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Erythromycin and Eplerenone Interaction

Drug interaction information between Erythromycin and Eplerenone.

Erythromycin and Eplerenone have a documented major interaction in FDA labeling.

FDA drug labeling documents a major-severity interaction between Erythromycin and Eplerenone. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.

Drug A

Erythromycin

Macrolide Antibiotic

Drug B

Eplerenone

Aldosterone Antagonist

How They Interact

Erythromycin blocks the proteins that break down eplerenone, leading to more of the drug staying in your body.

What To Do

If you are taking erythromycin, your daily dose of eplerenone should not exceed 25 mg.

FDA Label Information

7 DRUG INTERACTIONS • CYP3A Inhibitors: In post-MI HFrEF patients, do not exceed 25 mg once daily when used with moderate CYP3A inhibitors (e.g., verapamil, erythromycin, saquinavir, fluconazole).

Frequently Asked Questions

Can I take Erythromycin and Eplerenone together?

This is a major interaction. If you are taking erythromycin, your daily dose of eplerenone should not exceed 25 mg.

How serious is the interaction between Erythromycin and Eplerenone?

This interaction is classified as "major" severity by the FDA. Major interactions may be life-threatening or cause serious side effects.

Why do Erythromycin and Eplerenone interact?

Erythromycin blocks the proteins that break down eplerenone, leading to more of the drug staying in your body.

Understanding the Erythromycin and Eplerenone Interaction

FDA-approved prescribing information for these two drugs flags their combination as a major-severity interaction. Erythromycin belongs to the Macrolide Antibiotic class and Eplerenone belongs to the Aldosterone Antagonist class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Erythromycin blocks the proteins that break down eplerenone, leading to more of the drug staying in your body. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.

Context around a specific patient determines real-world impact. Erythromycin has 63 total documented interactions on file in this dataset, and Eplerenone has 12. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: If you are taking erythromycin, your daily dose of eplerenone should not exceed 25 mg. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.

An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Erythromycin or Eplerenone based on a web page, speak with your prescriber or pharmacist before making any change.

Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.