Drug interactions
Epinephrine racemic + Erythromycin
Severity: Moderate
Epinephrine racemic 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
Both agents have been associated with QT prolongation, and catecholamines can also provoke arrhythmias. Combined use may add to the risk of ventricular arrhythmia, though the clinical significance with inhaled or topical racemic epinephrine is uncertain.
What this interaction means in plain words
Epinephrine racemic 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.
Why it happens
Additive proarrhythmic effects: erythromycin blocks cardiac potassium channels while adrenergic stimulation shifts repolarization and raises ectopy.
What to do
Monitor the ECG and correct potassium and magnesium in patients with other QT risk factors or cardiac disease. Use the lowest effective epinephrine dose.
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
Frequently asked questions
Can I take Epinephrine racemic with Erythromycin?
MediHelp rates the interaction as moderate. Epinephrine racemic 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. Both agents have been associated with QT prolongation, and catecholamines can also provoke arrhythmias. Combined use may add to the risk of ventricular arrhythmia, though the clinical significance with inhaled or topical racemic epinephrine is uncertain.
How serious is the interaction between Epinephrine racemic 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: Monitor the ECG and correct potassium and magnesium in patients with other QT risk factors or cardiac disease. Use the lowest effective epinephrine dose.
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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