{"id":3953,"date":"2025-03-31T18:11:53","date_gmt":"2025-03-31T18:11:53","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/erythromycin-txt\/"},"modified":"2025-03-31T18:11:53","modified_gmt":"2025-03-31T18:11:53","slug":"erythromycin-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/erythromycin-txt\/","title":{"rendered":"Erythromycin.txt"},"content":{"rendered":"

Erythromycin<\/h1>\n

CLINICAL USE <\/H3>
\nAntibacterial agent

DOSE IN NORMAL RENAL FUNCTION <\/H3>IV: 25\u201350 mg\/kg\/dayOral: 250\u2013500 mg every 6 hours or 0.5\u20131 g every 12 hoursMaximum 4 g daily

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :733.9<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :70\u201395<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 2\u201315<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :0.6\u20131.2 (increased in CKD 5)<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :1.5\u20132\/4\u20137

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : 50\u201375 % of normal dose; maximum 2 g daily

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugsAvoid concomitant use with reboxetine and cilostazol\n
  • Anti-arrhythmics: increased risk of ventricular arrhythmias with parenteral erythromycin and amiodarone \u2013 avoid concomitant use; increased toxicity with disopyramide\n
  • Antibacterials: increased risk of ventricular arrhythmias with moxifloxacin and parenteral erythromycin avoid concomitant use; increased rifabutin concentration\n
  • Anticoagulants: enhanced effect of coumarins\n
  • Anti-epileptics: increased carbamazepine concentration and possibly valproateAntihistamines: possibly increases loratadine concentration; inhibits mizolastine metabolism \u2013 avoid concomitant use\n
  • Antimalarials: avoid concomitant administration with artemether\/lumefantrineAntimuscarinics: avoid concomitant use with tolterodine\n
  • Antipsychotics: increased risk of ventricular arrhythmias with amisulpride and parenteral erythromycin avoid concomitant use; possibly increases clozapine concentration and possibly increased risk of convulsions; possibly increased risk of ventricular arrhythmias with pimozide and sertindole \u2013 avoid concomitant use; possibly increased quetiapine concentration\n
  • Antivirals: concentration of both drugs increased with amprenavir; concentration increased by ritonavirAnxiolytics and hypnotics: inhibits midazolam and zopiclone metabolism; increases buspirone concentration\n
  • Atomoxetine: increased risk of ventricular arrhythmias with parenteral erythromycin\n
  • Calcium-channel blockers: possibly inhibit metabolism of felodipine and verapamil; avoid concomitant use with lercanidipine\n
  • Ciclosporin: markedly elevated ciclosporin blood levels \u2013 decreased levels on withdrawing drug. Monitor blood levels of ciclosporin carefully and adjust dose promptly as necessaryColchicine: increased risk of colchicine toxicityCytotoxics: possible interaction with docetaxol; increases vinblastine toxicity \u2013 avoid concomitant use\n
  • Diuretics: increased eplerenone concentration \u2013reduce eplerenone dose\n
  • Ergot alkaloids: increase risk of ergotism \u2013 avoid concomitant use5HT 1 agonists: increased eletriptan concentration \u2013 avoid concomitant useIvabradine: increased risk of ventricular arrhythmias \u2013 avoid concomitant use.278 eRYtHROMYCINLipid-lowering drugs: increased risk of myopathy; concentration of rosuvastatin reduced\n
  • Pentamidine: increased risk of ventricular arrhythmias with pentamidineSirolimus: concentration of both drugs increased\n
  • Tacrolimus: markedly elevated tacrolimus blood levels \u2013 decreased levels on withdrawing drug. Monitor blood levels of tacrolimus carefully and adjust dose promptly as necessaryTheophylline: inhibits theophylline metabolism; if erythromycin given orally decreased erythromycin concentration

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>1 g with 20 mL water for injection, then dilute resultant solution further to 1\u20135 mg\/mL

    Route <\/H4>IV, oral

    Rate of Administration <\/H4>20\u201360 minutes using constant rate infusion pump

    Comments<\/H4>Use central line if concentration greater than 5 mg\/mL; if >10 mg\/mL monitor carefully (some units use 1 g in 100 mL of sodium chloride 0.9%). (UK Critical Care Group, Minimum Infusion Volumes for fluid restricted critically ill patients, 3rd Edition, 2006)

    OTHER INFORMATION <\/H4>May also give one third of daily dose by infusion over 8 hours peripherally at concentration of 1 g\/250 mL (4 mg\/mL). Repeat 8 hourly, i.e. continuouslyIncreased risk of ototoxicity in renal impairmentAvoid peaks produced by oral twice-daily dosing, i.e. dose 4 times dailyMonitor closely for thrombophlebitic reactions at site of infusion.
    \n","protected":false},"excerpt":{"rendered":"

    Erythromycin CLINICAL USE Antibacterial agent DOSE IN NORMAL RENAL FUNCTION<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3953","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3953","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=3953"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3953\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3953"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3953"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3953"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}