Drug interactions
Erythromycin lactobionate + Prochlorperazine
Severity: Major
Erythromycin lactobionate and Prochlorperazine: 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
Intravenous erythromycin is strongly associated with QT prolongation, and adding prochlorperazine increases the risk of torsades de pointes and other ventricular arrhythmias. Erythromycin also inhibits CYP3A4 and may modestly raise phenothiazine exposure. Risk is greater with electrolyte disturbances or heart disease.
What this interaction means in plain words
Erythromycin lactobionate and Prochlorperazine 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 lactobionate belongs to Anti Bacterial; Prochlorperazine belongs to Central Nervous System.
Why it happens
Additive QT prolongation through cardiac potassium channel (hERG) blockade, with possible CYP3A4 inhibition by erythromycin raising prochlorperazine levels.
What to do
Use a non-macrolide antibiotic or alternative antiemetic where possible. If combined, obtain a baseline ECG, correct potassium and magnesium, and monitor continuously or serially for QTc changes.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Erythromycin lactobionate and Prochlorperazine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Prochlorperazine
- Dronedarone + Prochlorperazine Contraindicated
- Ibutilide + Prochlorperazine Contraindicated
- Nilotinib + Prochlorperazine Contraindicated
- Pimozide + Prochlorperazine Contraindicated
- Prochlorperazine + Thioridazine Contraindicated
- Amiodarone + Prochlorperazine Major
Other interactions of Erythromycin lactobionate
- Cisapride + Erythromycin lactobionate Contraindicated
- Dihydroergotamine + Erythromycin lactobionate Contraindicated
- Dronedarone + Erythromycin lactobionate Contraindicated
- Eletriptan + Erythromycin lactobionate Contraindicated
- Ergotamine + Erythromycin lactobionate Contraindicated
- Erythromycin lactobionate + Flibanserin Contraindicated
Frequently asked questions
Can I take Erythromycin lactobionate with Prochlorperazine?
MediHelp rates the interaction as major. Erythromycin lactobionate and Prochlorperazine 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. Intravenous erythromycin is strongly associated with QT prolongation, and adding prochlorperazine increases the risk of torsades de pointes and other ventricular arrhythmias. Erythromycin also inhibits CYP3A4 and may modestly raise phenothiazine exposure. Risk is greater with electrolyte disturbances or heart disease.
How serious is the interaction between Erythromycin lactobionate and Prochlorperazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use a non-macrolide antibiotic or alternative antiemetic where possible. If combined, obtain a baseline ECG, correct potassium and magnesium, and monitor continuously or serially for QTc changes.
What other medicines interact with Prochlorperazine?
MediHelp also lists interactions of Prochlorperazine with, for example, Dronedarone, Ibutilide, Nilotinib. The full list is on the Prochlorperazine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
