Drug interactions
Erythromycin lactobionate + Rivaroxaban
Severity: Moderate
Erythromycin lactobionate and Rivaroxaban: 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 and P-glycoprotein and raises rivaroxaban exposure modestly in people with normal renal function. The increase is larger in renal impairment, raising bleeding risk.
What this interaction means in plain words
Erythromycin lactobionate and Rivaroxaban 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 lactobionate belongs to Anti Bacterial; Rivaroxaban belongs to Cardiovascular.
Why it happens
Combined P-glycoprotein and moderate CYP3A4 inhibition reduces rivaroxaban clearance.
What to do
In normal renal function no dose change is required, but monitor for bleeding. In renal impairment, use only if benefit justifies the risk or choose a non-interacting antibiotic such as a different class.
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 Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban 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 Rivaroxaban?
MediHelp rates the interaction as moderate. Erythromycin lactobionate and Rivaroxaban 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 and P-glycoprotein and raises rivaroxaban exposure modestly in people with normal renal function. The increase is larger in renal impairment, raising bleeding risk.
How serious is the interaction between Erythromycin lactobionate and Rivaroxaban?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: In normal renal function no dose change is required, but monitor for bleeding. In renal impairment, use only if benefit justifies the risk or choose a non-interacting antibiotic such as a different class.
What other medicines interact with Rivaroxaban?
MediHelp also lists interactions of Rivaroxaban with, for example, Defibrotide, Ketoconazole, Ketorolac. The full list is on the Rivaroxaban page.
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