Drug interactions
Erythromycin stearate + Zonisamide
Severity: Moderate
Erythromycin stearate and Zonisamide: moderate interaction.
Last updated
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 inhibits CYP3A4, which contributes to zonisamide clearance, so zonisamide levels may rise. This can increase drowsiness, dizziness and other dose-related adverse effects.
What this interaction means in plain words
Erythromycin stearate and Zonisamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Inhibition of CYP3A4-mediated zonisamide metabolism by erythromycin.
What to do
Monitor for zonisamide toxicity during the antibiotic course and consider dose reduction if symptoms appear. Alternatively choose a non-inhibiting antibiotic such as azithromycin.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide Moderate
Frequently asked questions
Can I take Erythromycin stearate with Zonisamide?
MediHelp rates the interaction as moderate. Erythromycin stearate and Zonisamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Erythromycin inhibits CYP3A4, which contributes to zonisamide clearance, so zonisamide levels may rise. This can increase drowsiness, dizziness and other dose-related adverse effects.
How serious is the interaction between Erythromycin stearate and Zonisamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for zonisamide toxicity during the antibiotic course and consider dose reduction if symptoms appear. Alternatively choose a non-inhibiting antibiotic such as azithromycin.
What other medicines interact with Zonisamide?
MediHelp also lists interactions of Zonisamide with, for example, Zuranolone, Acetazolamide, Amisulpride. The full list is on the Zonisamide page.
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