What happens if I overdose Erythromycin Bidiphar?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local, or emergency room immediately. Erythromycin Bidiphar solution may be harmful if swallowed.
Proper storage of Erythromycin Bidiphar solution:
Store Erythromycin Bidiphar solution at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), in a tightly-closed container. Store away from heat and light. Keep Erythromycin Bidiphar solution out of the reach of children and away from pets.
Overdose of Erythromycin Bidiphar in details
In case of overdosage, Erythromycin Bidiphar should be discontinued. Overdosage should be handled with the prompt elimination of unabsorbed drug and all other appropriate measures should be instituted.
Erythromycin Bidiphar is not removed by peritoneal dialysis or hemodialysis.
What should I avoid while taking Erythromycin Bidiphar?
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking Erythromycin Bidiphar and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Erythromycin Bidiphar warnings
There have been reports of hepatic dysfunction, including increased liver enzymes, and hepatocellular and/or cholestatic hepatitis, with or without jaundice, occurring in patients receiving oral Erythromycin Bidiphar products.
There have been reports suggesting that Erythromycin Bidiphar does not reach the fetus in adequate concentration to prevent congenital syphilis. Infants born to women treated during pregnancy with oral Erythromycin Bidiphar for early syphilis should be treated with an appropriate penicillin regimen.
Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including E.E.S. (Erythromycin Bidiphar ethylsuccinate), and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.
C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessa (Erythromycin Bidiphar ethylsuccinate) ry since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
Rhabdomyolysis with or without renal impairment has been reported in seriously ill patients receiving Erythromycin Bidiphar concomitantly with lovastatin. Therefore, patients receiving concomitant lovastatin and Erythromycin Bidiphar should be carefully monitored for creatine kinase (CK) and serum transaminase levels. (Erythromycin Bidiphar ethylsuccinate)
What should I discuss with my healthcare provider before taking Erythromycin Bidiphar?
Some medical conditions may interact with Erythromycin Bidiphar Filmtabs. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have diarrhea
- if you have a history of kidney or liver disease; heart problems; a fast, slow, or irregular heartbeat; low blood potassium or magnesium levels; myasthenia gravis; or the blood disease porphyria
- if you take any medicine that may increase the risk of a certain type of irregular heartbeat (prolonged QT interval). Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat
Some MEDICINES MAY INTERACT with Erythromycin Bidiphar Filmtabs. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Many prescription and nonprescription medicines (eg, used for aches and pains, allergies, blood thinning, breathing problems, cancer, diabetes, erection problems, gout, irregular heartbeat or other heart problems, hepatitis C infection, high blood calcium levels, high blood pressure, high cholesterol, HIV infection, inflammation, infections, low blood sodium levels, migraine, mood or mental problems, nausea and vomiting, overactive bladder, Parkinson disease, prevention of organ transplant rejection, seizures, stomach problems, trouble sleeping), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John's wort) may also interact with Erythromycin Bidiphar Filmtabs. Ask your doctor or pharmacist if you are unsure if any of your medicines might interfere with Erythromycin Bidiphar Filmtabs
This may not be a complete list of all interactions that may occur. Ask your health care provider if Erythromycin Bidiphar Filmtabs may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Erythromycin Bidiphar precautions
General: Prescribing Erythromycin Bidiphar Base Filmtab (Erythromycin Bidiphar tablets) tablets in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Since Erythromycin Bidiphar is principally excreted by the liver, caution should be exercised when Erythromycin Bidiphar is administered to patients with impaired hepatic function.
There have been reports that Erythromycin Bidiphar may aggravate the weakness of patients with myasthenia gravis.
There have been reports of infantile hypertrophic pyloric stenosis (IHPS) occurring in infants following Erythromycin Bidiphar therapy. In one cohort of 157 newborns who were given Erythromycin Bidiphar for pertussis prophylaxis, seven neonates (5%) developed symptoms of non-bilious vomiting or irritability with feeding and were subsequently diagnosed as having IHPS requiring surgical pyloromyotomy. A possible dose-response effect was described with an absolute risk of IHPS of 5.1% for infants who took Erythromycin Bidiphar for 8-14 days and 10% for infants who took Erythromycin Bidiphar for 15-21 days. Since Erythromycin Bidiphar may be used in the treatment of conditions in infants which are associated with significant mortality or morbidity (such as pertussis or neonatal Chlamydia trachomatis infections), the benefit of Erythromycin Bidiphar therapy needs to be weighed against the potential risk of developing IHPS. Parents should be informed to contact their physician if vomiting or irritability with feeding occurs.
Prolonged or repeated use of Erythromycin Bidiphar may result in an overgrowth of nonsusceptible bacteria or fungi. If superinfection occurs, Erythromycin Bidiphar should be discontinued and appropriate therapy instituted.
When indicated, incision and drainage or other surgical procedures should be performed in conjunction with antibiotic therapy.
Carcinogenesis, Mutagenesis, Impairment of Fertility: Long-term (2-year) oral studies conducted in rats with Erythromycin Bidiphar base did not provide evidence of tumorigenicity. Mutagenicity studies have not been conducted. There was no apparent effect on male or female fertility in rats fed Erythromycin Bidiphar (base) at levels up to 0.25 percent of diet.
Pregnancy: Teratogenic effects. Pregnancy Category B: There is no evidence of teratogenicity or any other adverse effect on reproduction in female rats fed Erythromycin Bidiphar base (up to 0.25 percent of diet) prior to and during mating, during gestation, and through weaning of two successive litters. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Labor and Delivery: The effect of Erythromycin Bidiphar on labor and delivery is unknown.
Nursing Mothers: Erythromycin Bidiphar is excreted in human milk. Caution should be exercised when Erythromycin Bidiphar is administered to a nursing woman.
Pediatric Use: See INDICATIONS and DOSAGE AND ADMINISTRATION.
REFERENCES
4. Honein, M.A., et. al.: Infantile hypertrophic pyloric stenosis after pertussis prophylaxis with Erythromycin Bidiphar: a case review and cohort study. The Lancet 1999; 354 (9196): 2101-5.
What happens if I miss a dose of Erythromycin Bidiphar?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
References
- DailyMed. "ERYTHROMYCIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DrugBank. "erythromycin". http://www.drugbank.ca/drugs/DB00199 (accessed September 17, 2018).
- MeSH. "Protein Synthesis Inhibitors". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
