Brand names: Erythromycin, Topical, A/T/S, Erycette, T-Stat

Why is Erythromycin, Topical prescribed?

Topical erythromycin (applied directly to the skin) is used for the treatment of acne.

Most important fact about Erythromycin, Topical

For best results, you should continue the treatment for as long as prescribed, even if your acne begins to clear up. This medicine is not an instant cure.

How should you take Erythromycin, Topical?

Use exactly as prescribed by your doctor.

Thoroughly wash the affected area with soap and water and pat dry before applying medication.

Moisten the applicator or pad with the medication and lightly spread it over the affected area. A/T/S Topical Gel should not be rubbed in.

• If you miss a dose…
  Apply the forgotten dose as soon as you remember. If it is almost time for the next application, skip the one you missed and go back to your regular schedule.

• Storage instructions…
  This medicine can be stored at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue using topical erythromycin.

• Side effects may include:
  Burning sensation, dryness, hives, irritation of the eyes, itching, oiliness, peeling, scaling, tenderness, unusual redness of the skin

Why should Erythromycin, Topical not be prescribed?

Erythromycin should not be used if you are sensitive to or have ever had an allergic reaction to any of the ingredients.

Special warnings about Erythromycin, Topical

This type of erythromycin is for external use only. Do not use it in the eyes, nose, or mouth.

If the acne does not improve after 6 to 8 weeks of treatment, or if it gets worse, stop using the topical erythromycin preparation and call your doctor.

The use of antibiotics can stimulate the growth of other bacteria that are resistant to the antibiotic you are taking. If new infections (called superinfections) occur, talk to your doctor. You may need to be treated with a different antibiotic drug.

If you develop diarrhea, let your doctor know right away. Drugs such as erythromycin can cause a potentially serious intestinal inflammation.

The use of other topical acne medications in combination with topical erythromycin may cause irritation, especially with the use of peeling, scaling, or abrasive medications.

The safety and effectiveness of A/T/S and Erycette have not been established in children.

Possible food and drug interactions when taking Erythromycin, Topical

If topical erythromycin is used with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining topical erythromycin with other topical acne medications.

Special information if you are pregnant or breastfeeding

The effects of topical erythromycin during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Erythromycin may appear in breast milk and could affect a nursing infant. If Erythromycin, Topical is essential to your health, your doctor may advise you to stop breastfeeding until your treatment with erythromycin is finished.

Recommended dosage for Erythromycin, Topical

Apply solution to the affected area 2 times a day. Moisten the applicator or a pad, then spread over the affected area. Use additional pads as needed. Apply gel products as a thin film over the affected area once or twice a day.

Make sure the area is thoroughly washed with soap and water and patted dry before applying medication. Thoroughly wash your hands after application of the medication.

Reducing the frequency of applications may reduce peeling and drying.

Overdosage

Although overdosage is unlikely, any medication used in excess can have serious consequences. If you suspect an overdose, seek medical treatment immediately.

Pronunciation: (eh-RITH-row-MY-sin/BEN-zoe-il)
Class: Benzoyl peroxide combination

Trade Names:
Benzamycin
- Gel 5% benzoyl peroxide, 3% erythromycin

Pharmacology

Exact mechanism not known, however, in part, due to antibacterial effect of erythromycin. The keratolytic and desquamative effects of benzoyl peroxide may also be beneficial.

Indications and Usage

Topical treatment of acne vulgaris.

Contraindications

Standard considerations.

Dosage and Administration

Adults and Children older than 12 yr of age

Topical Twice daily, morning and evening, or as directed by health care provider, to affected areas after skin is thoroughly washed with warm water and patted dry.

General Advice

• For topical use only. Avoid contact with eyes, nose, mouth, and all mucus membranes.
• Assess the skin and identify areas where medication is to be applied. Avoid areas that are sunburned, have eczema, abrasions, or cuts.

Storage/Stability

Store in refrigerator. Do not freeze. Keep container tightly capped. Discard any unused gel after 3 mo.

Drug Interactions

None well documented.

Adverse Reactions

Dermatologic

Dry skin; urticarial reaction; skin irritation and peeling; itching; burning sensation; erythema; inflammation of the face, eyes, and nose; eye irritation; skin discoloration; skin oiliness and tenderness.

Precautions

Pregnancy

Category C .

Lactation

Undetermined; however, erythromycin is excreted in breast milk after oral and parenteral administration.

Children

Safety and efficacy unknown in children.

Patient Information

• Advise patient that gel is applied topically to skin lesions twice daily, usually in the morning and evening.
• Teach patient proper technique for applying gel: wash hands; cleanse area with mild or soapless cleanser. Rinse and pat dry. Apply a thin film of gel to cover affected skin areas. Wash hands after applying gel.
• Warn patient that applying gel more often than prescribed or in excessive quantities will not produce more rapid improvement or better results but will result in greater adverse reactions (eg, redness, scaling, drying).
• Warn patient to avoid contact with the eyes, nose, mouth, and all mucous membranes.
• Advise patient to avoid areas where eczema, abrasions, or cuts exist.
• Caution patient that gel may bleach hair or colored fabric.
• Advise patient to talk to a health care provider before using any other topical agents (eg, medicated soaps, astringents, cosmetics, other acne products) on treated skin.
• Advise patient that if severe dermal reactions occur to stop using the gel and contact health care provider.

Copyright © 2009 Wolters Kluwer Health.

Erythromycin/

Sulfisoxazole

Generic Name: Erythromycin/Sulfisoxazole (e-RITH-roe-MYE-sin/SUL-fi-SOX-a-zole)
Brand Name: E.S.P.

Erythromycin/Sulfisoxazole is used for:

Treating ear infections caused by certain bacteria. It may also be used for other conditions as determined by your doctor.

Erythromycin/Sulfisoxazole is a macrolide and sulfonamide antibiotic combination. It works by slowing the growth of and killing sensitive bacteria.

