Erythromycin

Topical Antibiotic

Erythromycin is available as a prescription topical treatment. It is available in gel, ointment, solution, and pad forms.

  • Available forms:

    • Topical treatment: 

      • Gel / Jelly:
        • Brand names (US):
          • Erygel®
            Generic available (US)
      • Ointment:
        • Generic available (US)
      • Solution:
        • Generic available (US)
      • Pads:
        • Brand names (US):
          • Ery®
            Generic available
  • Available in these doses:

    • Gel / Jelly: 2% 
    • Ointment: 2%
    • Solution: 2%
    • Pads: 2%

Dosing information:

Erythromycin is usually applied twice a day however the gel is sometimes applied once a day.

  • Who is it for? 

    • Gender:
      • Males and females
    • Severity of acne:
      • Moderate-to-severe
    • Age:
      • Children of 12 years and older, adolescents, and adults

How to use it:

Erythromycin is a topical treatment and is available as a gel or jelly, ointment, solution, or pad.

Most forms of erythromycin are applied twice a day, once in the morning and once in the evening, except for the gel, which is sometimes applied once a day. 

Continue applying the medication even if you do not see a lot of improvement at the beginning because it may take up to 6 to 8 weeks to see the full effect of this medication. Increasing the dose or frequency will not make the medication work faster. Check with your physician if there is no effect on your acne after 6 to 8 weeks of use or if your acne becomes worse.

Do not get erythromycin in your eyes, nose, or mouth. If it does get into your eyes, wash your eyes with a generous amount of water and seek medical attention immediately if there is any irritation. 

Erythromycin should not only be applied to intact skin. If erythromycin gets into a cut or scrape, rinse it off with water. 

Erythromycin should not be used alone. It should be used in along with other therapies due to the risk of bacterial resistance if used alone. For mild acne, erythromycin should be used with benzoyl peroxide. For moderate-to-severe acne, erythromycin should be used with a topical retinoid (tretinoin, adapalene, or tazarotene) or an oral antibiotic.

Follow the instructions on your prescription carefully and use erythromycin exactly as prescribed by your physician. Do not change the dose or the frequency of your medication. Increasing the dose or frequency may cause skin irritation. Do not use the medication after the expiration date because the medication may not work properly anymore. If you have any questions about the medication or the prescription, ask your physician or pharmacist. 

  • Gel / Jelly, Ointment, and Solution:
    • Wash your hands with soap and water before using the medication.
    • Before applying erythromycin gel / jelly, wash the acne-affected skin with water and a mild cleanser. Pat the skin dry with a soft towel. 
    • Apply a pea-sized amount of gel / jelly and spread evenly on the acne-affected skin leaving a thin film of gel / jelly, ointment, or solution.
    • Wash your hands after application of the medication.
  • Pad:
    • Wash your hands with soap and water before using the medication.
    • Before using erythromycin pad, wash the acne-affected skin with water and a mild cleanser. Pat the skin dry with a soft towel. 
    • Rub the pad gently over the acne-affected areas of the skin.
    • Wash your hands after application of the medication.

Be aware of: 

  • Before using erythromycin, let your physician or pharmacist know if you are allergic to erythromycin, or any of the other ingredients in the medication. 
  • Before using erythromycin, inform your physician about the prescription and non-prescription medications, vitamins, nutritional supplements, and herbal products you are using/taking. You will find a complete list of drug interactions below.
  • Do not use other topical treatments, including peeling agents, without consulting your physician first because this may cause skin irritation or dryness. 
  • Erythromycin may cause skin irritation, dryness, or peeling.
  • Erythromycin gel / jelly may be flammable so do not mix, apply, or store near an open flame or heat.
  • If you are using erythromycin and are pregnant or are planning on becoming pregnant, talk to your physician about using erythromycin during pregnancy.
  • If you are using erythromycin and are breastfeeding, talk to your physician about using erythromycin during this period.
  • If erythromycin was prescribed for acne, you can continue your regular diet unless your physician advises otherwise.
  • Do not share your medication with anyone else. 
  • Keep your regular appointments with your physician to track your response to erythromycin.

Drug interactions: 

Inform your physician or pharmacist about all the prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take before starting erythromycin. Also inform your physician or pharmacist of the skin products you use including soaps, cleansers, moisturizers, and cosmetics. 

Drugs that are not recommended for use with erythromycin, but may be required to be taken together (dose and dosing regime may need to be adjusted), are:

  • Clindamycin

What if I overdose? 

In case of overdose, contact an emergency facility or call the American Association of Poison Control Centers at 1 (800) 222-1222 (available 24/7).

If immediate assistance is necessary because the victim has collapsed, had a seizure, has trouble breathing, or cannot be awakened, call 911 at once.

Information can also be found online at https://www.poisonhelp.org/help

What if I miss a dose?

As soon as you recall that you have missed a dose, apply the missed dose. However, skip the missed dose if it is almost time for your next dose and continue with your prescribed dosing schedule. Do not increase the quantity or frequency of dosing to make up for the missed dose. 

Storage:

Store your medication in the container that the pharmacist provided and keep it out of reach and out of sight of children. Many containers can be opened by children. Keep the container tightly closed. Always lock safety caps and immediately place the medication in a safe location that is up and away from the sight of young children, to prevent poisoning (www.upandaway.org).

Store the medication at room temperature. Keep the medication away from excessive heat and moisture – do not store in the bathroom. Do not freeze erythromycin.

Disposal:

Do not keep outdated medication and medication that you no longer use. Unneeded medications should be disposed of in a way that pets, children, and other people cannot consume them. Do not flush the medication down the toilet. Contact your pharmacist to learn about the availability of a medicine take-back program in your neighborhood, or get in touch with your local garbage/recycling department to ensure safe disposal. If you do not have access to a take-back program, you can find more information on safe disposal of medication on the FDA website: (https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm)

References
  1. Uptodate.com. (2019). Erythromycin (topical) [online] Available at: https://www-uptodate-com.eresources.mssm.edu/contents/erythromycin-topical-drug-information?search=erythromycin&source=panel_search_result&selectedTitle=1~143&usage_type=panel&display_rank=1. [Accessed 2 February 2019].
  2. Epocrates.com (2019). Erythromycin (topical) [online] Available at: https://online.epocrates.com/drugs/2510/erythromycin-topical/Monograph. [Accessed 2 February 2019].
  3. DailyMed. (2019). Erythromycin (topical). Available at: https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=erythromycin&pagesize=20&page=2&vfile=. [Accessed 2 February 2019].