Drug interactions
Erythromycin + Rivaroxaban
Severity: Moderate
Erythromycin and Rivaroxaban: 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 inhibits CYP3A4 and P-glycoprotein, increasing rivaroxaban exposure. The increase is larger in patients with renal impairment and may raise bleeding risk.
What this interaction means in plain words
Erythromycin and Rivaroxaban 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; Rivaroxaban belongs to Cardiovascular.
Why it happens
Combined CYP3A4 and P-glycoprotein inhibition by erythromycin reduces rivaroxaban clearance.
What to do
In patients with normal renal function, no dose change is usually needed but monitor for bleeding. In renal impairment use only if benefit outweighs risk, or choose a non-interacting antibiotic.
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 Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban Major
Frequently asked questions
Can I take Erythromycin with Rivaroxaban?
MediHelp rates the interaction as moderate. Erythromycin and Rivaroxaban 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 inhibits CYP3A4 and P-glycoprotein, increasing rivaroxaban exposure. The increase is larger in patients with renal impairment and may raise bleeding risk.
How serious is the interaction between Erythromycin and Rivaroxaban?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: In patients with normal renal function, no dose change is usually needed but monitor for bleeding. In renal impairment use only if benefit outweighs risk, or choose a non-interacting 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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