Drug interactions
Erythromycin + Indinavir
Severity: Major
Erythromycin and Indinavir: 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
Each drug inhibits CYP3A4 and can raise the other's concentrations. Higher indinavir levels increase the risk of nephrolithiasis, and higher erythromycin levels increase the risk of QT prolongation and other toxicity.
What this interaction means in plain words
Erythromycin and Indinavir 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
Mutual inhibition of CYP3A4-mediated metabolism.
What to do
Use an alternative antibiotic where feasible. If combined, maintain hydration and monitor renal function, the ECG and erythromycin adverse effects.
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
- Erythromycin 250 mg Gastro-resistant Tablets - SmPC sections 4.3/4.5 (class statement: Protease inhibitors; "Protease inhibitors: in concomitant administration of erythromycin and protease inhibitors, an inhibition of the decomposition of erythromycin has been observed") — electronic medicines compendium (UK SmPC)
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 Indinavir?
MediHelp rates the interaction as major. Erythromycin and Indinavir 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. Each drug inhibits CYP3A4 and can raise the other's concentrations. Higher indinavir levels increase the risk of nephrolithiasis, and higher erythromycin levels increase the risk of QT prolongation and other toxicity.
How serious is the interaction between Erythromycin and Indinavir?
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 where feasible. If combined, maintain hydration and monitor renal function, the ECG and erythromycin adverse effects.
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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