Drug interactions
Amiodarone + Erythromycin
Severity: Major
Amiodarone and Erythromycin: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs prolong the QT interval, and erythromycin may further raise amiodarone levels through CYP3A4 inhibition. This increases the risk of torsades de pointes, particularly with hypokalemia or structural heart disease.
What this interaction means in plain words
Amiodarone and Erythromycin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Erythromycin belongs to Anti Bacterial.
Why it happens
Additive QT prolongation with CYP3A4 inhibition by erythromycin raising amiodarone exposure.
What to do
Avoid if an alternative antibiotic exists; otherwise obtain baseline and follow-up ECGs and correct potassium and magnesium.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Erythromycin?
MediHelp rates the interaction as major. Amiodarone and Erythromycin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs prolong the QT interval, and erythromycin may further raise amiodarone levels through CYP3A4 inhibition. This increases the risk of torsades de pointes, particularly with hypokalemia or structural heart disease.
How serious is the interaction between Amiodarone and Erythromycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if an alternative antibiotic exists; otherwise obtain baseline and follow-up ECGs and correct potassium and magnesium.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
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