Drug interactions
Erythromycin ethylsuccinate + Miconazole
Severity: Moderate
Erythromycin ethylsuccinate and Miconazole: 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 is both a CYP3A4 substrate and a QT-prolonging macrolide, and azole inhibition of its metabolism can raise its levels. Miconazole itself has some QT-prolonging potential, so the combination may add to the risk of torsades de pointes, particularly with systemic miconazole exposure.
What this interaction means in plain words
Erythromycin ethylsuccinate and Miconazole 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
Miconazole inhibits CYP3A4, raising erythromycin concentrations, with additive QT prolongation.
What to do
With vaginal miconazole, systemic exposure is low and the combination is usually manageable, but check for other QT-prolonging drugs and electrolyte disturbances. Consider an alternative antibiotic if the patient has QT risk factors.
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 Miconazole
Frequently asked questions
Can I take Erythromycin ethylsuccinate with Miconazole?
MediHelp rates the interaction as moderate. Erythromycin ethylsuccinate and Miconazole 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 is both a CYP3A4 substrate and a QT-prolonging macrolide, and azole inhibition of its metabolism can raise its levels. Miconazole itself has some QT-prolonging potential, so the combination may add to the risk of torsades de pointes, particularly with systemic miconazole exposure.
How serious is the interaction between Erythromycin ethylsuccinate and Miconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: With vaginal miconazole, systemic exposure is low and the combination is usually manageable, but check for other QT-prolonging drugs and electrolyte disturbances. Consider an alternative antibiotic if the patient has QT risk factors.
What other medicines interact with Miconazole?
MediHelp also lists interactions of Miconazole with, for example, Cabazitaxel, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Miconazole page.
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