Drug interactions
Brexpiprazole + Erythromycin
Severity: Moderate
Brexpiprazole and Erythromycin: 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, increasing adverse effects such as sedation, akathisia and orthostasis. The effect is larger in patients who also take CYP2D6 inhibitors or are CYP2D6 poor metabolizers.
What this interaction means in plain words
Brexpiprazole and Erythromycin 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.
Brexpiprazole belongs to Central Nervous System; Erythromycin belongs to Anti Bacterial.
Why it happens
Inhibition of CYP3A4-mediated brexpiprazole metabolism.
What to do
Reduce the brexpiprazole dose to about half with a moderate CYP3A4 inhibitor, and to a quarter if a CYP2D6 inhibitor is also used; monitor for adverse effects.
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 Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Erythromycin?
MediHelp rates the interaction as moderate. Brexpiprazole and Erythromycin 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, increasing adverse effects such as sedation, akathisia and orthostasis. The effect is larger in patients who also take CYP2D6 inhibitors or are CYP2D6 poor metabolizers.
How serious is the interaction between Brexpiprazole and Erythromycin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the brexpiprazole dose to about half with a moderate CYP3A4 inhibitor, and to a quarter if a CYP2D6 inhibitor is also used; monitor for adverse effects.
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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