Erythromycin Ethylsuccinate

About Erythromycin Ethylsuccinate

Erythromycin ethylsuccinate is an ester of erythromycin, a macrolide antibiotic. The labels approve it for respiratory tract and skin infections, whooping cough, diphtheria, some chlamydia infections and others, and for preventing rheumatic fever in people allergic to penicillin. The usual adult dose is 400 mg every 6 hours, up to 4 g a day for severe infections. Children are dosed by weight, usually 30 to 50 mg/kg/day in divided doses every 6 hours, and strep infections are treated for at least 10 days. The label notes that 400 mg of the ethylsuccinate equals 250 mg of erythromycin base or stearate.

There is no boxed warning. It must not be used by anyone allergic to erythromycin or by people taking terfenadine, astemizole, pimozide, cisapride, lovastatin or simvastatin. The warnings cover liver problems, including hepatitis; QT prolongation and dangerous heart rhythms, so it is avoided with a known long QT interval, uncorrected low potassium or magnesium, or Class IA or III antiarrhythmics; and Clostridioides difficile diarrhea, which can appear more than two months after the last dose. It can worsen myasthenia gravis, and infantile hypertrophic pyloric stenosis has been reported in infants (parents report vomiting or feeding irritability). The most frequent side effects are nausea, vomiting, abdominal pain, diarrhea and loss of appetite.

What is distinctive is that storage depends on the product: E.E.S. Granules are refrigerated after mixing and used within 10 days, while EryPed and a generic suspension keep at room temperature for 35 days. It also raises levels of many other medicines. In pregnancy the label warns it may not prevent congenital syphilis, so exposed infants need penicillin treatment; it passes into breast milk. Erythromycin base, stearate and the eye ointment are different products not covered here. It is not a controlled substance.

Taking Erythromycin Ethylsuccinate

How to take it

Take it exactly as prescribed, with or without meals, spacing doses evenly. Ask the pharmacist how to measure liquid doses. Finish the full course even if you feel better sooner.

If you miss a dose

Take the missed dose as soon as you can, but skip it if it is almost time for the next dose. Do not take two doses at once.

Storage

Keep tablets and unmixed powder below 30 degrees C (86 degrees F), out of reach of children. After mixing, follow the bottle label: refrigerate E.E.S. Granules and use within 10 days.

Interactions to know about

Never take it with simvastatin, lovastatin, pimozide, cisapride, ergotamine or dihydroergotamine. It can raise levels of colchicine, theophylline, digoxin, oral blood thinners and others; tell the pharmacist about every medicine.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Erythromycin Ethylsuccinate differs from pharmacy to pharmacy

Quotes depend on the form and strength. The suspensions come as 200 mg per 5 mL (E.E.S. Granules, EryPed 200 and generics) and 400 mg per 5 mL (EryPed 400 and generics), and a quote for one strength is not a quote for the other. The 400 mg tablet comes from few sources, so some pharmacies order it in. A brand prescription with substitution blocked is priced as a brand.

Bottle size also matters: the granules come in 100 mL and 200 mL bottles, and children are dosed by weight, so the volume needed differs. On a short course, the dispensing fee is a noticeable share of the quote.

Ways to pay less for Erythromycin Ethylsuccinate without insurance

• Ask the prescriber to write the generic name with the strength in mg per 5 mL and allow substitution.
• Ask each pharmacy whether it has the exact strength in stock, since 200 mg and 400 mg per 5 mL doses differ in volume.
• For someone who can swallow tablets, ask the prescriber whether the 400 mg tablet would suit.
• Compare more than one pharmacy, and ask whether it is on a flat-price generic list.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Erythromycin Ethylsuccinate

1. 1.Is my bottle 200 mg or 400 mg per 5 mL, and how many mL is my child’s dose?
2. 2.Does my suspension go in the refrigerator, and when do I throw it away?
3. 3.Do any of my other medicines, such as a statin or colchicine, interact with erythromycin?
4. 4.Will this bottle last for my whole course?

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