Do NOT use Erythromycin/Sulfisoxazole if:

• you are allergic to any ingredient in Erythromycin/Sulfisoxazole
• you are pregnant and at term (38 to 42 weeks)
• you are breast-feeding a child younger than 2 months old
• the patient is a child younger than 2 months old
• you have severe kidney problems, bladder blockage, or anemia caused by folic acid deficiency
• you are taking astemizole, cisapride, conivaptan, diltiazem, dofetilide, an ergot alkaloid (eg, dihydroergotamine, ergotamine), everolimus, an HIV protease inhibitor (eg, ritonavir), imidazoles (eg, ketoconazole), nilotinib, pimozide, a QT-prolonging agent (eg, quinidine, sotalol), a quinolone (eg, ciprofloxacin), a streptogramin (eg, quinupristin/dalfopristin), terfenadine, or verapamil

Contact your doctor or health care provider right away if any of these apply to you.

Before using Erythromycin/Sulfisoxazole:

Some medical conditions may interact with Erythromycin/Sulfisoxazole. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have diarrhea or throat inflammation
• if you have a history of asthma, blood problems, a glucose-6-phosphate dehydrogenase deficiency, kidney or liver problems, heart problems, a fast or irregular heartbeat, myasthenia gravis, or the blood disease porphyria

Some MEDICINES MAY INTERACT with Erythromycin/Sulfisoxazole. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Astemizole, cisapride, diltiazem, dofetilide, an HIV protease inhibitor (eg, ritonavir), imidazoles (eg, ketoconazole), nilotinib, pimozide , a QT-prolonging agent (eg, quinidine, sotalol), a quinolone (eg, ciprofloxacin), a streptogramin (eg, quinupristin/dalfopristin), terfenadine, or verapamil because side effects, such as heart toxicity or irregular heartbeat, may occur. Check with your doctor if you have questions about which medicines may affect your heartbeat.
• Conivaptan, ergot alkaloids (eg, dihydroergotamine, ergotamine), or everolimus because the risk of their side effects may be increased by Erythromycin/Sulfisoxazole
• Many prescription and nonprescription medicines (eg, used for aches and pains, allergies, blood thinning, breathing problems, cancer, diabetes, erection problems, gout, heart problems, high blood calcium levels, high blood pressure, high cholesterol, HIV infection, inflammation, infections, low blood sodium levels, migraine, mood or mental problems, overactive bladder, Parkinson disease, prevention of organ transplant rejection, seizures, stomach problems, trouble sleeping), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John’s wort) may also interact with Erythromycin/Sulfisoxazole. Ask your doctor or pharmacist if you are unsure if any of your medicines might interfere with Erythromycin/Sulfisoxazole.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Erythromycin/Sulfisoxazole may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Erythromycin/Sulfisoxazole:

Use Erythromycin/Sulfisoxazole as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Erythromycin/Sulfisoxazole by mouth with or without food.
• Drinking extra fluids while you are taking Erythromycin/Sulfisoxazole is recommended. Check with your doctor for instructions.
• Do not eat grapefruit or drink grapefruit juice while you use Erythromycin/Sulfisoxazole.
• Erythromycin/Sulfisoxazole works best if it is taken at the same time each day.
• To clear up your infection completely, take Erythromycin/Sulfisoxazole for the full course of treatment. Keep taking it even if you feel better in a few days.
• If you miss a dose of Erythromycin/Sulfisoxazole, take it as soon as possible. If it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Erythromycin/Sulfisoxazole.

Important safety information:

• Erythromycin/Sulfisoxazole may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Erythromycin/Sulfisoxazole with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
• Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.
• Erythromycin/Sulfisoxazole only works against bacteria; it does not treat viral infections (eg, the common cold).
• Be sure to use Erythromycin/Sulfisoxazole for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
• Long-term or repeated use of Erythromycin/Sulfisoxazole may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
• Tell your doctor or dentist that you take Erythromycin/Sulfisoxazole before you receive any medical or dental care, emergency care, or surgery.
• Rarely, patients taking Erythromycin/Sulfisoxazole have developed reversible hearing loss. This risk is greater if you have kidney problems or you take high doses of Erythromycin/Sulfisoxazole. Contact your doctor if you develop decreased hearing or hearing loss.
• Erythromycin/Sulfisoxazole may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Erythromycin/Sulfisoxazole. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
• Erythromycin/Sulfisoxazole may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Erythromycin/Sulfisoxazole.
• Lab tests, including liver function, kidney function, complete blood counts, and urinalysis, may be performed while you use Erythromycin/Sulfisoxazole. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Erythromycin/Sulfisoxazole should not be used in CHILDREN younger than 2 months old; safety and effectiveness in these children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Erythromycin/Sulfisoxazole while you are pregnant. Do not take Erythromycin/Sulfisoxazole if you are pregnant and at term (38 to 42 weeks). Erythromycin/Sulfisoxazole is found in breast milk. Do not breast-feed while taking Erythromycin/Sulfisoxazole.

Possible side effects of Erythromycin/Sulfisoxazole:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; headache; loss of appetite; nausea; stomach pain; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or dark urine; bloody stools; change in the amount of urine ; decreased hearing or hearing loss; fainting; fast or irregular heartbeat; fever, chills, or sore throat; mood or mental changes; muscle weakness; numbness or tingling of the hands or feet; pale skin; red, swollen, blistered, or peeling skin; ringing in the ear; seizures; severe or persistent diarrhea, dizziness, or headache; severe stomach pain or cramps; shortness of breath; sore mouth or tongue; symptoms of liver problems (eg, yellowing of skin or eyes, pale stool, severe or persistent nausea, vomiting, loss of appetite, dark urine); unusual bruising or bleeding; unusual weakness or fatigue; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include blood in the urine; high fever; loss of consciousness; severe or persistent loss of appetite, nausea, stomach upset, or vomiting.

Proper storage of Erythromycin/Sulfisoxazole:

Store Erythromycin/Sulfisoxazole in the refrigerator, between 36 and 46 degrees F (2 and 8 degrees C). Do not freeze. Throw away any unused medicine after 14 days. Store away from heat, moisture, and light. Do not store in the bathroom. Keep tightly closed. Keep Erythromycin/Sulfisoxazole out of the reach of children and away from pets.

General information:

• If you have any questions about Erythromycin/Sulfisoxazole, please talk with your doctor, pharmacist, or other health care provider.
• Erythromycin/Sulfisoxazole is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Erythromycin/Sulfisoxazole. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Generic Name: erythromycin and sulfisoxazole (ee RITH roe MYE sin and SUL fa SOX i zole)
Brand Names: Pediazole

What is Eryzole (erythromycin and sulfisoxazole)?

