Erythromycin – Eritromicin HF 250 mg and 500 mg film-coated tablets (macrolide antibiotic)

Erythromycin is a broad-spectrum antibiotic of the macrolide group. In Serbia it is authorised as Eritromicin HF film-coated tablets of 250 mg and 500 mg (erythromycin as erythromycin ethylsuccinate), made by Hemofarm.

It is used to treat and prevent bacterial infections of the upper and lower respiratory tract, ear, mouth, eyelids, skin and soft tissue, digestive tract and other infections listed in the leaflet. Erythromycin has many interactions with other medicines, so your doctor must know everything you take.

What is erythromycin used for and how should it be taken?

Basic information about the medicine

What is erythromycin used for?

• Upper respiratory tract: tonsillitis, peritonsillar abscess, pharyngitis, laryngitis, sinusitis, bacterial superinfection after flu and colds.
• Lower respiratory tract: tracheitis, acute and chronic bronchitis, pneumonia, bronchiectasis, Legionnaires' disease.
• Ear: middle and outer ear infection, mastoiditis.
• Mouth and eyes: gingivitis, Vincent's angina; blepharitis (eyelid inflammation).
• Skin and soft tissue: boils and carbuncles, paronychia, abscesses, pustular acne, impetigo, cellulitis, erysipelas.
• Digestive tract: cholecystitis, staphylococcal enterocolitis.
• Prevention: peri- and post-operative trauma, burns, rheumatic fever.
• Other infections: osteomyelitis, urethritis, gonorrhoea, syphilis, lymphogranuloma venereum, diphtheria, prostatitis, scarlet fever.

How is it taken and dosed?

• Swallow the tablets whole, without splitting or chewing, with enough water, just before or with a meal.
• Adults and children over 8 years: for mild to moderate infections 1–2 g a day in divided doses; for severe infections up to 4 g a day in divided doses.
• Elderly: no dose adjustment needed.
• Children under 8, newborns and infants: erythromycin as a suspension is recommended (per the leaflet: children 2–8 years 1 g a day, newborns and infants 500 mg a day in divided doses; doses may be doubled for severe infections).
• Do not stop treatment without your doctor's advice, even if you feel better.

Special patient groups

• Liver disease: erythromycin is broken down mainly in the liver – caution in liver disease or with medicines that can damage the liver.
• Myasthenia gravis: erythromycin may worsen muscle weakness.
• Newborns treated with erythromycin: cases of narrowing of the stomach outlet (infantile hypertrophic pyloric stenosis) have been reported – contact the doctor if vomiting or irritability occurs after feeding.
• Kidney failure and high doses: isolated cases of temporary hearing loss have been reported.

Contraindications – when the medicine must not be used

• allergy to erythromycin or any ingredient of the medicine;
• concomitant use of simvastatin, tolterodine, terfenadine, astemizole, mizolastine, cisapride, pimozide, amisulpride, domperidone, ergotamine, dihydroergotamine or lomitapide;
• abnormally low blood potassium or magnesium;
• ventricular arrhythmia, torsades de pointes or long QT syndrome in you or your family.

Warnings and precautions

• Caution in heart disease and with other medicines that prolong the QT interval.
• In severely ill patients taking statins, cases of rhabdomyolysis (severe muscle damage) have been reported.
• Serious allergic and skin reactions are possible, including acute generalised exanthematous pustulosis – stop the medicine immediately if they occur.
• Newborns of mothers treated with erythromycin for early syphilis during pregnancy must receive appropriate penicillin treatment.
• Tell your doctor you take erythromycin if you have a urine test for catecholamines.

Interactions with other medicines, food and drink

Tell your doctor about all medicines. Apart from the contraindicated ones, according to the leaflet the effects of erythromycin and other medicines may be changed by:

• statins (e.g. lovastatin), protease inhibitors (saquinavir), oral contraceptives, colchicine;
• cimetidine, omeprazole; fluconazole, ketoconazole, itraconazole;
• digoxin, disopyramide, quinidine, verapamil, cilostazol, sildenafil;
• warfarin, acenocoumarol, rivaroxaban;
• valproate, carbamazepine, phenytoin; hexobarbital, phenobarbital, midazolam, alprazolam, zopiclone, triazolam; alfentanil;
• theophylline; ciclosporin, tacrolimus; bromocriptine; vinblastine;
• rifabutin, rifampicin; clindamycin, lincomycin, chloramphenicol, streptomycin, tetracyclines, colistin;
• hydroxychloroquine and chloroquine (higher heart risk); corticosteroids (oral, injected, inhaled), methylprednisolone;
• the herbal medicine St John's wort.

