Drug interactions
Erythromycin + Voclosporin
Severity: Major
Erythromycin and Voclosporin: 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 raises voclosporin exposure through CYP3A4 inhibition, increasing nephrotoxicity and other toxicity risk. Both drugs also prolong the QT interval.
What this interaction means in plain words
Erythromycin and Voclosporin 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; Voclosporin belongs to Miscellaneous.
Why it happens
CYP3A4 inhibition reduces voclosporin clearance, with additive QT prolongation.
What to do
Reduce the voclosporin dose as labeling advises for moderate CYP3A4 inhibitors and monitor eGFR, blood pressure, potassium and ECG. Consider 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 Voclosporin
- Clarithromycin + Voclosporin Contraindicated
- Cyclosporin + Voclosporin Contraindicated
- Ensitrelvir + Voclosporin Contraindicated
- Itraconazole + Voclosporin Contraindicated
- Ketoconazole + Voclosporin Contraindicated
- Posaconazole + Voclosporin Contraindicated
Frequently asked questions
Can I take Erythromycin with Voclosporin?
MediHelp rates the interaction as major. Erythromycin and Voclosporin 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 raises voclosporin exposure through CYP3A4 inhibition, increasing nephrotoxicity and other toxicity risk. Both drugs also prolong the QT interval.
How serious is the interaction between Erythromycin and Voclosporin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the voclosporin dose as labeling advises for moderate CYP3A4 inhibitors and monitor eGFR, blood pressure, potassium and ECG. Consider 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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