Erythromycin is in a group of drugs called macrolide antibiotics. Erythromycin fights bacteria in the body.

Sulfisoxazole is a sulfa drug that also fights bacteria in the body.

The combination of erythromycin and sulfisoxazole is used to ear infections in children.

Erythromycin and sulfisoxazole may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Eryzole (erythromycin and sulfisoxazole)?

Do not take this medication if you are allergic to erythromycin or sulfisoxazole, if you are in your 9th month of pregnancy, or if you are breast-feeding a baby younger than 2 months old.

Before taking erythromycin and sulfisoxazole, tell your doctor if you have liver or kidney disease, diabetes, myasthenia gravis, a history of “Long QT Syndrome,” or if you are allergic to sulfa drugs or other antibiotics such as azithromycin (Zithromax) or clarithromycin (Biaxin).

Take this medication for the full prescribed length of time. Your symptoms may get better before the infection is completely cleared. Erythromycin and sulfisoxazole will not treat a viral infection such as the common cold or flu.

What should I discuss with my healthcare provider before taking Eryzole (erythromycin and sulfisoxazole)?

Do not take this medication if you are allergic to erythromycin or sulfisoxazole, or if::

• you are in your 9th month of pregnancy; or

• you are breast-feeding a baby younger than 2 months old.

Erythromycin may interact with these medicines and could cause dangerous or life-threatening heart rhythm disorders.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

• kidney disease;

• liver disease;

• diabetes;

• myasthenia gravis;

• a history of “Long QT Syndrome”; or

• if you are allergic to sulfa drugs or other antibiotics such as azithromycin (Zithromax) or clarithromycin (Biaxin).

FDA pregnancy category C. It is not known whether erythromycin and sulfisoxazole is harmful to an unborn baby when taken in early pregnancy. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. Do not take erythromycin and sulfisoxazole during late pregnancy. Erythromycin and sulfisoxazole can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not take erythromycin and sulfisoxazole if you are breast-feeding a baby younger than 2 months old. Older adults may be more likely to have side effects from this medication. Do not give this medication to a child younger than 2 months old.

How should I take Eryzole (erythromycin and sulfisoxazole)?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Take erythromycin and sulfisoxazole with a full glass (8 ounces) of water. Drink plenty of fluids every day while taking this medication.

Take this medication with food or milk if it upsets your stomach.

Shake the liquid medicine well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Erythromycin and sulfisoxazole is usually given 3 or 4 times daily. Try to take the medicine at evenly spaced intervals throughout the day.

Take this medication for the full prescribed length of time. Your symptoms may get better before the infection is completely cleared. Erythromycin and sulfisoxazole will not treat a viral infection such as the common cold or flu. If you need to have any type of surgery, tell the surgeon ahead of time that you are using erythromycin and sulfisoxazole. You may need to stop using the medicine for a short time.

Erythromycin and sulfisoxazole can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using erythromycin.

Store this medication in the refrigerator. Do not freeze. Throw away any unused medicine that is older than 14 days

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include dizziness, drowsiness, loss of appetite, nausea, vomiting, diarrhea, ringing in your ears, headache, stomach pain, fever, and fainting.

What should I avoid while taking Eryzole (erythromycin and sulfisoxazole)?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, stop taking this medication and call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Avoid exposure to sunlight, sunlamps, or tanning beds. Erythromycin and sulfisoxazole can make your skin more sensitive to sunlight, and a sunburn may result. Wear protective clothing and use sunscreen (SPF 15 or higher) when you are outdoors.

Eryzole (erythromycin and sulfisoxazole) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

• dizziness, fainting, fast or pounding heartbeat;

• diarrhea that is watery or bloody;

• confusion, hallucinations;

• muscle pain, tenderness, or weakness with fever or flu symptoms and dark colored urine;

• white patches or sores inside your mouth or on your lips;

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;

• the first sign of any skin rash, no matter how mild;

• pale skin, easy bruising or bleeding;

• ringing in your ears, or problems with hearing;

• numbness or tingly feeling in your hands or feet;

• sore throat, swelling or lump in your throat or neck;

• cough, feeling short of breath;

• blood in your urine, pain in your side or lower back, pain when you urinate;

• urinating less than usual or not at all; or

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• mild nausea, vomiting, diarrhea, or stomach pain;

• headache, mild dizziness, spinning sensation; or

• vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Eryzole (erythromycin and sulfisoxazole)?

Many drugs can interact with erythromycin. Below is just a partial list. Tell your doctor if you are using:

• bromocriptine (Parlodel);

• colchicine (Colcrys);

• alprazolam (Xanax), midazolam (Versed), or triazolam (Halcion);

• a blood thinner such as warfarin (Coumadin);

• cyclosporine (Gengraf, Neoral, Sandimmune);

• digoxin (Lanoxin);

• methotrexate (Rheumatrex, Trexall);

• theophylline (Elixophyllin, Theo-24, Uniphyl);

• antifungal medication such as itraconazole (Sporanox), fluconazole (Diflucan), ketoconazole (Nizoral), or voriconazole (Vfend);

• any other antibiotic, especially clarithromycin (Biaxin), dalfopristin/quinupristin (Synercid), levofloxacin (Levaquin), moxifloxacin (Avelox), or rifabutin (Mycobutin);

• a blood thinner such as warfarin (Coumadin);

• diabetes medication you take by mouth;

• a diuretic (water pill);

• a cholesterol-lowering medication such as lovastatin (Mevacor) or simvastatin (Zocor);

• heart or blood pressure medication such as amiodarone (Cordarone, Pacerone), diltiazem (Cartia, Cardizem), dofetilide (Tikosyn), felodipine (Plendil), nifedipine (Nifedical, Procardia), sotalol (Betapace), or verapamil (Calan, Covera, Isoptin, Verelan);

• heart rhythm medicine such as disopyramide (Norpace), procainamide (Procan, Pronestyl), propafenone (Rythmol), quinidine (Quinidex, Quin-Release Quin-G);

• migraine headache medicine such as eletriptan (Relpax), ergotamine (Ercaf, Cafergot, Ergostat, Ergomar) or dihydroergotamine (D.H.E. 45, Migranal); or

• seizure medication such as carbamazepine (Tegretol), phenytoin (Dilantin), or valproic acid (Depakote, Depakene).

