Drug interactions
Erythromycin + Fexinidazole
Severity: Major
Erythromycin and Fexinidazole: 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
Fexinidazole and its metabolites can inhibit CYP3A4 and may raise erythromycin levels. Both drugs can also prolong the QT interval, so combined use increases arrhythmia risk.
What this interaction means in plain words
Erythromycin and Fexinidazole 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
CYP3A4 inhibition raises erythromycin exposure, with additive QT prolongation.
What to do
Avoid the combination and use a non-QT-prolonging antibiotic during fexinidazole treatment. If unavoidable, monitor the ECG 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
Frequently asked questions
Can I take Erythromycin with Fexinidazole?
MediHelp rates the interaction as major. Erythromycin and Fexinidazole 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. Fexinidazole and its metabolites can inhibit CYP3A4 and may raise erythromycin levels. Both drugs can also prolong the QT interval, so combined use increases arrhythmia risk.
How serious is the interaction between Erythromycin and Fexinidazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use a non-QT-prolonging antibiotic during fexinidazole treatment. If unavoidable, monitor the ECG 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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