Erythrodar and other macrolides inhibit bacterial protein synthesis and are bacteriostatic. Macrolides are primarily applied in the treatment of infections with Gram-positive germs, but are also effective against Haemophilus influenzae and intracellular pathogens such as chlamydia. Macrolides offer an alternative for patients with penicillin allergy.
Erythrodar is the oldest medication of this group. Its resorption can be delayed in the third trimester. Gastrointestinal side effects can lead to lower than therapeutic plasma concentrations, resulting in treatment failure ( Larsen 1998 ). Only 5–20% of the maternal Erythrodar concentration is obtained in the fetus. Therefore, Erythrodar is not a sufficiently reliable drug for fetal or amniotic infections.
The newer macrolide antibiotics azithromycin, clarithromycin, dirithromycin, josamycin, midecamycin, roxithromycin and troleandomycin have a similar antibacterial spectrum as Erythrodar, but to some degree less gastrointestinal side effects. Spiramycin is used for toxoplasmosis in the first trimester.
Telithromycin is the first ketolide antibiotic for clinical use. It is structurally related to Erythrodar.
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to Erythrodar.
What should I avoid while using Erythrodar?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor before using anti-diarrhea medicine.
How does Erythrodar work in skin diseases?
- Erythrodar has bacteriostatic effects and prevents the proliferation of bacteria.
- It inhibits pro- inflammatory cytokines such as IL-8 and decreases neutrophil oxidative bursts.
What is Erythrodar, and how does it work (mechanism of action)?
Erythrodar is an antibiotic in the class of antibiotics known as macrolide antibiotics which also includes azithromycin (Zithromax, Zmax) and clarithromycin (Biaxin).
Erythrodar, like all macrolide antibiotics, prevents bacterial cells from growing and multiplying by interfering with their ability to make proteins while not affecting human cells. Bacteria such as Haemophilus influenzae are resistant to Erythrodar alone and must be treated with a combination of Erythrodar and adequate doses of sulfonamides.
The FDA approved E.E.S in April 1965.
7. Pregnancy and breastfeeding
It's usually safe to take Erythrodar during pregnancy and while breastfeeding.
For more information about how Erythrodar can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website.
Before taking Erythrodar,
- tell your doctor and pharmacist if you are allergic to Erythrodar, any other medications, or any of the ingredients in Erythrodar capsules, tablets, or suspension. Ask your pharmacist or check the manufacturer's patient information for a list of the ingredients.
- tell your doctor if you are taking astemizole (Hismanal) (not available in the U.S.), cisapride (Propulsid) (not available in the U.S.), dihydroergotamine (DHE 45, Migranal), ergotamine (Ergomar, in Cafergot, in Migergot), pimozide (Orap), or terfenadine (Seldane) (not available in the U.S.). Your doctor will probably tell you not to take Erythrodar if you are taking one or more of these medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: alprazolam (Xanax), amlodipine (Norvasc, in Caduet, in Lotrel), anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven), bromocriptine (Cycloset), carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), cilostazol (Pletal), colchicine (Colcrys, Mitigare), cyclosporine (Neoral, Sandimmune), digoxin (Lanoxin), diltiazem (Cardizem, Cartia, Diltzac, Tiazac), disopyramide (Norpace), dofetilide (Tikosyn), lovastatin (Altoprev), midazolam, phenytoin (Dilantin, Phenytek), procainamide (Procanbid), quinidine, sildenafil (Revatio, Viagra), simvastatin (Zocor, in Vytorin), sotalol (Betapace), valproic acid (Depakene, Depakote), verapamil (Calan, Covera, in Tarka, Verelan). theophylline (Elixophyllin, Theochron, Theo-Dur), and triazolam (Halcion). Many other medications may also interact with Erythrodar, so tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had prolonged QT interval (a rare heart problem that may cause fainting or irregular heartbeat), an irregular heartbeat, low levels of magnesium or potassium in your blood, or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking Erythrodar, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Erythrodar.
Erythrodar is an oral macrolide antibiotic that has been in common use since the 1950s. Erythrodar has been linked to rare instances of acute liver injury that are usually self-limited, but can result in severe injury and death.
6. How to cope with s >
What to do about:
- feeling sick (nausea) - stick to simple meals and do not eat rich or spicy food while you're taking this medicine. It might help to take your Erythrodar with a meal or snack.
- being sick (vomiting) and diarrhoea - drink lots of fluids, such as water or squash - take small, frequent sips if you feel sick to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines without speaking to a pharmacist or doctor.
- stomach cramps - try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or doctor.
