Drug interactions
Erythromycin + Escitalopram
Severity: Major
Erythromycin and Escitalopram: major interaction.
Last updated Sources: UK SmPC
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 drugs can prolong the QT interval, and escitalopram does so in a dose-related way. Combined use raises the risk of torsades de pointes, especially with other risk factors.
What this interaction means in plain words
Erythromycin and Escitalopram 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 belongs to Anti Bacterial; Escitalopram belongs to Central Nervous System.
Why it happens
Additive QT prolongation; erythromycin may also modestly raise escitalopram exposure through CYP3A4/2C19 inhibition.
What to do
Use an alternative antibiotic such as one with less QT effect if possible. Otherwise obtain an ECG, keep escitalopram at the lowest effective dose, and correct electrolytes.
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 Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Erythromycin with Escitalopram?
MediHelp rates the interaction as major. Erythromycin and Escitalopram 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. Both drugs can prolong the QT interval, and escitalopram does so in a dose-related way. Combined use raises the risk of torsades de pointes, especially with other risk factors.
How serious is the interaction between Erythromycin and Escitalopram?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use an alternative antibiotic such as one with less QT effect if possible. Otherwise obtain an ECG, keep escitalopram at the lowest effective dose, and correct electrolytes.
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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