Drug interactions
Erythromycin base + Sotalol
Severity: Major
Erythromycin base and Sotalol: 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 prolongs the QT interval and has been linked to torsades de pointes, and sotalol adds to this risk. The combination can produce life-threatening ventricular arrhythmias, especially with hypokalemia, hypomagnesemia, or renal impairment.
What this interaction means in plain words
Erythromycin base and Sotalol 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 IKr potassium channel blockade leading to delayed ventricular repolarization.
What to do
Prefer a non-QT-prolonging antibiotic such as a beta-lactam or doxycycline where suitable. If a macrolide is required, obtain a baseline ECG, correct electrolytes, and monitor 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
Other interactions of Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Frequently asked questions
Can I take Erythromycin base with Sotalol?
MediHelp rates the interaction as major. Erythromycin base and Sotalol 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 prolongs the QT interval and has been linked to torsades de pointes, and sotalol adds to this risk. The combination can produce life-threatening ventricular arrhythmias, especially with hypokalemia, hypomagnesemia, or renal impairment.
How serious is the interaction between Erythromycin base and Sotalol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-QT-prolonging antibiotic such as a beta-lactam or doxycycline where suitable. If a macrolide is required, obtain a baseline ECG, correct electrolytes, and monitor QTc.
What other medicines interact with Sotalol?
MediHelp also lists interactions of Sotalol with, for example, Arsenic trioxide, Artemether / lumefantrine, Disopyramide. The full list is on the Sotalol page.
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