Drug interactions
Erythromycin base + Irinotecan
Severity: Moderate
Erythromycin base and Irinotecan: 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, which converts irinotecan to inactive metabolites. Irinotecan and SN-38 exposure may rise, increasing toxicity.
What this interaction means in plain words
Erythromycin base and Irinotecan 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.
Why it happens
CYP3A4 inhibition decreases oxidative clearance of irinotecan.
What to do
Prefer a non-CYP3A4-inhibiting antibiotic such as azithromycin; otherwise monitor for diarrhea and neutropenia.
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 Irinotecan
- Clozapine + Irinotecan Contraindicated
- Irinotecan + Sacituzumab govitecan Contraindicated
- Adenovirus types 4 and 7 live + Irinotecan Major
- Apalutamide + Irinotecan Major
- Atazanavir + Irinotecan Major
- Carbamazepine + Irinotecan Major
Frequently asked questions
Can I take Erythromycin base with Irinotecan?
MediHelp rates the interaction as moderate. Erythromycin base and Irinotecan 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, which converts irinotecan to inactive metabolites. Irinotecan and SN-38 exposure may rise, increasing toxicity.
How serious is the interaction between Erythromycin base and Irinotecan?
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 a non-CYP3A4-inhibiting antibiotic such as azithromycin; otherwise monitor for diarrhea and neutropenia.
What other medicines interact with Irinotecan?
MediHelp also lists interactions of Irinotecan with, for example, Clozapine, Sacituzumab govitecan, Adenovirus types 4 and 7 live. The full list is on the Irinotecan page.
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