Drug interactions
Erythromycin lactobionate + Tolvaptan
Severity: Major
Erythromycin lactobionate and Tolvaptan: 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
Intravenous erythromycin is a moderate CYP3A4 inhibitor and increases tolvaptan exposure. This raises the risk of excessive aquaresis, dehydration and overly rapid rise in serum sodium.
What this interaction means in plain words
Erythromycin lactobionate and Tolvaptan 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; Tolvaptan belongs to Endocrine.
Why it happens
Erythromycin inhibits CYP3A4, decreasing the metabolism of tolvaptan.
What to do
Use a reduced tolvaptan dose according to labeling or choose a non-interacting antibiotic. Monitor serum sodium and volume status closely.
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 Tolvaptan, 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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
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 Tolvaptan?
MediHelp rates the interaction as major. Erythromycin lactobionate and Tolvaptan 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 a moderate CYP3A4 inhibitor and increases tolvaptan exposure. This raises the risk of excessive aquaresis, dehydration and overly rapid rise in serum sodium.
How serious is the interaction between Erythromycin lactobionate and Tolvaptan?
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 reduced tolvaptan dose according to labeling or choose a non-interacting antibiotic. Monitor serum sodium and volume status closely.
What other medicines interact with Tolvaptan?
MediHelp also lists interactions of Tolvaptan with, for example, Atazanavir, Ceritinib, Cobicistat. The full list is on the Tolvaptan 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.
