Drug interactions
Erythromycin lactobionate + Warfarin
Severity: Major
Erythromycin lactobionate and Warfarin: 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
Erythromycin can raise the anticoagulant effect of warfarin and increase INR, with a higher risk of bleeding. Older patients appear to be especially susceptible.
What this interaction means in plain words
Erythromycin lactobionate and Warfarin 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; Warfarin belongs to Cardiovascular.
Why it happens
Erythromycin inhibits CYP3A4 (and possibly other CYPs), reducing warfarin clearance.
What to do
Check INR within a few days of starting or stopping erythromycin and adjust the warfarin dose as needed. Consider a non-interacting antibiotic if feasible.
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 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
Other interactions of Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Frequently asked questions
Can I take Erythromycin lactobionate with Warfarin?
MediHelp rates the interaction as major. Erythromycin lactobionate and Warfarin 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 can raise the anticoagulant effect of warfarin and increase INR, with a higher risk of bleeding. Older patients appear to be especially susceptible.
How serious is the interaction between Erythromycin lactobionate and Warfarin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check INR within a few days of starting or stopping erythromycin and adjust the warfarin dose as needed. Consider a non-interacting antibiotic if feasible.
What other medicines interact with Erythromycin lactobionate?
MediHelp also lists interactions of Erythromycin lactobionate with, for example, Cisapride, Dihydroergotamine, Dronedarone. The full list is on the Erythromycin lactobionate page.
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