Drug interactions
Erythromycin + Rilpivirine
Severity: Moderate
Erythromycin and Rilpivirine: 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
Erythromycin can raise rilpivirine exposure through CYP3A4 inhibition, and both drugs are associated with QT interval prolongation. The combined effect may increase the risk of QT prolongation and torsades de pointes, especially with other risk factors.
What this interaction means in plain words
Erythromycin and Rilpivirine 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; Rilpivirine belongs to Anti Virals.
Why it happens
Erythromycin inhibits CYP3A4-mediated rilpivirine metabolism, and both agents have additive QT-prolonging effects.
What to do
Prefer an alternative macrolide such as azithromycin where possible. If combined, obtain an ECG and correct potassium and magnesium abnormalities.
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 Rilpivirine
- Carbamazepine + Rilpivirine Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexlansoprazole + Rilpivirine Contraindicated
- Efavirenz + Rilpivirine Contraindicated
- Eslicarbazepine + Rilpivirine Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
Frequently asked questions
Can I take Erythromycin with Rilpivirine?
MediHelp rates the interaction as moderate. Erythromycin and Rilpivirine 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 can raise rilpivirine exposure through CYP3A4 inhibition, and both drugs are associated with QT interval prolongation. The combined effect may increase the risk of QT prolongation and torsades de pointes, especially with other risk factors.
How serious is the interaction between Erythromycin and Rilpivirine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative macrolide such as azithromycin where possible. If combined, obtain an ECG and correct potassium and magnesium abnormalities.
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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