Drug interactions
Erythromycin lactobionate + Sunitinib
Severity: Major
Erythromycin lactobionate and Sunitinib: 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 inhibits CYP3A4, the main enzyme that metabolizes sunitinib, which can raise sunitinib exposure and toxicity. Both drugs also prolong the QT interval, so arrhythmia risk is increased.
What this interaction means in plain words
Erythromycin lactobionate and Sunitinib 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; Sunitinib belongs to Oncology.
Why it happens
CYP3A4 inhibition by erythromycin increases sunitinib levels, combined with additive QT prolongation.
What to do
Use a non-interacting antibiotic that neither inhibits CYP3A4 nor prolongs QT. If unavoidable, consider a sunitinib dose reduction and monitor ECG and electrolytes.
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 Sunitinib
- Adagrasib + Sunitinib Major
- Amiodarone + Sunitinib Major
- Amisulpride + Sunitinib Major
- Anagrelide + Sunitinib Major
- Apalutamide + Sunitinib Major
- Arsenic trioxide + Sunitinib 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 Sunitinib?
MediHelp rates the interaction as major. Erythromycin lactobionate and Sunitinib 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 inhibits CYP3A4, the main enzyme that metabolizes sunitinib, which can raise sunitinib exposure and toxicity. Both drugs also prolong the QT interval, so arrhythmia risk is increased.
How serious is the interaction between Erythromycin lactobionate and Sunitinib?
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-interacting antibiotic that neither inhibits CYP3A4 nor prolongs QT. If unavoidable, consider a sunitinib dose reduction and monitor ECG and electrolytes.
What other medicines interact with Sunitinib?
MediHelp also lists interactions of Sunitinib with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Sunitinib page.
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