Drug interactions
Eplerenone + Erythromycin
Severity: Major
Eplerenone and Erythromycin: 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, a moderate CYP3A4 inhibitor, increases eplerenone exposure and raises the risk of hyperkalemia.
What this interaction means in plain words
Eplerenone and Erythromycin 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.
Eplerenone belongs to Cardiovascular; Erythromycin belongs to Anti Bacterial.
Why it happens
Inhibition of CYP3A4-mediated metabolism of eplerenone.
What to do
Limit eplerenone to a reduced dose (for example 25 mg daily in hypertension labeling) 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 Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
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?
MediHelp rates the interaction as major. Eplerenone and Erythromycin 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, a moderate CYP3A4 inhibitor, increases eplerenone exposure and raises the risk of hyperkalemia.
How serious is the interaction between Eplerenone and Erythromycin?
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 (for example 25 mg daily in hypertension labeling) and monitor serum potassium and renal function; consider an alternative antibiotic such as azithromycin.
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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