MAJOR — Use With Caution
FDA-documented interaction. Monitor digoxin levels. Consider alternative antibiotics.
Evidence level: STRONG
Erythromycin can increase digoxin levels in your blood through two mechanisms — it reduces how your body eliminates digoxin and kills gut bacteria that normally break down some digoxin.
Erythromycin inhibits P-glycoprotein and eliminates gut flora that inactivate digoxin (Eubacterium lentum), both increasing digoxin levels. FDA labels document this.
Tell your doctor you take digoxin before starting erythromycin. Watch for signs of digoxin toxicity. Get digoxin level checked if symptoms develop.
Follow each medication's specific timing instructions. Erythromycin — check if it requires an empty stomach or should be taken with food. Digoxin follows its normal schedule. Complete the full antibiotic course as prescribed.
Renal impairment, elderly, pre-existing elevated digoxin levels
Nausea, vomiting, loss of appetite, visual disturbances, irregular heartbeat, fatigue
Request digoxin level monitoring. Consider azithromycin as alternative. Report any new heart rhythm symptoms.
Antibiotic interactions are often temporary (duration of treatment). Space supplements and probiotics 2-3 hours away from antibiotic doses. Ask your pharmacist if timing adjustments can reduce the interaction risk.
Erythromycin can increase digoxin levels in your blood through two mechanisms — it reduces how your body eliminates digoxin and kills gut bacteria that normally break down some digoxin.
Follow each medication's specific timing instructions. Erythromycin — check if it requires an empty stomach or should be taken with food. Digoxin follows its normal schedule. Complete the full antibiotic course as prescribed.
Nausea, vomiting, loss of appetite, visual disturbances, irregular heartbeat, fatigue
Antibiotic interactions are often temporary (duration of treatment). Space supplements and probiotics 2-3 hours away from antibiotic doses. Ask your pharmacist if timing adjustments can reduce the interaction risk.
Request digoxin level monitoring. Consider azithromycin as alternative. Report any new heart rhythm symptoms.
Or browse the full interaction database (121,000+ pairs).