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 | |
|---|---|---|---|
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ABCB1 |
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Publications |
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CYP2C8 |
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Publications |
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CYP2D6 |
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Publications |
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CYP3A |
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Publications |
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CYP3A4 |
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Publications |
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CYP3A5 |
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Publications |
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KCNH2 |
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Publications |
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NR1I2 |
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Publications |
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SCN5A |
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Publications |
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SLCO1A2 |
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Publications |
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SLCO1B3 |
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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 | |
|---|---|---|---|
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dexamethasone |
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Publications |
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digoxin |
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Publications |
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galantamine |
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Publications |
A list of non-curated publications that mention this drug along with other drugs is available.
Drug Interactions
| Drug | Description | |
|---|---|---|
| acenocoumarol |
|
The macrolide increases anticoagulant effect (source: Drug Bank) |
| alfentanil |
|
The macrolide increases the effect and toxicity of alfentanil (source: Drug Bank) |
| alprazolam |
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The macrolide increases the effect of the benzodiazepine (source: Drug Bank) |
| amiodarone |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| astemizole |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| atorvastatin |
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The macrolide possibly increases the statin toxicity (source: Drug Bank) |
| bretylium |
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Increased risk of cardiotoxicity and arryhthmias (source: Drug Bank) |
| bromocriptine |
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Erythromycin increases serum levels of bromocriptine (source: Drug Bank) |
| buspirone |
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The macrolide increases the effect and toxicity of buspirone (source: Drug Bank) |
| cabergoline |
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Erythromycin increases serum levels and toxicity of cabergoline (source: Drug Bank) |
| carbamazepine |
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The macrolide increases the effect of carbamazepine (source: Drug Bank) |
| cerivastatin |
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The macrolide possibly increases the statin toxicity (source: Drug Bank) |
| cisapride |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| citalopram |
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Possible serotoninergic syndrome with this combination (source: Drug Bank) |
| clozapine |
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Erythromycin increases the effect of clozapine (source: Drug Bank) |
| colchicine |
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Severe colchicine toxicity can occur (source: Drug Bank) |
| cyclosporine |
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The macrolide increases the effect of cyclosporine (source: Drug Bank) |
| diazepam |
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The macrolide increases the effect of the benzodiazepine (source: Drug Bank) |
| dicumarol |
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The macrolide increases anticoagulant effect (source: Drug Bank) |
| digoxin |
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The macrolide increases the effect of digoxin in 10% of patients (source: Drug Bank) |
| disopyramide |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| docetaxel |
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The agent increases the serum levels and toxicity of docetaxel (source: Drug Bank) |
| dofetilide |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| eletriptan |
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The macrolide increases the effect and toxicity of eletriptan (source: Drug Bank) |
| ergonovine |
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Possible ergotism and severe ischemia with this combination (source: Drug Bank) |
| erlotinib |
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This CYP3A4 inhibitor increases levels/toxicity of erlotinib (source: Drug Bank) |
| felodipine |
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Erythromycin increases the effect of felodipine (source: Drug Bank) |
| fluoxetine |
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Possible serotoninergic syndrome with this combination (source: Drug Bank) |
| gefitinib |
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This CYP3A4 inhibitor increases levels/toxicity of gefitinib (source: Drug Bank) |
| grepafloxacin |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| imatinib |
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The macrolide increases levels of imatinib (source: Drug Bank) |
| itraconazole |
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The macrolide increases the effect and toxicity of itraconazole (source: Drug Bank) |
| levofloxacin |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| lovastatin |
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The macrolide possibly increases the statin toxicity (source: Drug Bank) |
| mesoridazine |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| methylergonovine |
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Possible ergotism and severe ischemia with this combination (source: Drug Bank) |
| methylprednisolone |
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The macrolide increases the effect of corticosteroid (source: Drug Bank) |
| midazolam |
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The macrolide increases the efect of the benzodiazepine (source: Drug Bank) |
| moxifloxacin |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| pimozide |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| quetiapine |
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This macrolide increases the effect/toxicity of quetiapine (source: Drug Bank) |
| quinidine |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| repaglinide |
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This macrolide increases effect of repaglinide (source: Drug Bank) |
| rifabutin |
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The rifamycin decreases the effect of the macrolide (source: Drug Bank) |
| rifampin |
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The rifamycin decreases the effect of the macrolide (source: Drug Bank) |
| ritonavir |
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Increased toxicity of both agents (source: Drug Bank) |
| sertraline |
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Possible serotoninergic syndrome with this combination (source: Drug Bank) |
| sibutramine |
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Erythromycin increases the effect and toxicity of sibutramine (source: Drug Bank) |
| sildenafil |
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The macrolide increases the effect and toxicity of sildenafil (source: Drug Bank) |
| simvastatin |
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The macrolide possibly increases the statin toxicity (source: Drug Bank) |
| sirolimus |
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The macrolide increases sirolimus levels (source: Drug Bank) |
| sotalol |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| sparfloxacin |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| tacrolimus |
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Erythromycin increases the effect and toxicity of tacrolimus (source: Drug Bank) |
| terfenadine |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| theophylline |
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The macrolide increases the effect and toxicity of theophylline (source: Drug Bank) |
| thioridazine |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| triazolam |
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The macrolide increases the effect of the benzodiazepine (source: Drug Bank) |
| vardenafil |
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The macrolide increases the effect and toxicity of vardenafil (source: Drug Bank) |
| verapamil |
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Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank) |
| vinblastine |
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Erythromycin increases vinblastine toxicity (source: Drug Bank) |
| warfarin |
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The macrolide increases anticoagulant effect (source: Drug Bank) |
| zafirlukast |
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Erythromycin decreases the effect of zafirlukast (source: Drug Bank) |
Curated Information
The following diseases are in curated knowledge about this drug.
| Disease | Relationship | Evidence | |
|---|---|---|---|
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Arrhythmias, Cardiac |
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Publications |
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Heart Arrest |
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Publications |
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Seizures |
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Publications |
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Syncope |
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Publications |
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Tachycardia, Ventricular |
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Publications |
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Torsades de Pointes |
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Publications |
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Ventricular Fibrillation |
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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.
- mRNA expression levels of PXR splice variants in livers




- FA
Submitted by Erin G. Schuetz, PhD involving CYP3A4, NR1I2, , amiodarone, cimetidine, dopamine, erythromycin, ethanol, glucocorticoids, hmg coa reductase inhibitors, midazolam, nicotine, phenobarbital, phenytoin, propofol, thyroid preparations and vasopressin
Additional Datasets
These datasets are minimally curated and are sorted alphabetically by title.
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LinkOuts
Common Searches
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Non-Curated Publications
A list of non-curated publications that mention this drug is available.
