ERYKO (Erythromycin Stearate Tablets)

ERYKO (Erythromycin Stearate Tablets) is a medication that belongs to the macrolide antibiotic class, commonly used for the treatment of bacterial infections such as respiratory tract infections, skin infections, and sexually transmitted infections. The active ingredient in ERYKO, erythromycin stearate, works by stopping the growth of bacteria, thereby preventing the infection from spreading further. ERYKO is available in tablet form and is usually taken orally. It is important to follow the dosage instructions carefully and complete the full course of treatment as prescribed by a healthcare professional to ensure that the infection is completely eradicated. ERYKO may cause side effects such as stomach upset, diarrhea, and nausea

Erythromycin exerts its antimicrobial action by binding to the 50s ribosomal sub-unit of susceptible microorganisms and suppresses protein synthesis. Erythromycin may be either bacteriostatic or bactericidal depending upon its serum concentration and the susceptibility of the micro-organism. The in-vitro antibacterial spectrum of pathogens usually sensitive to erythromycin is as follows

Gram-positive aerobes: Listeria monocytogenes, Corynebacterium diphtheria (as an adjunct to antitoxin), Staphylococci spp, Streptococci spp (including Enterococci).

Gram-negative aerobes: Haemophilius influenza, Neisseria meningitis, Neisseria gonorrhoeae, Legionella pneumophilia, Moraxella (Branhamella) catarrhalis, Bordetella pertusis, Campylobacter spp.

Mycoplasma: Mycoplasma pneumonia, Ureaplasma urealyticum.

Other organisms: Treponema pallidum, Chlamydia spp, Clostridia spp, L-forms, the agents causing trachoma and Lymphogranuloma venereum.

Indications

ERYKO Tablets are indicated in treatment of susceptible infections in patients:

• Oral infections
• Respiratory tract infections (including legionnaire’s disease)
• Whooping cough
• Campylobacter enteritis
• Syphilis
• Non-gonococcal urethritis
• Skin infections
• Chronic prostatitis
• Prophylaxis of diphtheria
• Group A streptococcal infections
• Acne vulgaris and rosacea.

Dosage

Adult and Children over 8 years: 250-500mg every 6 hours or 0.5-1g every 12 hours up to 4g daily in divided doses in severe infections.

Early syphilis: 500mg 4 times daily for 14 days

Uncomplicated genital Chlamydia, non-gonococcal urethritis: 500mg twice daily for 14 days

Lyme disease: 500mg 4 times daily for 14-21 days

Renal impairment: Max. 1.5g daily.

ERYKO Tablets should be taken orally with a glass of water

Contraindications

Known hypersensitivity to erythromycin or any other macrolides. Use is contraindicated in acute porphyria.

Side effects

Common: Nausea, vomiting, diarrhea and abdominal discomfort.

Less common: Hepatotoxicity (including cholestatic jaundice) and rash.

Drug interactions

Erythromycin increases plasma concentration of alfentanil, disopyramide, dronedarone. Concurrent administration with erythromycin should be avoided due to increased risk of toxicity and side-effects. Erythromycin enhances plasma concentration of carbamazepine, loratadine, rupatadine, darifenacin, clozapine, quetiapine, buspirone, zopiclone, digoxin, cilostazole, everolimus, eplerenone, eletriptan, pravastatin, galantamine, sildenafil, sirolimus, tacrolimus, tadalafil, theophylline, vardenafil. Concomitant use should be avoided.

Erythromycin inhibits metabolism of mizolastine, midazolam, felodipine, ciclosporin, corticosteroids, avoid concomitant use.

Plasma concentration of erythromycin increased by cimetidine and ritonavir. Concomitant use should be avoided.

Avoid use of Erythromycin with tolterodine, droperidol, amisulpride, pimozide, lercanidipine, colchicines, nilotinib, docetaxel, vinblastine, bromocriptine, cabergoline, ergotamine,

Erythromycin possibly reducesanti-platelet effect of clopidogrel, increases toxicity of arsenic trioxide, reduces contraceptive effect of oestrogens and enhances anticoagulant effect of coumarins.

Erythromycin reduces plasma concentration of zafirlukast, rosuvastatin while plasma concentration of erythromycin is possibly increased by ritonavir. Dose regimen should be revised or monitored in case of concomitant use.

Precautions and warnings

Erythromycin is excreted principally by the liver, so caution should be exercised in administering the antibiotic to patients with impaired hepatic function or concomitantly receiving potentially hepatotoxic agents.

ERYKO Tablets are not recommended for use in Neonates and Children below 8 years of age.

Pseudomembraneous colitis has been reported with nearly all antibacterial agents, including macrolides and may range in severity from mild to life-threatening. Treatment with antibacterial agents alters the normal flora of the colon, which may lead to overgrowth of C.difficile or other non-susceptible micro-organisms. There have been reports that erythromycin may aggravate the weakness of patients with myasthenia gravis.

Rhabdomyolysis with or without renal impairment has been reported in seriously ill patients receiving erythromycin concomitantly with statins.

Pregnancy and lactation

Erythromycin is reported to cross placenta barrier in humans as well as it is excreted in breast milk. Although Erythromycin is reported not to be harmful in pregnant and nursing mothers, caution should be exercised when erythromycin is administered to nursing and pregnant mothers.

Overdose

Symptoms: Hearing loss, severe nausea, vomiting and diarrhea.

Treatment: Gastric lavage, general supportive measures.