Drug interactions
Eplerenone + Erythromycin stearate
Severity: Major
Eplerenone and Erythromycin stearate: major interaction.
Last updated Sources: US FDA label
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 raises eplerenone exposure. This increases the risk of hyperkalemia, especially with renal impairment.
What this interaction means in plain words
Eplerenone and Erythromycin stearate 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
Inhibition of CYP3A4-mediated eplerenone metabolism raises plasma concentrations.
What to do
Limit eplerenone to a reduced dose (such as 25 mg daily) per labeling when combined with moderate CYP3A4 inhibitors, and monitor serum potassium and renal function. Consider an alternative antibiotic such as azithromycin.
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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References
Other interactions of Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Frequently asked questions
Can I take Eplerenone with Erythromycin stearate?
MediHelp rates the interaction as major. Eplerenone and Erythromycin stearate 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 is a moderate CYP3A4 inhibitor and raises eplerenone exposure. This increases the risk of hyperkalemia, especially with renal impairment.
How serious is the interaction between Eplerenone and Erythromycin stearate?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit eplerenone to a reduced dose (such as 25 mg daily) per labeling when combined with moderate CYP3A4 inhibitors, and monitor serum potassium and renal function. Consider an alternative antibiotic such as azithromycin.
What other medicines interact with Eplerenone?
MediHelp also lists interactions of Eplerenone with, for example, Amiloride, Atazanavir, Clarithromycin. The full list is on the Eplerenone page.
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