Drug interactions
Brexpiprazole + Erythromycin base
Severity: Moderate
Brexpiprazole and Erythromycin base: moderate 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 is a moderate CYP3A4 inhibitor and can raise brexpiprazole exposure. The effect is modest alone but becomes more important if the patient also takes a CYP2D6 inhibitor, since both of brexpiprazole's main clearance pathways are then impaired.
What this interaction means in plain words
Brexpiprazole and Erythromycin base can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Inhibition of CYP3A4-mediated metabolism of brexpiprazole by erythromycin.
What to do
Monitor for increased adverse effects such as akathisia, sedation and orthostasis. Reduce brexpiprazole to a quarter of the usual dose if a CYP2D6 inhibitor is also being taken with erythromycin.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Erythromycin base?
MediHelp rates the interaction as moderate. Brexpiprazole and Erythromycin base can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Erythromycin is a moderate CYP3A4 inhibitor and can raise brexpiprazole exposure. The effect is modest alone but becomes more important if the patient also takes a CYP2D6 inhibitor, since both of brexpiprazole's main clearance pathways are then impaired.
How serious is the interaction between Brexpiprazole and Erythromycin base?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for increased adverse effects such as akathisia, sedation and orthostasis. Reduce brexpiprazole to a quarter of the usual dose if a CYP2D6 inhibitor is also being taken with erythromycin.
What other medicines interact with Brexpiprazole?
MediHelp also lists interactions of Brexpiprazole with, for example, Alfentanil, Amisulpride, Apalutamide. The full list is on the Brexpiprazole page.
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