Erythromycin Warnings and Precautions

People who are already taking certain medications may not be able to take erythromycin. Precautions and warnings also apply to people who have a specific type of irregular heart rhythm and to women who are pregnant or breastfeeding. When given to children, this drug can cause a serious stomach condition called pyloric stenosis; however, this condition is treatable.

What Should I Tell My Healthcare Provider Before Beginning Treatment?

Prior to taking erythromycin, tell your healthcare provider if you have:
  • Liver disease, such as cirrhosis, liver failure, or hepatitis
  • Kidney disease, such as kidney failure (renal failure)
  • Myasthenia gravis
  • An irregular heart rhythm (arrhythmia)
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Erythromycin

Warnings and precautions to be aware of prior to taking erythromycin include the following:
  • Antibiotics (like erythromycin) can disrupt the normal bacteria in the digestive tract, allowing undesirable bacteria to overgrow. A serious problem known as pseudomembranous colitis may result and can occur while you are taking the antibiotic or even weeks later. Be sure to watch for signs of this problem, which can become life-threatening, such as bloody or severe diarrhea.

Mild, short-term diarrhea is a common side effect of many antibiotics, including erythromycin, and is usually not a cause for concern.

  • Erythromycin can cause a change in the heart rhythm known as QT prolongation. This can be dangerous, especially in people who already have a similar problem known as long QT syndrome or in people who take other medications that also cause QT prolongation (see Erythromycin Drug Interactions).
  • Overuse of antibiotics increases the risk of developing antibiotic-resistant bacteria. Your healthcare provider should prescribe antibiotics only when necessary, and only to treat bacterial infections. These medications are not effective for treating viral infections, such as the common cold or the flu.
  • Make sure your healthcare provider knows if you have kidney or liver disease, as you may need a lower or less frequent erythromycin dosage. Also, since this medicine can cause liver damage in rare cases, it may not be a good choice for people who already have liver disease.
  • Sometimes, antibiotics can cause yeast infections, since they can get rid of "good" bacteria that help protect against yeast infections. Let your healthcare provider know if you develop a vaginal yeast infection or thrush (a yeast infection of the mouth) while taking erythromycin or shortly thereafter.
  • There have been reports of pyloric stenosis (a serious but treatable stomach condition) in infants who were given erythromycin. Contact your child's healthcare provider right away if your child has signs or symptoms of pyloric stenosis, such as vomiting or sudden and extreme fussiness during feeding.
  • There have been reports that erythromycin may worsen or, in rare cases, even cause myasthenia gravis.
  • Erythromycin can potentially react with several other medications (see Erythromycin Drug Interactions).
  • Erythromycin is considered a pregnancy Category B medication. This means that it may be safe for use during pregnancy, although the full risks are not known (see Erythromycin and Pregnancy).
  • This medication passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to beginning treatment (see Erythromycin and Breastfeeding).
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