This list is not complete and there are many other drugs that can interact with erythromycin and sulfisoxazole. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

• Your pharmacist can provide more information about erythromycin and sulfisoxazole.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 2.01. Revision Date: 09/02/2009 11:55:05 AM.

Brand names: Eryzole, Pediazole

Why is Erythromycin ethylsuccinate, Sulfisoxazole acetyl prescribed?

Pediazole is prescribed for the treatment of severe middle ear infections in children.

Most important fact about Erythromycin ethylsuccinate, Sulfisoxazole acetyl

Sulfisoxazole is one of a group of drugs called sulfonamides, which prevent the growth of certain bacteria in the body. However, sulfonamides have been known to cause rare but sometimes fatal reactions such as Stevens-Johnson syndrome (a skin condition characterized by severe blisters and bleeding in the mucous membranes of the lips, mouth, nose, and eyes), sudden and severe liver damage, a severe blood disorder (agranulocytosis), and a lack of red and white blood cells because of a bone marrow disorder.

Notify your doctor at the first sign of a side effect such as skin rash, sore throat, fever, abnormal skin paleness, reddish or purplish skin spots, or yellowing of the skin or whites of the eyes.

How should you take Erythromycin ethylsuccinate, Sulfisoxazole acetyl?

Be sure to keep giving Pediazole for the full time prescribed, even if your child begins to feel better after the first few days. Keep to a regular schedule; the medication works best when there is a constant amount in the blood.

Pediazole can be given with or without food. However, you should not give Erythromycin ethylsuccinate, Sulfisoxazole acetyl with or immediately after carbonated beverages, fruit juice, or tea. If the child develops an upset stomach, give the medicine with crackers or a light snack.

To prevent sediment in the urine and the formation of stones, make sure that the child drinks plenty of fluids during treatment with Pediazole.

This medication increases the skin’s sensitivity to sunlight. Overexposure can cause a rash, itching, redness, or sunburn. Keep the child out of direct sunlight, or provide protective clothing.

Shake well before using.

• If you miss a dose…
  Give the forgotten dose as soon as you remember, then give the rest of the day’s doses at evenly spaced intervals.

• Storage instructions…
  Store Pediazole in the refrigerator. Keep tightly closed. Do not allow it to freeze. Use within 14 days; discard unused portion.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe to continue giving Pediazole.

• Side effects may include:
  Abdominal pain and discomfort, diarrhea, lack or loss of appetite, nausea, vomiting

Why should Erythromycin ethylsuccinate, Sulfisoxazole acetyl not be prescribed?

If your child is sensitive to or has ever had an allergic reaction to erythromycin, sulfonamides, or other drugs of this type, do not use Erythromycin ethylsuccinate, Sulfisoxazole acetyl. Make sure that your doctor is aware of any drug reactions that your child has experienced.

Pediazole should not be used if the child is taking astemizole or terfenadine.

This medication should not be prescribed for infants under 2 months of age.

Pediazole should not be taken by pregnant women at the end of their pregnancy or by mothers nursing infants under 2 months of age.

Special warnings about Erythromycin ethylsuccinate, Sulfisoxazole acetyl

If your child has impaired kidney or liver function or a history of severe allergies or bronchial asthma, Pediazole may not be the best drug to use. Check with your doctor.

Prolonged or repeated use of Pediazole may cause new infections. If your child develops a new infection (called a superinfection), talk to your doctor. A different antibiotic may be needed.

If your child develops a cough or becomes short of breath, call your doctor. Also seek care immediately if the child develops diarrhea; it could signal a serious intestinal disorder.

If your child has the muscle-weakening disorder myasthenia gravis, Pediazole could make the condition worse.

Your doctor may recommend frequent urine tests while your child is taking Pediazole.

Possible food and drug interactions when taking Erythromycin ethylsuccinate, Sulfisoxazole acetyl

If Pediazole is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Pediazole with the following:

Blood thinners such as warfarin
Bromocriptine
Carbamazepine
Cyclosporine
Digoxin
Disopyramide
Ergotamine
Lovastatin
Methotrexate
Oral antidiabetic drugs such as glyburide
Phenytoin
Theophylline
Triazolam

Special information if you are pregnant or breastfeeding

This drug is not prescribed for adults, and should never be taken at term of pregnancy or when breastfeeding.

Recommended dosage for Erythromycin ethylsuccinate, Sulfisoxazole acetyl

CHILDREN

The recommended dose for children 2 months of age or older is determined by weight. The total daily amount is divided into several smaller doses given 3 or 4 times a day for 10 days.

• Four-times-a-day schedule
  Less than 18 pounds: Determined by doctor
  18 pounds: 1/2 teaspoonful
  35 pounds: 1 teaspoonful
  53 pounds: 1-1/2 teaspoonfuls
  Over 70 pounds: 2 teaspoonfuls

• Three-times-a-day schedule
  Less than 13 pounds: Determined by doctor
  13 pounds: 1/2 teaspoonful
  26 pounds: 1 teaspoonful
  40 pounds: 1-1/2 teaspoonfuls
  53 pounds: 2 teaspoonfuls
  Over 66 pounds: 2-1/2 teaspoonfuls

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical treatment immediately.

• Symptoms of Pediazole overdose may include:
  Blood in the urine, colic, dizziness, drowsiness, fever, headache, loss of appetite, nausea, unconsciousness, vomiting, yellowed eyes and skin

Pronunciation: (eh-RITH-row-MY-sin ETH-il-SUX-inate/sul-fih-SOX-uh-zole)
Class: Antibiotic combination

Trade Names:
E. S. P.
- Granules for oral suspension Erythromycin ethylsuccinate (equivalent to 200 mg erythromycin activity) and sulfisoxazole acetyl (equivalent to 600 mg sulfisoxazole) per 5 mL when reconstituted

Pharmacology

Erythromycin suppresses bacterial protein synthesis; sulfonamides interfere with bacterial folic acid synthesis.

Pharmacokinetics

Absorption

C _max is 0.3 to 2 mcg/mL. T _max is 1.6 h.

Distribution

Largely bound to plasma proteins. Diffuses into most body fluids. Passage across the blood-brain barrier increases in meningitis. Crosses the placenta and is excreted in breast milk.