The medicine is taken just before or with a meal.

Pregnancy and breastfeeding

Caution is needed. Data on the risk of birth defects are inconsistent, but some studies have reported heart defects after use in early pregnancy. The medicine is used in pregnant and breastfeeding women only when truly necessary and when the doctor judges that the benefit to the mother outweighs the risk to the foetus or infant.

Driving and using machines

There are no data showing that Eritromicin HF affects the ability to drive or use machines.

Possible side effects

Stop the medicine and contact your doctor immediately if you have difficulty breathing, fainting, swelling of the face, lips or throat, itching and rash, severe skin reactions, sores in the mouth and throat, jaundice, a severe heart rhythm disorder or severe or prolonged diarrhoea with blood or mucus.

• Rare: pseudomembranous colitis.
• Frequency not known: eosinophilia; QT prolongation, torsades de pointes, palpitations and other rhythm disorders; deafness, ringing in the ears; upper abdominal discomfort, nausea, vomiting, diarrhoea, pancreatitis, loss of appetite; chest pain, fever, weakness; liver inflammation and damage, jaundice; allergic reactions up to anaphylaxis; raised liver enzymes; confusion, seizures, vertigo; hallucinations; blurred vision; interstitial nephritis; rash, itching, hives, angioedema, severe skin reactions; low blood pressure.
• Side effects in children are similar to those in adults.

Overdose, missed dose and stopping treatment

• Overdose: contact your doctor, pharmacist or nearest healthcare facility immediately. Symptoms: temporary hearing loss, severe nausea, vomiting and diarrhoea.
• Missed dose: take it as soon as possible; if it is nearly time for the next dose, continue with the usual schedule. Never take a double dose.
• Stopping treatment: do not stop without your doctor's advice – symptoms may return.

Further information

For additional care and support of the gut flora during and after antibiotic treatment, see also the category Products with probiotics – products in this category do not replace the medicine prescribed for you.

Composition, packaging and manufacturer

• Active substance: erythromycin 250 mg or 500 mg (as erythromycin ethylsuccinate) per film-coated tablet.
• Tablet core: maize starch; microcrystalline cellulose; magnesium stearate.
• Film coating (Opadry White YS-1-7002): hypromellose, macrogol 8000, titanium dioxide (E171).
• Pack: carton with 2 blisters of 10 film-coated tablets (20 tablets) for each strength.
• Marketing authorisation holder and manufacturer: Hemofarm AD Vršac, Beogradski put bb, Vršac, Serbia.

Storage

• 250 mg: store below 25 °C in the original package to protect from light.
• 500 mg: no special storage conditions.
• Keep out of the sight and reach of children; do not use after the expiry date.

Frequently asked questions

Is "erythromycin" the same as Eritromicin HF?

Erythromycin is the name of the active substance. In Serbia, Eritromicin HF (Hemofarm) is the medicine authorised for systemic use, as 250 mg and 500 mg film-coated tablets; this page describes that medicine.

Should erythromycin be taken before or after food?

According to the leaflet, the tablets are taken just before or with a meal, whole, without splitting or chewing, with enough water.

Can I take erythromycin if I take cholesterol medicines?

Simvastatin must not be combined with erythromycin, and other statins may also interact (rhabdomyolysis has been reported). Be sure to tell your doctor which cholesterol medicine you take.

What should I do if I get diarrhoea during treatment?

Diarrhoea is a possible side effect. If it is severe, persistent or contains blood or mucus, contact your doctor immediately – it may be a sign of pseudomembranous colitis.

Sources

• ALIMS – Summary of Product Characteristics, Eritromicin HF 250 mg and 500 mg film-coated tablets (SmPC, Serbian, 250 mg authorisation)
• ALIMS – Package leaflet, Eritromicin HF 250 mg and 500 mg (PIL, Serbian, 250 mg authorisation)
• ALIMS – Package leaflet, Eritromicin HF 250 mg and 500 mg (PIL, Serbian, 500 mg authorisation)

Sources checked on: 25 October 2026.