Erythromycin often (in 5 to 30% of the cases) causes gastrointestinal pain (nausea, vomiting, gastric pain, abdominal cramps). High single doses are not suitable; children experience adverse reactions more frequently. There seem to be hepatotoxic reactions with all erythromycin preparations, but they are reversible after the discontinuation of the drug. The transaminases increase in about 10%; jaundice appears in only 1 of 1000 treated subjects. Ototoxic effects are also infrequent and reversible (hearing loss, ringing in the ear). Other rare side-effects include skin reactions, nephritis, fever and eosinophilia, pancreatitis, colitis and myasthenia.

Erythromycin: Interactions

Erythromycin and other macrolides are enzyme inhibitors and can increase the effect of oral anticoagulants and the toxicity of carbamazepine and theophylline amongst others. There is a risk of dangerous arrhythmias when the drug is used in combination with astemizol and terfenadine! The risks associated to digoxin and ergot derivatives are also increased.

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