Drug interactions
Erythromycin stearate + Methadone
Severity: Major
Erythromycin stearate and Methadone: 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
Oral erythromycin can raise methadone exposure by inhibiting its metabolism. This may produce excess sedation, respiratory depression and QT prolongation. Erythromycin also prolongs the QT interval on its own.
What this interaction means in plain words
Erythromycin stearate and Methadone 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.
Why it happens
Erythromycin inhibits CYP3A4, reducing methadone clearance, and both drugs have additive QT-prolonging effects.
What to do
Choose an alternative antibiotic such as one without CYP3A4 inhibition when possible. If combined, monitor for opioid toxicity, check an ECG and electrolytes, and lower the methadone dose if signs of excess effect appear.
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 Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone Contraindicated
Frequently asked questions
Can I take Erythromycin stearate with Methadone?
MediHelp rates the interaction as major. Erythromycin stearate and Methadone 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. Oral erythromycin can raise methadone exposure by inhibiting its metabolism. This may produce excess sedation, respiratory depression and QT prolongation. Erythromycin also prolongs the QT interval on its own.
How serious is the interaction between Erythromycin stearate and Methadone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Choose an alternative antibiotic such as one without CYP3A4 inhibition when possible. If combined, monitor for opioid toxicity, check an ECG and electrolytes, and lower the methadone dose if signs of excess effect appear.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.
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