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Drug interactions

Erythromycin base + Liposomal doxorubicin

Severity: Moderate

Erythromycin base and Liposomal doxorubicin: 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 may raise exposure to doxorubicin, which is partly cleared by CYP3A4 and P-glycoprotein. Higher levels could increase myelosuppression, mucositis and cardiotoxicity. The effect with the liposomal form is less well characterized.

What this interaction means in plain words

Erythromycin base and Liposomal doxorubicin 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.

Evidence level: Low

Why it happens

Erythromycin inhibits CYP3A4 and P-glycoprotein, reducing doxorubicin metabolism and efflux.

What to do

Where possible choose an antibiotic that does not inhibit CYP3A4 or P-gp, such as azithromycin. If combined, monitor blood counts, mucositis and cardiac function closely.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Erythromycin base with Liposomal doxorubicin?

MediHelp rates the interaction as moderate. Erythromycin base and Liposomal doxorubicin 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 may raise exposure to doxorubicin, which is partly cleared by CYP3A4 and P-glycoprotein. Higher levels could increase myelosuppression, mucositis and cardiotoxicity. The effect with the liposomal form is less well characterized.

How serious is the interaction between Erythromycin base and Liposomal doxorubicin?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Where possible choose an antibiotic that does not inhibit CYP3A4 or P-gp, such as azithromycin. If combined, monitor blood counts, mucositis and cardiac function closely.

What other medicines interact with Liposomal doxorubicin?

MediHelp also lists interactions of Liposomal doxorubicin with, for example, Dengue vaccine, Belatacept, Cyclosporine. The full list is on the Liposomal doxorubicin page.

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