Metabolism

Metabolized in the liver by demethylation.

Elimination

Mostly excreted in the bile; less than 5% recovered in the active form in the urine.

Indications and Usage

Treatment of acute otitis media in children caused by susceptible strains of Haemophilus influenzae .

Contraindications

Hypersensitivity to chemically related drugs (eg, sulfonylureas, thiazide and loop diuretics, carbonic anhydrase inhibitors, sunscreens containing PABA, local anesthetics) or salicylates; patients taking terfenadine or astemizole; porphyria; use in infants younger than 20 mo of age, pregnant women at term and women breast-feeding infants younger than 2 mo of age.

Dosage and Administration

Children

PO 50 mg/kg/day erythromycin and 150 mg/kg/day (max 6 g/day) sulfisoxazole in equally divided doses 4 times daily for 10 days.

General Advice

• Give with full glass of water 1 h before or 2 h after meals.
• If GI upset is significant, administer with food or milk.
• Shake oral suspension well.

Storage/Stability

Refrigerate after opening. Discard unused portion after 14 days.

Drug Interactions

Anticoagulants

May increase anticoagulant effects.

Antihistamines, non-sedating (eg, astemizole, terfenadine)

Erythromycin significantly alters metabolism of terfenadine. Rare cases of serious CV events including death have been reported.

Astemizole, bromocriptine, carbamazepine, disopyramide, hexobarbital, methylprednisolone, phenytoin

May cause decreased metabolism and increased concentrations of these drugs.

Cyclosporine

Erythromycin may interfere with metabolism while sulfonamides may decrease cyclosporine levels; both increase risk of nephrotoxicity.

Digoxin

May increase digoxin levels.

Lovastatin

Severe myopathy or rhabdomyolysis may occur.

Methotrexate

Sulfonamides can displace methotrexate from protein-binding sites and increase free methotrexate levels.

Sulfonylureas

Sulfisoxazole may potentiate hypoglycemic effects.

Theophyllines

May increase theophylline plasma concentrations.

Thiopental

May enhance anesthetic effects of thiopental.

Laboratory Test Interactions

Sulfosalicylic acid turbidity test for urinary protein

Sulfisoxazole may produce false-positive results.

Urinary glucose test

Sulfonamides may produce false-positive results when performed by Benedict’s method.

Urobilistix test

Sulfisoxazole may interfere with test results.

Adverse Reactions

CNS

Headache; peripheral neuropathy; dizziness; psychosis; hallucinations; depression; convulsions.

Dermatologic

Urticaria; skin eruptions; pruritus; photosensitivity; anaphylaxis; erythema multiforme; toxic epidermal necrolysis; exfoliative dermatitis; angioedema; arteritis; vasculitis.

EENT

Hearing loss (associated with high doses erythromycin and renal insufficiency).

GI

Nausea; vomiting; abdominal pain/cramping; diarrhea; anorexia.

Genitourinary

Crystalluria; hematuria; increased BUN and creatinine; nephritis; toxic nephrosis with oliguria.

Hepatic

Hepatic dysfunction; abnormal LFT results; pseudomembranous colitis; GI hemorrhage; pancreatitis.

Hematologic

Leukopenia; agranulocytosis; aplastic anemia; thrombocytopenia; hemolytic anemia; purpura; eosinophilia; clotting disorders; methemoglobinemia.

Miscellaneous

Fever; chills; arthralgias; myalgias; periarteritis nodosum; systemic lupus erythematosus; serum sickness.

Precautions

Monitor Response to therapy Monitor patient’s response to therapy. Notify health care provider if infection does not improve or appears to worsen.

Pregnancy

Category C .

Lactation

Both erythromycin and sulfisoxazole are excreted in breast milk.

Children

Do not expose children younger than 2 mo of age (directly or through breast milk) to sulfonamides because of risk of kernicterus.

Renal Function

Use drug with caution in patients with renal function impairment. Hepatotoxicity has been associated with erythromycin.

Hepatic Function

Use drug with caution in patients with hepatic function impairment. Hepatotoxicity has been associated with erythromycin.

Special Risk Patients

May aggravate weakness in patients with myasthenia gravis. Use drug with caution in patients with severe allergies or bronchial asthma. Dose-related hemolytic anemia may occur in patients with G-6-PD deficiency.

Superinfection

Prolonged use may result in bacterial or fungal overgrowth of nonsusceptible microorganisms.

Fatalities

Rare fatalities from severe reactions associated with hypersensitivity, agranulocytosis, aplastic anemia, blood dyscrasias, renal and hepatic damage, irreversible neuromuscular and CNS changes, and fibrosing alveolitis have been reported with sulfonamides.

Ototoxicity

May occur, especially in patients with renal or hepatic insufficiency and elderly patients and with administration of large doses.

Pseudomembranous colitis

Consider possibility in patients with diarrhea.

Overdosage

Symptoms

Nausea, vomiting, diarrhea, hearing loss, vertigo, dizziness, headache, drowsiness, unconsciousness, toxic fever, acidosis, hemolytic anemia.

Patient Information

• Instruct patient/family to follow complete course of therapy.
• Advise patient to shake suspension well before using and refrigerate after opening.
• Tell patient to take drug with full glass of water 1 h before or 2 h after meals. If GI distress occurs, take with food or milk.
• Instruct patient to report these symptoms to health care provider: tachycardia, palpitations, syncope, cyanosis, seizures, hallucinations, shortness of breath, rash, bleeding, diarrhea, inability to void, urticaria, abdominal pain, signs of superinfection.
• Caution patient to avoid exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.

Copyright © 2009 Wolters Kluwer Health.

Generic Name: Erythromycin Base and Stearate (e-RITH-roe-MYE-sin BASE STEER-ate)
Brand Name: Examples include Erythromycin Filmtabs and Erythrocin

Erythromycin Filmtabs is used for:

Treating infections caused by certain bacteria. It is also used to prevent attacks of rheumatic fever. It is also used to treat certain sexually transmitted diseases.

Erythromycin Filmtabs is a macrolide antibiotic. It works by slowing the growth of, or sometimes killing, sensitive bacteria by reducing the production of important proteins needed by the bacteria to survive.

