Erythromycin: caution required due to cardiac risks (QT interval prolongation); drug interaction with rivaroxaban

Erythromycin should not be given to patients with a history of QT interval prolongation or ventricular cardiac arrhythmia. A potential drug interaction between rivaroxaban and erythromycin resulting in increased risk of bleeding has also been identified.

SPS commentary:

Following a European review of safety data, the product information for erythromycin will be updated in line with that for clarithromycin to include warnings regarding the risk of QT interval prolongation and fatal arrhythmia, and a new contraindication for those with risk factors for QT interval prolongation and arrhythmia will be added.

 

The review also concluded that rivaroxaban should be included as an example of a potential interaction between erythromycin and oral anticoagulants in the product information since this interaction could lead to increased risk of bleeding. This interaction is already identified in the Xarelto® product information.

Medicines and Healthcare products Regulatory Agency