Drug products: Abboticin Amdipharm, Abboticin®, Abboticin® Novum, Ery 500 mg, Ery-Max®, Erythromycin Ebb, Erythromycin Panpharma
ATC code: J01FA01
Substances: erythromycin, erythromycin acistrate, erythromycin estolate, erythromycin ethyl carbonate, erythromycin ethylsuccinate, erythromycin gluceptate, erythromycin lactobionate, erythromycin propionate, erythromycin stearate, erythromycin stinoprate, erythromycin thiocyanate
Erythromycin is associated with QT-prolongation on ECG and thus a risk of potentially fatal arrhythmias of the type Torsade de pointes ventricular tachycardia. No difference in risk between men and women has been shown for clarithromycin but a known risk factor for Torsade de Pointes is female sex.
In our opinion, the described differences do not motivate differentiated dosing or treatment in men and women.
Erythromycin pharmacokinetics was examined after a single dose intravenous administration to healthy volunteers (12 men, 12 women; age 17-23 years). A small sex difference was found in total body clearance adjusted per kilogram bodyweight. The serum concentration-time profiles of erythromycin in men and women were not sufficiently different over the 7h to warrant dosage adjustment . No sex differentiation in dosing has been recommended by the manufacturer .
During pregnancy, erythromycin blood concentration is decreased, due to increased volume of distribution and enhanced metabolism [2, 3].
A study showed that a four-day treatment with erythromycin 500 mg twice daily against chlamydia trachomatis infection was not better than seven-day treatment and the results were similar in men and women .
Erythromycin has been associated with prolonged QT-interval and a risk of Torsades de pointes ventricular tachycardia [4, 6-8]. Among the known risk factors of drug-induced ventricular arrhythmias are female sex, hypokalemia, bradycardia, and base line QT-prolongation .
Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).
A study found no association between occurrence of erythromycin resistance and the patient’s sex .
Date of litterature search: 2015-12-10
Reviewed by: Mia von Euler
Approved by: Karin Schenck-Gustafsson