Brand names of Erythromycin in Kenya
Asomycin, Astra Lifecare
Biotrocin, Biodeal Laboratories Ltd.
Elocin , Elys Chemical Industries Ltd
Erocin, Laboratory & Allied Ltd
Erocos, Cosmos Limited
Eromycin, Square Pharmaceuticals Ltd.
Erythromed , Medisel Kenya Limited
Erythrolite, Skylight Chemical Industries
Erygyl , Harleys Limited
Erythro, National Pharmacy Ltd
Erythromycin , Medopharm
Erythromycin, Macleods Pharmaceuticals Limited
Erythrox, Dawa Limited
Erythyl, Regal Pharmaceuticals Limited
Ethro, Universal Corporation Limited
Etocin, Cadila Pharmaceuticals (EA) Ltd
Indo, Indoco Remedies Limited
Labcin, Laborate pharmaceuticals India Limited
Throcin, Zest pharma
MODE OF ACTION
Erythromycin exerts its antimicrobial action by binding to the 50S ribosomal sub-unit of susceptible microorganisms and suppresses protein synthesis. Erythromycin is usually active against most strains of the following organisms both in vitro and in clinical infections:
Gram positive bacteria – Listeria monocytogenes, Corynebacterium diphtheriae (as an adjunct to antitoxin), Staphylococci spp, Streptococci spp (including Enterococci).
Gram negative bacteria – Haemophilus influenzae, Neisseria meningitidis, Neisseria gonorrhoeae, Legionella pneumophila, Moraxella (Branhamella) catarrhalis, Bordetella pertussis, Campylobacter spp.
Mycoplasma – Mycoplasma pneumoniae, Ureaplasma urealyticum.
Other organisms – Treponema pallidum, Chlamydia spp, Clostridia spp, L-forms, the agents causing trachoma and lymphogranuloma venereum.
For the prophylaxis and treatment of infections caused by erythromycin-sensitive organisms.
Erythromycin is highly effective in the treatment of a great variety of clinical infections such as:
- Upper Respiratory Tract infections: tonsillitis, peritonsillar abscess, pharyngitis, laryngitis, sinusitis, secondary infections in influenza and common colds
- Lower Respiratory Tract infections: tracheitis, acute and chronic bronchitis, pneumonia (lobar pneumonia, bronchopneumonia, primary atypical pneumonia), bronchiectasis, Legionnaire’s disease
- Ear infection: otitis media and otitis externa, mastoiditis
- Oral infections: gingivitis, Vincent’s angina
- Eye infections: blepharitis
- Skin and soft tissue infections: boils and carbuncles, paronychia, abscesses, pustular acne, impetigo, cellulitis, erysipelas
- Gastrointestinal infections: cholecystitis, staphylococcal enterocolitis
- Prophylaxis: pre- and post- operative trauma, burns, rheumatic fever
- Other infections: osteomyelitis, urethritis, gonorrhoea, syphilis, lymphogranuloma venereum, diphtheria, prostatitis, scarlet fever
DOSAGE AND ADMINISTRATION
Adults and children over 8 years: For mild to moderate infections 2g daily in divided doses. Up to 4g daily in severe infections.
Elderly: No special dosage recommendations.
Note: For younger children, infants and babies, erythromycin ethylsuccinate suspensions, are normally recommended. The recommended dose for children age 2-8 years, for mild to moderate infections, is 1 gram daily in divided doses. The recommended dose for infants and babies, for mild to moderate infections, is 500 mg daily in divided doses. For severe infections doses may be doubled.
Known hypersensitivity to erythromycin.
Erythromycin is contraindicated in patients taking simvastatin, tolterodine, mizolastine, amisulpride, astemizole, terfenadine, domperidone, cisapride or pimozide.
Erythromycin is contraindicated with ergotamine and dihydroergotamine.
There have been reports of increased anticoagulant effects when erythromycin and oral anticoagulants were used concomitantly. Increased anticoagulation effects due to interactions of erythromycin with oral anticoagulants may be more pronounced in the elderly.
Erythromycin has been reported to decrease the clearance of triazolam and midazolam, and thus, may increase the pharmacologic effect of these Triazolobenzodiazepines.
Erythromycin use in patients who are receiving high doses of theophylline may be associated with an increase in serum theophylline levels and potential theophylline toxicity
Concomitant administration of erythromycin and digoxin has been reported to result in elevated digoxin serum levels.
Erythromycin has been reported to increase concentrations of HMG-CoA reductase inhibitors (e.g., lovastatin and simvastatin). Rare reports of rhabdomyolysis have been reported in patients taking these drugs concomitantly.
Erythromycin has been reported to increase the systemic exposure (AUC) of sildenafil. Reduction of sildenafil dosage should be considered.
There have been spontaneous or published reports of CYP3A based interactions of erythromycin with cyclosporine, carbamazepine, tacrolimus, alfentanil, disopyramide, rifabutin, quinidine, methylprednisolone, cilostazol, vinblastine, and bromocriptine.
