Drug interactions
Erythromycin + Nimodipine
Severity: Major
Erythromycin and Nimodipine: 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 can raise nimodipine concentrations, which may cause excessive hypotension, flushing, headache and tachycardia. Nimodipine has high first-pass metabolism by CYP3A4, so inhibition has a notable effect.
What this interaction means in plain words
Erythromycin and Nimodipine 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; Nimodipine belongs to Cardiovascular.
Why it happens
Erythromycin inhibits CYP3A4, reducing first-pass and systemic metabolism of nimodipine.
What to do
Monitor blood pressure and heart rate closely, and reduce the nimodipine dose if hypotension occurs. Consider azithromycin as an alternative antibiotic.
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 Nimodipine
- Apalutamide + Nimodipine Major
- Carbamazepine + Nimodipine Major
- Ceritinib + Nimodipine Major
- Clarithromycin + Nimodipine Major
- Cobicistat + Nimodipine Major
- Darunavir + Nimodipine Major
Frequently asked questions
Can I take Erythromycin with Nimodipine?
MediHelp rates the interaction as major. Erythromycin and Nimodipine 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 can raise nimodipine concentrations, which may cause excessive hypotension, flushing, headache and tachycardia. Nimodipine has high first-pass metabolism by CYP3A4, so inhibition has a notable effect.
How serious is the interaction between Erythromycin and Nimodipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure and heart rate closely, and reduce the nimodipine dose if hypotension occurs. Consider azithromycin as an alternative antibiotic.
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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