Erythromycin-induced drug interactions. An illustrative case and review of the literature.
The authors report a case of erythromycin-induced carbamazepine toxicity in a 6-year-old child following use of erythromycin ethylsuccinate (50 mg/kg/day). Within 5 days of erythromycin use, vomiting, weakness, lethargy, ataxia, nystagmus, and cogwheeling movements developed. A serum carbamazepine concentration had increased from 11.9 mg/L (measured 1 week prior to antibiotic use) to 25.8 mg/L. Following erythromycin withdrawal, serum concentrations returned toward baseline, and symptoms resolved. Erythromycin has known effects on hepatic enzyme function, with altered cytochrome P-450 function. The dramatic reduction in carbamazepine clearance observed in this patient is similar to that reported when erythromycin is used concurrently with other drugs. A brief review of potentially significant erythromycin drug interactions is presented.
D002220:Carbamazepine / Q000097:blood / Q000506:poisoning*; D002648:Child; D003524:Cyclosporins / Q000378:metabolism; D004077:Digoxin / Q000378:metabolism; D004347:Drug Interactions; D004917:Erythromycin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008657:Metabolic Clearance Rate / Q000187:drug effects; D013806:Theophylline / Q000378:metabolism; D014859:Warfarin / Q000378:metabolism
D003524:Cyclosporins; D002220:Carbamazepine; D014859:Warfarin; D004917:Erythromycin; D004077:Digoxin; D013806:Theophylline