Drug interactions
Erythromycin + Ibrutinib
Severity: Major
Erythromycin and Ibrutinib: 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 raises ibrutinib exposure, which increases the risk of bleeding, infection, arrhythmias such as atrial fibrillation, and cytopenias. The effect is clinically relevant because ibrutinib is extensively cleared by CYP3A4.
What this interaction means in plain words
Erythromycin and Ibrutinib 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; Ibrutinib belongs to Oncology.
Why it happens
Moderate inhibition of CYP3A4 by erythromycin reduces first-pass and systemic metabolism of ibrutinib.
What to do
Reduce the ibrutinib dose as stated in labeling for moderate CYP3A4 inhibitors and monitor for toxicity; return to the previous dose after erythromycin is stopped.
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 Ibrutinib
- Abciximab + Ibrutinib Major
- Acetylsalicylic acid + Ibrutinib Major
- Alteplase + Ibrutinib Major
- Amobarbital + Ibrutinib Major
- Apalutamide + Ibrutinib Major
- Apixaban + Ibrutinib Major
Frequently asked questions
Can I take Erythromycin with Ibrutinib?
MediHelp rates the interaction as major. Erythromycin and Ibrutinib 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 raises ibrutinib exposure, which increases the risk of bleeding, infection, arrhythmias such as atrial fibrillation, and cytopenias. The effect is clinically relevant because ibrutinib is extensively cleared by CYP3A4.
How serious is the interaction between Erythromycin and Ibrutinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the ibrutinib dose as stated in labeling for moderate CYP3A4 inhibitors and monitor for toxicity; return to the previous dose after erythromycin is stopped.
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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