Concomitant administration of erythromycin with cisapride, pimozide, astemizole, or terfenadine is contraindicated
Erythromycin has been reported to significantly alter the metabolism of the nonsedating antihistamines terfenadine and astemizole when taken concomitantly. Rare cases of serious cardiovascular adverse events, including electrocardiographic QT/QTc interval prolongation, cardiac arrest, torsades de pointes, and other ventricular arrhythmias have been observed
Erythromycin is considered a moderate inhibitor of CYP3A4. A significant increase in colchicine plasma concentration is anticipated when co-administered with moderate CYP3A4 inhibitors such as erythromycin.
Prescribing Erythromycin in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Since erythromycin is principally excreted by the liver, caution should be exercised when erythromycin is administered to patients with impaired hepatic function.
Exacerbation of symptoms of myasthenia gravis and new onset of symptoms of the myasthenic syndrome has been reported in patients receiving erythromycin therapy.
There have been reports of infantile hypertrophic pyloric stenosis (IHPS) occurring in infants following erythromycin therapy
Prolonged or repeated use of erythromycin may result in an overgrowth of nonsusceptible bacteria or fungi. If superinfection occurs, erythromycin should be discontinued and appropriate therapy instituted.
When indicated, incision and drainage or other surgical procedures should be performed in conjunction with antibiotic therapy.
Observational studies in humans have reported cardiovascular malformations after exposure to drug products containing erythromycin during early pregnancy.
There have been reports of hepatic dysfunction, including increased liver enzymes, and hepatocellular and/or cholestatic hepatitis, with or without jaundice, occurring in patients receiving oral erythromycin products.
Erythromycin has been associated with prolongation of the QT interval and infrequent cases of arrhythmia.
There have been reports suggesting that erythromycin does not reach the fetus in adequate concentration to prevent congenital syphilis. Infants born to women treated during pregnancy with oral erythromycin for early syphilis should be treated with an appropriate penicillin regimen.
Clostridium difficile associated diarrhoea (CDAD) has been reported with the use of nearly all antibacterial agents, including Erythromycin, and may range in severity from mild diarrhoea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
Occasional side effects such as nausea, abdominal discomfort, vomiting and diarrhoea may be experienced. Reversible hearing loss associated with doses of erythromycin usually greater than 4g per day has been reported. Allergic reactions are rare and mild, although anaphylaxis has occurred. Skin reactions ranging from mild eruptions to erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis have rarely been reported. There are no reports implicating erythromycin products with abnormal tooth development, and only rare reports of damage to the blood, kidneys or central nervous system. There have been reports of mitochondrial optic neuropathy and infantile hypertrophic pyloric stenosis.
Cardiac arrhythmias have been very rarely reported in patients receiving erythromycin therapy. There have been isolated reports of chest pain, dizziness and palpitations, however, a cause and effect relationship has not been established.
Symptoms of hepatitis, hepatic dysfunction and/or abnormal liver function test results may occur.
Skin and subcutaneous tissue disorders
Not known: acute generalised exanthematous pustulosis (AGEP)
Reporting of suspected adverse reactions:
The PPB Department of Pharmacovigilance was set up with a vision to develop, implement and continuously upgrade an appropriate system for detecting, reporting, and monitoring adverse drug reactions (ADRs) and other relevant problems with medicines in Kenya. The department strives to ensure the safety and efficacy of pharmaceutical products in Kenya.
Reporting suspected adverse reactions after authorization of the medicinal product are important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals/ Patients are encouraged to report any suspected adverse reactions via Pharmacovigilance Yellow Form, email@example.com or clicking below button:
Erythromycin In Kenya
Erythromycin In Kenya
Erythromycin In Kenya
Erythromycin In Kenya
Erythromycin In Kenya
Erythromycin In Kenya
Clinical | Pharmacokinetic data
Pregnancy Category: B (No risk in non-human studies)
Routes of Administration: By mouth, intravenous (IV), intramuscular (IM)
Bioavailability: Depends on the ester type between 30% - 65%
Protein Binding: 90%
Metabolosim: liver (under 5% excreted unchanged)
Onset of Action: N/A
Elimination Half life: 1.5 hours
Legal Status | Dosage forms & Strengths
Prescription only Medicine (POM) , ℞-only
Narcotic Drugs and Psychotropic Substances (Control ) Act Schedule:
This drug is not a controlled substance under Narcotic Drugs and Psychotropic Substances (Control ) Act
Dosage Forms | Strengths:
|CompTox Dashboard (EPA)|
- Houin, G., et al. “Erythromycin pharmacokinetics in man.” The Journal of international medical research 8 (1980): 9-14.
- Lakritz, Jeffrey, and W. David Wilson. “Erythromycin: pharmacokinetics, bioavailability, nonantimicrobial activity, and possible mechanisms associated with adverse reactions.” Proc Annu Conv Am Assoc Equine Pract. Vol. 43. 1997.
- Weisblum, Bernard. “Erythromycin resistance by ribosome modification.” Antimicrobial agents and chemotherapy 39.3 (1995): 577.