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Some forms of erythromycin are most effective when taken on an empty stomach. Your doctor may advise you to take each dose at least 1/2 hour and preferably 2 hours before meals. Delayed release formulations may be taken with or without food. If the drug upsets your stomach, taking it with meals may help. Ask your doctor whether this is advisable for you.

Chewable forms of erythromycin should be crushed or chewed before being swallowed.

Delayed-release brands and tablets and capsules that are coated to slow their breakdown should be swallowed whole. Do not crush or break. If you are not sure about the form of erythromycin you are taking, ask your pharmacist.

The liquid should be shaken well before each use.

If you miss an Erythromycin dose: Take it as soon as you remember. If it is almost time for your next dose, and you take 2 doses a day, space the missed dose and the next dose 5 to 6 hours apart; if you take 3 or more doses a day, space the missed dose and the next one 2 to 4 hours apart. Never take 2 doses at the same time.

Dosage instructions are determined by the type (and severity) of infection being treated and may vary slightly for different brands of erythromycin.

Adults

Streptococcal Infections: The usual dose of erythromycin is 333 milligrams every 8 hours, or 500 milligrams every 12 hours. Depending on the severity of the infection, the dose may be increased to a total of 4 grams a day. However, when the daily dosage is larger than 1 gram, twice-a-day doses are not recommended, and the drug should be taken more often in smaller doses.

To treat streptococcal infections of the upper respiratory tract (tonsillitis or strep throat), erythromycin should be taken for at least 10 days.

To prevent repeated infections in people who have had rheumatic fever, the usual dose of erythromycin is 250 milligrams twice a day.

Urinary Tract Infections Due to Chlamydia Trachomatis During Pregnancy: The usual dosage is 500 milligrams of erythromycin orally 4 times a day or 666 milligrams every 8 hours on an empty stomach for at least 7 days. For women who cannot tolerate this regimen, a decreased dose of 500 milligrams every 12 hours or 333 milligrams every 8 hours a day should be used for at least 14 days.

For Those with Uncomplicated Urinary, Reproductive Tract, or Rectal Infections Caused by Chlamydia Trachomatis When Tetracycline Cannot Be Taken

The usual oral dosage is 500 milligrams of erythromycin 4 times a day or 666 milligrams every 8 hours for at least 7 days.

For Those with Nongonococcal Urethral Infections When Tetracycline Cannot Be Taken

The usual dosage is 500 milligrams of erythromycin by mouth 4 times a day or 666 milligrams orally every 8 hours for at least 7 days.

Acute Pelvic Inflammatory Disease Caused by Neisseria Gonorrhoeae: The usual treatment is three days of intravenous erythromycin followed by 500 milligrams orally every 12 hours or 333 milligrams orally every 8 hours for 7 days.

Syphilis: The usual dose of Erythromycin is 30 to 40 grams divided into smaller doses over a period of 10 to 15 days.

Intestinal Infections: The usual dose of Erythromycin is 500 milligrams every 12 hours, or 333 milligrams every 8 hours, for 10 to 14 days.

Legionnaires' Disease: The usual dose of Erythromycin ranges from 1 to 4 grams daily, divided into smaller doses.

Children: Age, weight, and severity of the infection determine the correct dosage.

The usual dose of Erythromycin is from 30 to 50 milligrams daily for each 2.2 pounds of body weight, divided into equal doses for 10 to 14 days. For pneumonia in infants due to chlamydia, treatment lasts at least 3 weeks.

For more severe infections: The dosage may be doubled, but it should not exceed 4 grams per day.

Children weighing over 44 pounds should follow the recommended adult dose schedule.

For prevention of bacterial endocarditis: The dose for children is 10 milligrams per 2.2 pounds of body weight 2 hours before dental work or surgery, followed by 5 milligrams per 2.2 pounds 6 hours later.

Erythromycin Overdose: Erythromycin taken in excess can have serious consequences. If you suspect an overdose, seek medical help immediately.

Symptoms of erythromycin overdose may include: Diarrhea, nausea, stomach cramps, vomiting.

Erythromycin Storage instructions: The liquid form of erythromycin should be kept in the refrigerator; use E.E.S. within 10 days. Do not freeze. Store tablets and capsules at room temperature in a tightly closed container.

Erythromycin Preparations: Tablets: usually 250 mg and 500 mg. Liquid, capsules, and topical solutions also available.

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Combining Erythromycin with lovastatin (Mevacor) can cause severe muscle wasting and damage to the kidneys. If you are taking both of these drugs, your doctor will monitor you closely for warning signs of Erythromycin.

If Erythromycin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Erythromycin with the following:

• Benzodiazepines such as Halcion and Versed,
• Blood-thinning drugs such as Coumadin,
• Bromocriptine (Parlodel),
• Carbamazepine (Tegretol),
• Cyclosporine (Sandimmune, Neoral),
• Digoxin (Lanoxin),
• Dihydroergotamine (D.H.E. 45),
• Disopyramide (Norpace),
• Ergotamine (Cafergot),
• Hexobarbital,
• Seizure medications such as Depakene, Depakote, and Dilantin,
• Tacrolimus (Prograf),
• Theophylline (Theo-Dur).

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