Drug interactions
Erythromycin lactobionate + Trazodone
Severity: Major
Erythromycin lactobionate and Trazodone: 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
Both drugs can prolong the QT interval, and intravenous erythromycin is also a CYP3A4 inhibitor that can raise trazodone exposure. Together they increase the risk of torsades de pointes and other ventricular arrhythmias, especially with electrolyte disturbances or heart disease.
What this interaction means in plain words
Erythromycin lactobionate and Trazodone 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; Trazodone belongs to Central Nervous System.
Why it happens
Additive QT prolongation, plus erythromycin inhibition of CYP3A4-mediated trazodone metabolism.
What to do
Prefer a non-macrolide antibiotic with less QT effect when possible. If the combination is needed, obtain a baseline ECG, correct potassium and magnesium, and monitor the QTc.
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 Trazodone
- Arsenic trioxide + Trazodone Contraindicated
- Ibutilide + Trazodone Contraindicated
- Isocarboxazid + Trazodone Contraindicated
- Levoketoconazole + Trazodone Contraindicated
- Methylene blue + Trazodone Contraindicated
- Phenelzine + Trazodone 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 Trazodone?
MediHelp rates the interaction as major. Erythromycin lactobionate and Trazodone 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. Both drugs can prolong the QT interval, and intravenous erythromycin is also a CYP3A4 inhibitor that can raise trazodone exposure. Together they increase the risk of torsades de pointes and other ventricular arrhythmias, especially with electrolyte disturbances or heart disease.
How serious is the interaction between Erythromycin lactobionate and Trazodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-macrolide antibiotic with less QT effect when possible. If the combination is needed, obtain a baseline ECG, correct potassium and magnesium, and monitor the QTc.
What other medicines interact with Trazodone?
MediHelp also lists interactions of Trazodone with, for example, Arsenic trioxide, Ibutilide, Isocarboxazid. The full list is on the Trazodone page.
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