Erythrom Lac 500mg Inj, 1vial

Erythromycin binds to the 50S ribosomal subunit of susceptible microorganisms, thereby inhibiting bacterial protein synthesis without affecting nucleic acid synthesis. It is generally considered bacteriostatic but may be bactericidal at high concentrations or against highly susceptible organisms.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, difficulty breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of liver problems: dark urine, fatigue, decreased appetite, stomach pain or upset, light-colored stools, vomiting, or yellow skin or eyes.
Signs of a severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis): red, swollen, blistered, or peeling skin (with or without fever), red or irritated eyes, or sores in the mouth, throat, nose, or eyes.
Difficulty urinating or changes in urine output.
Severe dizziness or fainting.
Rapid heartbeat.
Abnormal heartbeat (long QT on ECG), which can be life-threatening. This risk may increase when taking other medications with this drug. Seek medical help immediately if you experience an irregular heartbeat.
Diarrhea, particularly if it is severe, bloody, or watery, as this can be a sign of a potentially life-threatening condition called C. diff-associated diarrhea (CDAD). CDAD can occur during or after antibiotic treatment.
Hearing loss, which is rare but may be more likely if you have kidney problems or take high doses of this medication.

Common Side Effects

Most people experience no side effects or only mild ones. However, if you notice any of the following side effects, contact your doctor or seek medical attention if they bother you or persist:

Diarrhea, stomach pain, upset stomach, vomiting, or decreased appetite.
* Irritation at the injection site (if applicable).

Reporting Side Effects

This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
Certain health conditions, including:
+ Abnormal heartbeat patterns, such as a prolonged QTc interval on an electrocardiogram (ECG)
+ Other irregular heartbeats
+ Slow heartbeat
+ Low potassium or magnesium levels

Additionally, tell your doctor about all the medications you are currently taking, including:

Prescription and over-the-counter (OTC) medications
Natural products
* Vitamins

This is crucial because some medications, such as those used to treat mood disorders, irregular heartbeats, or migraine headaches, may interact with this medication and should not be taken together.

Please note that this is not an exhaustive list of all potential interactions. To ensure your safety, it is vital to discuss all your medications and health conditions with your doctor and pharmacist. Before starting, stopping, or changing the dose of any medication, consult with your doctor to confirm that it is safe to do so in conjunction with this medication.

Important Information for Patients Taking This Medication

If you are taking this medication, it is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, about your treatment.

Long-term use of this medication requires regular blood work checks. Consult with your doctor to discuss the necessity and frequency of these checks.

This medication may interfere with certain laboratory tests. Be sure to notify all your healthcare providers and laboratory personnel that you are taking this medication to ensure accurate test results.

Do not take this medication for a longer period than prescribed by your doctor. Prolonged use may increase the risk of a second infection.

If you have myasthenia gravis, consult with your doctor before taking this medication. Monitor your symptoms closely, and contact your doctor immediately if they worsen. Additionally, be aware that myasthenia gravis symptoms, such as new or worsening muscle weakness, difficulty chewing or swallowing, breathing problems, droopy eyelids, or changes in vision (including blurred vision or double vision), can occur in people without a history of the condition. Seek medical attention promptly if you experience any of these symptoms.

Patients 65 years or older should exercise caution when taking this medication, as they may be more susceptible to side effects.

If you are pregnant, planning to become pregnant, or breastfeeding, consult with your doctor to discuss the potential benefits and risks of this medication to you and your baby.

Special Considerations for Newborns

Newborns taking this medication are at risk of developing a severe stomach problem. If your child vomits or becomes irritable during feeding, contact your doctor immediately.

• Astemizole
• Cisapride
• Pimozide
• Terfenadine
• Ergotamine
• Dihydroergotamine
• Colchicine (in patients with renal/hepatic impairment)

• Statins (e.g., Simvastatin, Lovastatin, Atorvastatin)
• Warfarin
• Carbamazepine
• Cyclosporine
• Tacrolimus
• Theophylline
• Digoxin
• Quinidine
• Disopyramide
• Sildenafil
• Verapamil
• Diltiazem
• Amiodarone
• Fluconazole
• Ketoconazole
• Itraconazole
• Ritonavir
• Nelfinavir
• Saquinavir
• Alprazolam
• Midazolam
• Triazolam
• Quetiapine
• Lumacaftor/Ivacaftor
• Ivacaftor
• Flibanserin
• Lurasidone
• Tolvaptan
• Ranolazine
• Domperidone
• Eplerenone
• Fesoterodine
• Solifenacin
• Tamsulosin
• Silodosin
• Dabigatran etexilate
• Ticagrelor
• Rivaroxaban
• Apixaban

