Drug interactions
Aprepitant + Erythromycin ethylsuccinate
Severity: Major
Aprepitant and Erythromycin ethylsuccinate: 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
Erythromycin inhibits CYP3A4 and can raise aprepitant exposure, while aprepitant is itself a moderate CYP3A4 inhibitor that may raise erythromycin levels. Higher erythromycin exposure adds to the risk of QT prolongation and arrhythmia, and aprepitant adverse effects may increase.
What this interaction means in plain words
Aprepitant and Erythromycin ethylsuccinate 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.
Why it happens
Mutual inhibition of CYP3A4-mediated metabolism, with additional QT risk from erythromycin.
What to do
Prefer a non-macrolide antibiotic when feasible. If both are required, monitor ECG and electrolytes and watch for aprepitant adverse effects such as fatigue and dizziness.
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 Aprepitant
- Aprepitant + Lomitapide Contraindicated
- Aprepitant + Pimozide Contraindicated
- Aprepitant + Avapritinib Major
- Aprepitant + Bosutinib Major
- Aprepitant + Carbamazepine Major
- Aprepitant + Cobicistat Major
Frequently asked questions
Can I take Aprepitant with Erythromycin ethylsuccinate?
MediHelp rates the interaction as major. Aprepitant and Erythromycin ethylsuccinate 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. Erythromycin inhibits CYP3A4 and can raise aprepitant exposure, while aprepitant is itself a moderate CYP3A4 inhibitor that may raise erythromycin levels. Higher erythromycin exposure adds to the risk of QT prolongation and arrhythmia, and aprepitant adverse effects may increase.
How serious is the interaction between Aprepitant and Erythromycin ethylsuccinate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-macrolide antibiotic when feasible. If both are required, monitor ECG and electrolytes and watch for aprepitant adverse effects such as fatigue and dizziness.
What other medicines interact with Aprepitant?
MediHelp also lists interactions of Aprepitant with, for example, Lomitapide, Pimozide, Avapritinib. The full list is on the Aprepitant page.
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