Do NOT use Erythromycin Filmtabs if:

• you are allergic to any ingredient in Erythromycin Filmtabs
• you are taking astemizole, cisapride, conivaptan, diltiazem, dofetilide, an ergot alkaloid (eg, dihydroergotamine, ergotamine), everolimus, an HIV protease inhibitor (eg, ritonavir), imidazoles (eg, ketoconazole), nilotinib, pimozide, a QT-prolonging agent (eg, quinidine, sotalol), a quinolone (eg, ciprofloxacin), a streptogramin (eg, quinupristin/dalfopristin), terfenadine, or verapamil

Contact your doctor or health care provider right away if any of these apply to you.

Before using Erythromycin Filmtabs:

Some medical conditions may interact with Erythromycin Filmtabs. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you are a child 9 years old or younger with diarrhea or gastrointestinal infection
• if you have kidney or liver disease, myasthenia gravis, or the blood disease porphyria

Some MEDICINES MAY INTERACT with Erythromycin Filmtabs. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Astemizole, cisapride, diltiazem, dofetilide, an HIV protease inhibitor (eg, ritonavir), imidazoles (eg, ketoconazole), nilotinib, pimozide, a QT-prolonging agent (eg, quinidine, sotalol), a quinolone (eg, ciprofloxacin), a streptogramin (eg, quinupristin/dalfopristin), terfenadine, or verapamil because side effects, such as heart toxicity or irregular heartbeat, may occur. Check with your doctor if you have questions about which medicines may affect your heartbeat
• Conivaptan, ergot alkaloids (eg, dihydroergotamine, ergotamine), or everolimus because the risk of their side effects may be increased by Erythromycin Filmtabs
• Many prescription and nonprescription medicines (eg, used for aches and pains, allergies, blood thinning, breathing problems, cancer, diabetes, erection problems, gout, heart problems, high blood calcium levels, high blood pressure, high cholesterol, HIV infection, inflammation, infections, low blood sodium levels, migraine, mood or mental problems, overactive bladder, Parkinson disease, prevention of organ transplant rejection, seizures, stomach problems, trouble sleeping), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John’s wort) may also interact with Erythromycin Filmtabs. Ask your doctor or pharmacist if you are unsure if any of your medicines might interfere with Erythromycin Filmtabs.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Erythromycin Filmtabs may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Erythromycin Filmtabs:

Use Erythromycin Filmtabs as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Erythromycin Filmtabs by mouth on an empty stomach at least 1 hour before or 2 hours after eating. If stomach upset occurs, take with food to reduce stomach irritation.
• Take Erythromycin Filmtabs with a full glass of water (8 oz/240 mL).
• Erythromycin Filmtabs works best if it is taken at the same time each day.
• To clear up your infection completely, take Erythromycin Filmtabs for the full course of treatment. Keep taking it even if you feel better in a few days.
• Do not eat grapefruit or drink grapefruit juice while you use Erythromycin Filmtabs. Serious heart problems can occur.
• If you miss a dose of Erythromycin Filmtabs, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Erythromycin Filmtabs.

Important safety information:

• Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.
• Erythromycin Filmtabs only works against bacteria; it does not treat viral infections (eg, the common cold).
• Be sure to use Erythromycin Filmtabs for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
• Long-term or repeated use of Erythromycin Filmtabs may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
• Tell your doctor or dentist that you take Erythromycin Filmtabs before you receive any medical or dental care, emergency care, or surgery.
• Rarely, patients taking Erythromycin Filmtabs have developed reversible hearing loss. The risk is greater if you have kidney problems or you take high doses of Erythromycin Filmtabs. Contact your doctor if you develop decreased hearing or hearing loss.
• Erythromycin Filmtabs may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Erythromycin Filmtabs.
• Lab tests, including liver function, kidney function, and complete blood cell counts, may be performed while you use Erythromycin Filmtabs. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Erythromycin Filmtabs while you are pregnant. Erythromycin Filmtabs is found in breast milk. If you are or will be breast-feeding while you use Erythromycin Filmtabs, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Erythromycin Filmtabs:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; loss of appetite; nausea; stomach pain; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; decreased hearing or hearing loss; irregular heartbeat; muscle weakness; red, swollen, blistered, or peeling skin; seizures; severe diarrhea; stomach pain/cramps; symptoms of liver problems (eg, yellowing of the skin or eyes, pale stools, severe or persistent nausea, vomiting, loss of appetite, or dark urine).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately.

Proper storage of Erythromycin Filmtabs:

Store Erythromycin Filmtabs at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep tightly closed. Keep Erythromycin Filmtabs out of the reach of children and away from pets.

General information:

• If you have any questions about Erythromycin Filmtabs, please talk with your doctor, pharmacist, or other health care provider.
• Erythromycin Filmtabs is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Erythromycin Filmtabs. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Generic Name: Erythromycin Lactobionate (e-RITH-roe-MYE-sin LAK-toe-BYE-oh-nate)
Brand Name: Erythromycin Lactobionate – I.V.

Erythromycin Lactobionate is used for:

Treating infections caused by certain bacteria. It may also be used for other conditions as determined by your doctor.

Erythromycin Lactobionate is a macrolide antibiotic. It works by killing sensitive bacteria.

Do NOT use Erythromycin Lactobionate if:

• you are allergic to any ingredient in Erythromycin Lactobionate
• you are taking astemizole, cisapride, conivaptan, diltiazem, dofetilide, an ergot alkaloid (eg, dihydroergotamine, ergotamine), everolimus, an HIV protease inhibitor (eg, ritonavir), imidazoles (eg, ketoconazole), nilotinib, pimozide, a QT-prolonging agent (eg, quinidine, sotalol), a quinolone (eg, ciprofloxacin), a streptogramin (eg, quinupristin/dalfopristin), terfenadine, or verapamil

Contact your doctor or health care provider right away if any of these apply to you.