- loss of appetite - eat when you would usually expect to be hungry. If it helps, eat smaller meals more often than usual. Snack when you're hungry.
- bloating and indigestion - try not to eat foods that cause wind (like lentils, peas, beans and onions). Eat smaller meals, eat and drink slowly, and exercise regularly. Pharmacy medicines like simethicone can also help.
Serious Side Effects of Erythrodar
- Severe inflammation of the colon caused by antibiotic use (pseudomembranous colitis)
- Inflammation of the liver
- Confusion or hallucinations
- Kidney inflammation or infection
- Abdominal pain
If you have diarrhea, gas, or begin vomiting, stop taking Erythrodar immediately and call your doctor.
Erythrodar Base Filmtab tablets (Erythrodar tablets, USP) are supplied as pink, unscored oval tablets in the following strengths and packages.
250 mg tablets (debossed with and EB):
Bottles of 100. (NDC 0074-6326-13); Bottles of 500. (NDC 0074-6326-53); ABBO-PAC® unit dose strip packages of 100 tablets . (NDC 0074-6326-11).
500 mg tablets (debossed with and EA):
Bottles of 100. (NDC 0074-6227-13).
Recommended Storage: Store below 86°F (30°C). Keep tightly closed.
Abbott Laboratories, North Chicago, IL 60064, USA. Revised: November, 2004. FDA Rev date: 12/1/1998
3. Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, the American Heart Association: Prevention of Rheumatic Fever. Circulation. 78(4):1082-1086, October 1988.
5. Data on file, Abbott Laboratories.
How should this medicine be used?
Erythrodar comes as a capsule, tablet, delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) capsule, delayed-release tablet, and an oral suspension (liquid) to take by mouth. It usually is taken with or without food every 6 hours (four times a day), every 8 hours (three times a day), or every 12 hours (twice a day). Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Erythrodar exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Shake the suspension well before each use to mix the medication evenly.
If you are taking the suspension, do not use a household spoon to measure your dose. Use the measuring spoon, dropper, or cup that came with the medication or use a spoon made especially for measuring medication.
Swallow the capsules and tablets whole with a full glass of water; do not chew or crush them.
Continue to take Erythrodar even if you feel well. Do not stop taking Erythrodar without talking to your doctor.
Erythrodar (e rith" roe mye' sin) is a semisynthetic macrolide antibiotic used widely for many decades to treat mild-to-moderate bacterial infections caused by sensitive agents. Erythrodar is bacteriostatic against many gram positive bacteria including many strains of streptococci, staphylococci, clostridia, corynebacteria, listeria, haemophilus sp., moxicella, and Neisseria meningitidis. Modifications of Erythrodar have been developed with a wider range of activity and less likelihood for resistance (azithromycin, clarithromycin, telithromycin). The macrolide antibiotics are believed to act by inhibiting protein synthesis of bacteria by binding to the 50S ribosomal element. Resistance occurs by several mechanisms. Erythrodar was approved for use in the United States in 1967, and currently more than 1.5 million prescriptions are filled yearly. Specific indications include mild-to-moderate upper or lower respiratory tract infections, urethritis, pelvic inflammatory disease, urogenital chlamydia infections, Legionnaires’ disease, and intestinal amebiasis. Erythrodar is commonly used as a second-line agent when penicillin, tetracyclines or metronidazole are contraindicated. Erythrodar is available in multiple formulations (estolate, ethylsuccinate, lactobionate, stearate) in many generic and brand name forms in capsules or tablets of 250 or 500 mg including enteric coated and delayed release forms. The usual adult dose is 1 to 4 grams daily in divided doses for 7 to 21 days, depending upon the type, nature and severity of the infection. Gastrointestinal side effects (abdominal pain, nausea, and diarrhea) are common, but are rarely severe.
Common Side Effects of Erythrodar
The most frequent side effects of oral Erythrodar preparations are gastrointestinal and are dose-related. They include nausea, vomiting, abdominal pain, diarrhea and anorexia. Symptoms of hepatitis, hepatic dysfunction and/or abnormal liver function test results may occur. (See WARNINGS.)
Onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment. (See WARNINGS.) Erythrodar has been associated with QT prolongation and ventricular arrhythmias, including ventricular tachycardia and torsades de pointes.
Allergic reactions ranging from urticaria to anaphylaxis have occurred. Skin reactions ranging from mild eruptions to erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis have been reported rarely.
There have been rare reports of pancreatitis and convulsions.
There have been isolated reports of reversible hearing loss occurring chiefly in patients with renal insufficiency and in patients receiving high doses of Erythrodar.