Drug interactions
Erythromycin base + Escitalopram
Severity: Major
Erythromycin base and Escitalopram: major interaction.
Last updated Sources: UK SmPC
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 and escitalopram can each prolong the QT interval, and erythromycin inhibits CYP3A4, which may modestly raise escitalopram levels. Together they increase the risk of torsades de pointes.
What this interaction means in plain words
Erythromycin base and Escitalopram 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.
Why it happens
Additive QTc prolongation, with CYP3A4 inhibition by erythromycin possibly increasing escitalopram exposure.
What to do
Choose a non-macrolide antibiotic with less QT effect where feasible; if used, check ECG and electrolytes and monitor the QTc.
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
- Escitalopram 10 mg film-coated tablets - SmPC sections 4.3/4.5 (names the partner; "erythromycin IV") — electronic medicines compendium (UK SmPC)
Other interactions of Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Erythromycin base with Escitalopram?
MediHelp rates the interaction as major. Erythromycin base and Escitalopram 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 and escitalopram can each prolong the QT interval, and erythromycin inhibits CYP3A4, which may modestly raise escitalopram levels. Together they increase the risk of torsades de pointes.
How serious is the interaction between Erythromycin base and Escitalopram?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Choose a non-macrolide antibiotic with less QT effect where feasible; if used, check ECG and electrolytes and monitor the QTc.
What other medicines interact with Escitalopram?
MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.
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