Drug interactions
Erythromycin + Sildenafil
Severity: Moderate
Erythromycin and Sildenafil: 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 raises sildenafil exposure, which may cause greater hypotension, headache, flushing and visual disturbances. Risk is higher in older patients and those on antihypertensives.
What this interaction means in plain words
Erythromycin and Sildenafil 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; Sildenafil belongs to Genitourinary.
Why it happens
Erythromycin inhibits CYP3A4, the main enzyme metabolizing sildenafil.
What to do
Start sildenafil at 25 mg in patients taking erythromycin and watch for hypotension and adverse effects.
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 Sildenafil
- Amyl nitrite + Sildenafil Contraindicated
- Atazanavir + Sildenafil Contraindicated
- Cobicistat + Sildenafil Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Sildenafil Contraindicated
- Glyceryl trinitrate pr + Sildenafil Contraindicated
- Isosorbide dinitrate + Sildenafil Contraindicated
Frequently asked questions
Can I take Erythromycin with Sildenafil?
MediHelp rates the interaction as moderate. Erythromycin and Sildenafil 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 raises sildenafil exposure, which may cause greater hypotension, headache, flushing and visual disturbances. Risk is higher in older patients and those on antihypertensives.
How serious is the interaction between Erythromycin and Sildenafil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start sildenafil at 25 mg in patients taking erythromycin and watch for hypotension and 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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