source: Drug Bank)
sildenafil Uncurated Annotation The macrolide increases the effect and toxicity of sildenafil (source: Drug Bank)
simvastatin Uncurated Annotation The macrolide possibly increases the statin toxicity (source: Drug Bank)
sirolimus Uncurated Annotation The macrolide increases sirolimus levels (source: Drug Bank)
sotalol Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
sparfloxacin Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
tacrolimus Uncurated Annotation Erythromycin increases the effect and toxicity of tacrolimus (source: Drug Bank)
terfenadine Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
theophylline Uncurated Annotation The macrolide increases the effect and toxicity of theophylline (source: Drug Bank)
thioridazine Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
triazolam Uncurated Annotation The macrolide increases the effect of the benzodiazepine (source: Drug Bank)
vardenafil Uncurated Annotation The macrolide increases the effect and toxicity of vardenafil (source: Drug Bank)
verapamil Uncurated Annotation Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
vinblastine Uncurated Annotation Erythromycin increases vinblastine toxicity (source: Drug Bank)
warfarin Uncurated Annotation The macrolide increases anticoagulant effect (source: Drug Bank)
zafirlukast Uncurated Annotation Erythromycin decreases the effect of zafirlukast (source: Drug Bank)

Curated Information

The following diseases are in curated knowledge about this drug.

  Disease Relationship Evidence
No phenotype data No genotype data Literature annotations available Not annotated
Arrhythmias, Cardiac
  • CO
  •   
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Heart Arrest
  •   
  • PD
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  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Seizures
  •   
  • PD
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  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Syncope
  •   
  • PD
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  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Tachycardia, Ventricular
  •   
  • PD
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  •   
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
Torsades de Pointes
  •   
  • PD
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Ventricular Fibrillation
  •   
  • PD
  •   
  •   
  •   
Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Curated Phenotype Datasets

These datasets are sorted alphabetically by title.

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

  1. Physicochemical determinants of human renal clearance
  2. The Connectivity Map: using gene-expression signatures to connect small molecules, genes, and disease
  3. The Influence of CYP3A5 Expression on the Extent of Hepatic CYP3A Inhibition Is Substrate-Dependent: An in Vitro-in Vivo Evaluation

Downloads

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LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00199
KEGG Compound ID:
C01912
KEGG Drug ID:
D00140
PubChem Compound ID:
12560
PubChem Substance ID:
5020

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.

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