Before using Erythromycin Lactobionate:

Some medical conditions may interact with Erythromycin Lactobionate. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have diarrhea or stomach or intestinal infection
• if you have kidney or liver problems, an autoimmune disease (eg, myasthenia gravis), or a blood disorder (eg, porphyria)

Some MEDICINES MAY INTERACT with Erythromycin Lactobionate. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Astemizole, cisapride, diltiazem, dofetilide, an HIV protease inhibitor (eg, ritonavir), imidazoles (eg, ketoconazole), nilotinib, pimozide, a QT-prolonging agent (eg, quinidine, sotalol), a quinolone (eg, ciprofloxacin), a streptogramin (eg, quinupristin/dalfopristin), terfenadine, or verapamil because side effects, such as heart toxicity or irregular heartbeat, may occur. Check with your doctor if you have questions about which medicines may affect your heartbeat.
• Conivaptan, ergot alkaloids (eg, dihydroergotamine, ergotamine), or everolimus because the risk of their side effects may be increased by Erythromycin Lactobionate
• Many prescription and nonprescription medicines (eg, used for aches and pains, allergies, blood thinning, breathing problems, cancer, diabetes, erection problems, gout, heart problems, high blood calcium levels, high blood pressure, high cholesterol, HIV infection, inflammation, infections, low blood sodium levels, migraine, mood or mental problems, overactive bladder, Parkinson disease, prevention of organ transplant rejection, seizures, stomach problems, trouble sleeping), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John’s wort) may also interact with Erythromycin Lactobionate. Ask your doctor or pharmacist if you are unsure if any of your medicines might interfere with Erythromycin Lactobionate.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Erythromycin Lactobionate may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Erythromycin Lactobionate:

Use Erythromycin Lactobionate as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Erythromycin Lactobionate is usually given as an injection at your doctor’s office, hospital, or clinic. If you will be using Erythromycin Lactobionate at home, a health care provider will teach you how to use it. Be sure you understand how to use Erythromycin Lactobionate. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
• Do not use Erythromycin Lactobionate if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
• To clear up your infection completely, use Erythromycin Lactobionate for the full course of treatment. Keep using it even if you feel better in a few days.
• If you miss a dose of Erythromycin Lactobionate, contact your doctor right away.

Ask your health care provider any questions you may have about how to use Erythromycin Lactobionate.

Important safety information:

• Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.
• Erythromycin Lactobionate only works against bacteria; it does not treat viral infections (eg, the common cold).
• Be sure to use Erythromycin Lactobionate for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
• Long-term or repeated use of Erythromycin Lactobionate may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
• Tell your doctor or dentist that you use Erythromycin Lactobionate before you receive any medical or dental care, emergency care, or surgery.
• Rarely, patients taking Erythromycin Lactobionate have developed reversible hearing loss. This risk is greater if you have kidney problems or you take high doses of Erythromycin Lactobionate. Contact the doctor if you develop decreased hearing or hearing loss.
• Erythromycin Lactobionate may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Erythromycin Lactobionate.
• Lab tests, including liver function or kidney function, may be performed while you use Erythromycin Lactobionate. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Erythromycin Lactobionate while you are pregnant. Erythromycin Lactobionate is found in breast milk. If you are or will be breast-feeding while you use Erythromycin Lactobionate, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Erythromycin Lactobionate:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Mild irritation, pain, redness, or swelling at the injection site.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; decreased hearing or hearing loss; fast or irregular heartbeat; muscle weakness; red, swollen, peeling, blistered, or peeling skin; seizures; severe diarrhea; stomach pain or cramps; symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, severe or persistent nausea, vomiting, or yellowing of the skin or eyes).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately.

Proper storage of Erythromycin Lactobionate:

Store Erythromycin Lactobionate at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep tightly closed. Keep Erythromycin Lactobionate out of the reach of children and away from pets.

General information:

• If you have any questions about Erythromycin Lactobionate, please talk with your doctor, pharmacist, or other health care provider.
• Erythromycin Lactobionate is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Erythromycin Lactobionate. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Generic Name: Erythromycin Lactobionate (e-RITH-roe-MYE-sin LAK-toe-BYE-oh-nate)
Brand Name: Erythromycin Lactobionate – I.V.

Erythromycin Lactobionate – I.V. is used for:

Treating infections caused by certain bacteria. It may also be used for other conditions as determined by your doctor.

Erythromycin Lactobionate – I.V. is a macrolide antibiotic. It works by killing sensitive bacteria.

Do NOT use Erythromycin Lactobionate – I.V. if:

• you are allergic to any ingredient in Erythromycin Lactobionate – I.V.
• you are taking astemizole, cisapride, conivaptan, diltiazem, dofetilide, an ergot alkaloid (eg, dihydroergotamine, ergotamine), everolimus, an HIV protease inhibitor (eg, ritonavir), imidazoles (eg, ketoconazole), nilotinib, pimozide, a QT-prolonging agent (eg, quinidine, sotalol), a quinolone (eg, ciprofloxacin), a streptogramin (eg, quinupristin/dalfopristin), terfenadine, or verapamil

Contact your doctor or health care provider right away if any of these apply to you.

Before using Erythromycin Lactobionate – I.V.:

Some medical conditions may interact with Erythromycin Lactobionate – I.V.. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have diarrhea or stomach or intestinal infection
• if you have kidney or liver problems, an autoimmune disease (eg, myasthenia gravis), or a blood disorder (eg, porphyria)

Some MEDICINES MAY INTERACT with Erythromycin Lactobionate – I.V.. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Astemizole, cisapride, diltiazem, dofetilide, an HIV protease inhibitor (eg, ritonavir), imidazoles (eg, ketoconazole), nilotinib, pimozide, a QT-prolonging agent (eg, quinidine, sotalol), a quinolone (eg, ciprofloxacin), a streptogramin (eg, quinupristin/dalfopristin), terfenadine, or verapamil because side effects, such as heart toxicity or irregular heartbeat, may occur. Check with your doctor if you have questions about which medicines may affect your heartbeat.
• Conivaptan, ergot alkaloids (eg, dihydroergotamine, ergotamine), or everolimus because the risk of their side effects may be increased by Erythromycin Lactobionate – I.V.
• Many prescription and nonprescription medicines (eg, used for aches and pains, allergies, blood thinning, breathing problems, cancer, diabetes, erection problems, gout, heart problems, high blood calcium levels, high blood pressure, high cholesterol, HIV infection, inflammation, infections, low blood sodium levels, migraine, mood or mental problems, overactive bladder, Parkinson disease, prevention of organ transplant rejection, seizures, stomach problems, trouble sleeping), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John’s wort) may also interact with Erythromycin Lactobionate – I.V.. Ask your doctor or pharmacist if you are unsure if any of your medicines might interfere with Erythromycin Lactobionate – I.V..