• Oral contraceptives (reduced efficacy)
• Phenytoin
• Valproic acid
• Zidovudine
• Clindamycin
• Lincomycin
• Chloramphenicol (antagonistic effects)
• Cimetidine
• Ranitidine
• Proton pump inhibitors (e.g., Omeprazole)
• Corticosteroids (e.g., Methylprednisolone)
• Bosentan
• Eletriptan
• Zolmitriptan
• Rifabutin
• Rifampin
• St. John's Wort

• Antacids (may reduce absorption of oral forms, less relevant for IV)
• Food (less relevant for IV)

• Nausea
• Vomiting
• Abdominal pain
• Diarrhea
• Hearing loss
• Tinnitus
• Vertigo
• Yellowing of skin/eyes (jaundice)
• Dark urine
• Light-colored stools
• Unusual fatigue
• Palpitations
• Dizziness
• Fainting
• Rash
• Itching
• Swelling of face/lips/tongue
• Difficulty breathing

Erythromycin is generally considered safe for use during pregnancy (Category B). It has been widely used and no evidence of teratogenicity has been consistently demonstrated in human studies. However, some studies have suggested a possible association with cardiovascular malformations or pyloric stenosis in infants exposed in utero, but these findings are not conclusive and overall risk is considered low.

Erythromycin is excreted into breast milk in small amounts. It is generally considered compatible with breastfeeding (L2 - Likely Compatible). Monitor breastfed infants for gastrointestinal disturbances (e.g., diarrhea, candidiasis) and, rarely, infantile hypertrophic pyloric stenosis.

Use with caution in neonates and young infants due to an association with infantile hypertrophic pyloric stenosis (IHPS), particularly with oral erythromycin. The risk is highest in the first 2 weeks of life. IV erythromycin may also carry this risk, though less studied. Monitor for signs of IHPS (projectile vomiting, abdominal mass). Dosing should be carefully calculated based on weight.

No specific dose adjustment is generally required based on age alone. However, elderly patients may be more susceptible to QT prolongation, hearing loss, and drug interactions due to polypharmacy, underlying cardiac conditions, or renal/hepatic impairment. Monitor renal and hepatic function, and ECG as appropriate.

• Erythromycin IV should be infused slowly (over 20-60 minutes) to minimize the risk of phlebitis and ototoxicity.
• High doses or rapid infusion can lead to transient hearing loss, especially in patients with renal or hepatic impairment.
• Erythromycin is a potent CYP3A4 inhibitor, leading to numerous significant drug interactions. Always review concomitant medications.
• It can prolong the QT interval, increasing the risk of Torsades de Pointes. Avoid use with other QT-prolonging drugs or in patients with pre-existing QT prolongation or uncorrected hypokalemia/hypomagnesemia.
• While primarily bacteriostatic, it can be bactericidal at higher concentrations against susceptible organisms.
• Erythromycin is also used as a prokinetic agent in some GI motility disorders due to its motilin receptor agonist activity, though this is off-label for the antibiotic formulation.

• Azithromycin (another macrolide, longer half-life, less CYP3A4 inhibition)
• Clarithromycin (another macrolide, less GI side effects than erythromycin, CYP3A4 inhibitor)
• Clindamycin (lincosamide, alternative for some anaerobic infections or penicillin allergy)
• Doxycycline (tetracycline, alternative for some respiratory or skin infections)
• Levofloxacin (fluoroquinolone, broad-spectrum, but with QT prolongation risk)
• Moxifloxacin (fluoroquinolone, broad-spectrum, but with QT prolongation risk)
• Beta-lactam antibiotics (e.g., Penicillins, Cephalosporins) if patient is not allergic

If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further evaluation and guidance.

To ensure safe use, do not share your medication with others, and never take someone else's medication. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion.

Proper disposal of unused or expired medications is crucial. Do not flush medications down the toilet or pour them down the drain unless specifically instructed to do so by a healthcare professional or pharmacist. If you are unsure about the best disposal method, consult with your pharmacist, who can provide guidance on safe disposal practices. Additionally, you may want to inquire about potential drug take-back programs in your area.

Some medications may come with an additional patient information leaflet; check with your pharmacist to see if this applies to your prescription. If you have any questions or concerns about your medication, do not hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider.

In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide critical information, including the name of the medication taken, the amount, and the time it was taken, to ensure prompt and effective treatment.