Drug interactions
Erythromycin + Mitotane
Severity: Moderate
Erythromycin and Mitotane: moderate interaction.
Last updated
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
Mitotane is a strong CYP3A4 inducer and can substantially lower erythromycin concentrations, possibly causing treatment failure of the antibiotic. The induction can persist for weeks after mitotane is stopped.
What this interaction means in plain words
Erythromycin and Mitotane can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Erythromycin belongs to Anti Bacterial; Mitotane belongs to Oncology.
Why it happens
Mitotane induces CYP3A4, increasing erythromycin metabolism.
What to do
Monitor for loss of antibacterial efficacy and consider an antibiotic that is not a CYP3A4 substrate. Allow for persistent induction after mitotane discontinuation.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Erythromycin with Mitotane?
MediHelp rates the interaction as moderate. Erythromycin and Mitotane can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Mitotane is a strong CYP3A4 inducer and can substantially lower erythromycin concentrations, possibly causing treatment failure of the antibiotic. The induction can persist for weeks after mitotane is stopped.
How serious is the interaction between Erythromycin and Mitotane?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for loss of antibacterial efficacy and consider an antibiotic that is not a CYP3A4 substrate. Allow for persistent induction after mitotane discontinuation.
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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