Drug interactions
Epinephrine + Erythromycin
Severity: Moderate
Epinephrine 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
Systemic epinephrine can cause hypokalemia and tachycardia, and erythromycin prolongs the QT interval. Together they may add to the risk of torsades de pointes, though the clinical risk is mainly relevant to systemic use rather than local anesthetic doses or emergency use.
What this interaction means in plain words
Epinephrine 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.
Epinephrine belongs to Endocrine; Erythromycin belongs to Anti Bacterial.
Why it happens
Additive QT prolongation with beta-adrenergic induced hypokalemia and increased arrhythmia susceptibility.
What to do
Do not withhold epinephrine in anaphylaxis or cardiac arrest. For non-emergency systemic use, monitor ECG and correct potassium and magnesium.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Epinephrine and Erythromycin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Epinephrine
- Epinephrine + Isocarboxazid Contraindicated
- Epinephrine + Phenelzine Contraindicated
- Epinephrine + Tranylcypromine Contraindicated
- Acebutolol + Epinephrine Major
- Amitriptyline + Epinephrine Major
- Amoxapine + Epinephrine Major
Frequently asked questions
Can I take Epinephrine with Erythromycin?
MediHelp rates the interaction as moderate. Epinephrine 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. Systemic epinephrine can cause hypokalemia and tachycardia, and erythromycin prolongs the QT interval. Together they may add to the risk of torsades de pointes, though the clinical risk is mainly relevant to systemic use rather than local anesthetic doses or emergency use.
How serious is the interaction between Epinephrine 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: Do not withhold epinephrine in anaphylaxis or cardiac arrest. For non-emergency systemic use, monitor ECG 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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