This may not be a complete list of all interactions that may occur. Ask your health care provider if Erythromycin Lactobionate – I.V. may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Erythromycin Lactobionate – I.V.:

Use Erythromycin Lactobionate – I.V. as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Erythromycin Lactobionate – I.V. is usually given as an injection at your doctor’s office, hospital, or clinic. If you will be using Erythromycin Lactobionate – I.V. at home, a health care provider will teach you how to use it. Be sure you understand how to use Erythromycin Lactobionate – I.V.. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
• Do not use Erythromycin Lactobionate – I.V. if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
• To clear up your infection completely, use Erythromycin Lactobionate – I.V. for the full course of treatment. Keep using it even if you feel better in a few days.
• If you miss a dose of Erythromycin Lactobionate – I.V., contact your doctor right away.

Ask your health care provider any questions you may have about how to use Erythromycin Lactobionate – I.V..

Important safety information:

• Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.
• Erythromycin Lactobionate – I.V. only works against bacteria; it does not treat viral infections (eg, the common cold).
• Be sure to use Erythromycin Lactobionate – I.V. for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
• Long-term or repeated use of Erythromycin Lactobionate – I.V. may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
• Tell your doctor or dentist that you use Erythromycin Lactobionate – I.V. before you receive any medical or dental care, emergency care, or surgery.
• Rarely, patients taking Erythromycin Lactobionate – I.V. have developed reversible hearing loss. This risk is greater if you have kidney problems or you take high doses of Erythromycin Lactobionate – I.V.. Contact the doctor if you develop decreased hearing or hearing loss.
• Erythromycin Lactobionate – I.V. may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using Erythromycin Lactobionate – I.V..
• Lab tests, including liver function or kidney function, may be performed while you use Erythromycin Lactobionate – I.V.. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Erythromycin Lactobionate – I.V. while you are pregnant. Erythromycin Lactobionate – I.V. is found in breast milk. If you are or will be breast-feeding while you use Erythromycin Lactobionate – I.V., check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Erythromycin Lactobionate – I.V.:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Mild irritation, pain, redness, or swelling at the injection site.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody stools; decreased hearing or hearing loss; fast or irregular heartbeat; muscle weakness; red, swollen, peeling, blistered, or peeling skin; seizures; severe diarrhea; stomach pain or cramps; symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, severe or persistent nausea, vomiting, or yellowing of the skin or eyes).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately.

Proper storage of Erythromycin Lactobionate – I.V.:

Store Erythromycin Lactobionate – I.V. at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep tightly closed. Keep Erythromycin Lactobionate – I.V. out of the reach of children and away from pets.

General information:

• If you have any questions about Erythromycin Lactobionate – I.V., please talk with your doctor, pharmacist, or other health care provider.
• Erythromycin Lactobionate – I.V. is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Erythromycin Lactobionate – I.V.. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Generic Name: erythromycin ophthalmic (e RITH row MYE sin off THAL mik)
Brand names: Roymicin, Ilotycin, Eyemycin

What is erythromycin ophthalmic?

Erythromycin ophthalmic is an antibiotic.

Erythromycin ophthalmic is used to treat bacterial infections of the eyes.

Erythromycin ophthalmic may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about erythromycin ophthalmic?

Do not touch the tube opening to any surface, including your eyes or hands. The tube opening is sterile. If it becomes contaminated, it could cause an infection in your eye.

If you wear contact lenses, ask your doctor if you should wear them during treatment. After applying this medication, wait at least 15 minutes before inserting contact lenses, unless otherwise directed by your doctor.

Who should not use erythromycin ophthalmic?

Do not use erythromycin ophthalmic if you have a viral or fungal infection in your eye. It is used to treat infections caused by bacteria only. Erythromycin ophthalmic is in the FDA pregnancy category B. This means that it is unlikely to harm an unborn baby. Do not use erythromycin ophthalmic without first talking to your doctor if you are pregnant. It is not known whether erythromycin ophthalmic passes into breast milk. Do not use erythromycin ophthalmic without first talking to your doctor if you are breast-feeding a baby.

How should I use erythromycin ophthalmic?

Use erythromycin ophthalmic eye ointment exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Wash your hands before using the eye ointment.

To apply the ointment:

• Hold the tube in your hand for a few minutes to warm it up so that the ointment comes out easily. Tilt your head back slightly and pull down gently on your lower eyelid. Apply a thin film of the ointment into your lower eyelid. Close your eye and roll your eyeball around in all directions for 1 to 2 minutes. If you are applying another eye medication, allow at least 10 minutes before the next application.

Do not touch the tube opening to any surface, including your eyes or hands. The tube opening is sterile. If it becomes contaminated, it could cause an infection in your eye. Store erythromycin ophthalmic at room temperature away from moisture and heat. Keep the tube properly capped.

What happens if I miss a dose?

Use the missed dose as soon as you remember. However, if it is almost time for your next regularly scheduled dose, skip the missed dose and use the next one as directed. Do not use a double dose of this medication.

What happens if I overdose?

An overdose of this medication is unlikely to occur. If you do suspect an overdose, wash the eye with water and call an emergency room or poison control center near you. If the ointment has been ingested, drink plenty of fluid and call an emergency center for advice.

What should I avoid while using erythromycin ophthalmic?

Use caution when driving, operating machinery, or performing other hazardous activities. Erythromycin ophthalmic may cause blurred vision. If you experience blurred vision, avoid these activities.

If you wear contact lenses, ask your doctor if you should wear them during treatment. After applying this medication, wait at least 15 minutes before inserting contact lenses, unless otherwise directed by your doctor.

Do not use other eye drops or medications during treatment with erythromycin ophthalmic unless otherwise directed by your doctor.

Erythromycin ophthalmic side effects

Serious side effects are not expected to occur during treatment with this medication.

Commonly, some eye burning, stinging, irritation, itching, redness, blurred vision, or sensitivity to light may occur.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect erythromycin ophthalmic?

Do not use other eye drops or medications during treatment with erythromycin ophthalmic unless otherwise directed by your doctor.

Drugs other than those listed here may also interact with erythromycin ophthalmic. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

• Your pharmacist has additional information about erythromycin ophthalmic written for health professionals that you may read.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 5.02. Revision Date: 4/12/2009 4:42:12 PM.