Experiences with

Erythromycin

Erythromycin is an antibiotic. It's widely used to treat chest infections, such as pneumonia, skin conditions, such as acne and rosacea, dental abscesses, and sexually transmitted infections.

In children, erythromycin is often used to treat ear infections or chest infections.

It’s available on prescription as tablets, capsules, a liquid you swallow or a skin solution to treat skin conditions like acne. It can also be given by injection, but this is usually only done in hospital.

Who can take erythromycin

Most adults and children can take erythromycin. It can also be taken during pregnancy and while breastfeeding.

Who may not be able to take erythromycin

Erythromycin is not suitable for everyone. To make sure it’s safe for you, tell your doctor if you have:

• ever had an allergic reaction to erythromycin or other antibiotics
• a rare, inherited blood disorder called porphyria
• liver or kidney problems
• had diarrhoea when you've taken antibiotics before
• fast, pounding or irregular heartbeats
• a sexually transmitted infection (STI) called syphilis, and you're pregnant – erythromycin alone may not be able to prevent your baby getting the infection
• a muscle-weakening condition called myasthenia gravis – erythromycin can make your symptoms worse
• low potassium or magnesium levels, or have been diagnosed with this in the past
• been trying to get pregnant, are pregnant or you're breastfeeding

Dosage

The usual dose of erythromycin is 250mg to 1,000mg, taken 4 times a day. Sometimes it's taken twice a day. The dose may be lower for children.

How to take it

Swallow erythromycin tablets or capsules whole with a drink of water. Do not chew or break them.

Liquid erythromycin is for children and people who find it difficult to swallow tablets.

If you or your child are taking erythromycin as a liquid, it will usually be made up for you by your pharmacist. The medicine will come with a syringe or spoon to help you take the right amount. If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure out the right amount.

Try to space the doses evenly throughout the day. For example, if you need 4 doses a day, you could take them first thing in the morning, midday, late in the afternoon and at bedtime.

Generally, it's better to take erythromycin with food so it does not upset your stomach.

How long to take it for

Your doctor will tell you how long to take erythromycin for.

If you're taking erythromycin for a skin infection, you may need to take it for several weeks to see an improvement.

Carry on taking this medicine until you finish the course, even if you feel better. If you stop your treatment early, your problem could come back.

If you forget to take a dose, take it as soon as you remember, unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Try to take the correct number of doses each day, leaving at least 4 hours between doses.

Taking an extra dose of erythromycin is unlikely to harm you or your child. It may, however, increase the chance of temporary side effects, such as hearing loss, feeling or being sick and diarrhoea.

Talk to your pharmacist or doctor if you're worried, or if you or your child takes more than 1 extra dose.

Common side effects

These common side effects of erythromycin happen in more than 1 in 100 people. There are things you can do to help cope with them:

Serious side effects are rare and happen in less than 1 in 1,000 people.

Call 111 or a doctor for advice straight away if you get:

• a skin rash
• severe stomach pain – this can be a sign of pancreas problems
• yellowing of whites of the eyes or the skin (although this may be more difficult to see on brown and black skin), or pale poo with dark pee – these can be signs of liver or gallbladder problems
• seeing or hearing things that are not there (hallucinations)
• ringing in the ears, temporary hearing loss, or feeling unsteady on your feet
• a high temperature

• you or your child has had a seizure or fit

Find your nearest A&E

• if you have chest pains or your heart is beating abnormally

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to erythromycin.

These are not all the side effects of erythromycin. For a full list, see the leaflet inside your medicine packet.

Erythromycin and pregnancy

Erythromycin is generally thought to be OK to take during pregnancy. It will often be prescribed if your waters break early, to reduce the risk of infection and going into labour early.

During the first 12 weeks of pregnancy, other antibiotics may be more suitable for you, but this does depend on the type of infection. Talk to your doctor about taking erythromycin as it should only be taken if the benefits outweigh the possible risks.

Ertythromycin and breastfeeding

If your doctor or health visitor says that your baby is healthy, it's OK to take erythromycin while breastfeeding.

Erythromycin passes into breast milk in very small amounts and is unlikely to cause any effects in your baby. However, it has caused some babies to become drowsy and have mild stomach upsets.

When used as a skin treatment, it is unlikely that any erythromycin will get into your breast milk. Be careful that your baby does not come into contact with the areas of your body you have put it on. Wash your hands after you have applied the skin treatment and before picking up your baby.

Contact your health visitor, midwife, pharmacist or doctor as soon as possible if:

• your baby is not feeding as well as usual or seems very unsettled after feeding
• your baby has a rash
• your baby is unusually sleepy
• your baby has an upset stomach
• your baby has oral thrush (a fungal infection in their mouth)
• you have any other concerns about your baby

Erythromycin and fertility

There's no evidence to suggest that taking erythromycin reduces fertility in either men or women.

Cautions with other medicines

There are some medicines that do not mix well with erythromycin. Tell your doctor if you're taking any of these medicines before you start erythromycin:

• antihistamine medicines, such as astemizole, terfenadine or mizolastine
• domperidone, an anti-sickness medicine
• medicines for mental health problems called pimozide or amisulpride
• migraine medicines called ergotamine or dihydroergotamine
• simvastatin, a cholesterol-lowering medicine
• tolterodine, a bladder weakness medicine
• anticoagulants like warfarin or rivaroxaban, which help to prevent blood clots – erythromycin can increase the risk of bleeding

Mixing erythromycin with herbal remedies and supplements

There's not enough information to say that complementary medicines and herbal remedies are safe to take with erythromycin. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

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