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Erythromycin
Erythromycin is a macrolide antibiotic used to treat a wide variety of bacterial infections. Several chemical forms of erythromycin are available for oral use to treat infections in the body. Erythromycin-containing products are also available to treat eye and skin infections.
Summary of Interactions with Vitamins, Herbs, & Foods
 May Be Beneficial: Depletion or interference—This medication may deplete these substances from the body or interfere with how they work; extra intake may help replenish them. | Magnesium* Vitamin B12* Vitamin B6* |
| May Be Beneficial: Side effect reduction and/or prevention—These substances may help reduce the likelihood and/or severity of a potential side effect caused by the medication.
| Bifidobacterium longum* Brewer’s Yeast* Lactobacillus acidophilus* Lactobacillus casei* |
| May Be Beneficial: Supportive interaction—These substances may help this medication work better. | Bromelain* |
 Avoid: Reduces drug effectiveness—When taking this medication, avoid these substances as they may decrease the medication's absorption and/or activity in the body. | none |
| Avoid: Adverse interaction—When taking this medication, avoid these substances, as the combination may cause undesirable or dangerous interactions. | none |
 Check: Explanation needed—When taking this medication, read the article details and discuss them with your doctor or pharmacist before taking these substances. | Calcium Folic Acid Saccharomyces boulardii* Vitamin K* |
An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
Also indexed as:
- A/T/S,
- Akne-Mycin,
- E.E.S.-200,
- E.E.S.-400,
- E.E.S.-400 Filmtab,
- EES 200,
- EES 400,
- E-Mycin,
- Eryc,
- Erycette,
- Eryderm,
- Erygel,
- Erymax,
- Eryped,
- EryPed 200,
- EryPed 400,
- Ery-Tab,
- Erythrocin,
- erythromycin,
- erythromycin estolate,
- erythromycin ethylsuccinate,
- erythromycin stearate,
- erythromycins,
- ethylsuccinate,
- Ilosone,
- Ilotycin,
- PCE,
- Theramycin Z,
- T-Stat
About this treatment
Interactions with Vitamins
Probiotics
A common side effect of antibiotics is diarrhea, which may be caused by the elimination of beneficial bacteria normally found in the colon. Yogurt containing Bifidobacterium longum culture has decreased erythromycin-induced diarrhea in a single-blind study of ten healthy people. Yogurt containing live cultures has also protected against other antibiotic-induced diarrhea.
Controlled studies have shown that taking probiotic microorganisms—such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii—helps prevent antibiotic-induced diarrhea.
The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast—such as Saccharomyces boulardii or Saccharomyces cerevisiae (baker’s or brewer’s yeast)—helps prevent recurrence of this infection. In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection. Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.
Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as “dysbiosis”). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.
Bromelain
One report found bromelain improved the action of antibiotic drugs, including penicillin and erythromycin, in treating a variety of infections. In that trial, 22 out of 23 people who had previously not responded to the antibiotics did so after adding bromelain four times per day. Doctors will sometimes prescribe enough bromelain to equal 2,400 gelatin dissolving units (listed as GDU on labels) per day. This amount would equal approximately 3,600 MCU (milk clotting units), another common measure of bromelain activity.
Vitamin K
Several cases of excessive bleeding have been reported in people who take antibiotics. This side effect may be the result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in the colon. One study showed that people who had taken broad-spectrum antibiotics had lower liver concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels remained normal. Several antibiotics appear to exert a strong effect on vitamin K activity, while others may not have any effect. Therefore, one should refer to a specific antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine sometimes recommend vitamin K supplementation to people taking antibiotics. Additional research is needed to determine whether the amount of vitamin K1 found in some multivitamins is sufficient to prevent antibiotic-induced bleeding. Moreover, most multivitamins do not contain vitamin K.
Other vitamins and minerals
Erythromycin may interfere with the absorption and/or activity of calcium, folic acid, magnesium, vitamin B6 and vitamin B12, which may cause problems, especially with long-term erythromycin treatment. Until more is known, it makes sense for people taking erythromycin for longer than two weeks to supplement with a daily multivitamin-multimineral.
Interactions with Herbs
Digitalis (Digitalis lanata, Digitalis purpurea)
Digitalis refers to a family of plants commonly called foxglove that contain digitalis glycosides, chemicals with actions and toxicities similar to the prescription drug digoxin.
Erythromycin can increase the serum level of digitalis glycosides, increasing the therapeutic effects and risk of side effects. Erythromycin and digitalis-containing products should be used only under the direct supervision of a doctor trained in their use.
Interactions with Foods & Other Compounds
Food
Some forms of erythromycin are best absorbed when taken on an empty stomach, one hour before or two hours after food. Individuals who experience stomach upset taking these forms of erythromycin on an empty stomach should use one of the other forms that can be taken with food.
Other forms of erythromycin may be taken with or without food. People taking erythromycin should ask their pharmacist about the form of erythromycin they are taking and compatibility with or without food. Erythromycin is best taken with water, rather than other beverages, to prevent degradation of the drug before it reaches the intestines. Erythromycin tablets should be swallowed whole, without cutting, chewing, or crushing.
Last Review: 05-11-2011
Copyright © 2011 Aisle7. All rights reserved. www.Aisle7.net
Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article. The Aisle7 knowledgebase does not contain every possible interaction.
Learn more about Aisle7, the company.
The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2011.
© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
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