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Erythromycin (ophthalmic): Drug information

Erythromycin (ophthalmic): Drug information
(For additional information see "Erythromycin (ophthalmic): Patient drug information" and see "Erythromycin (ophthalmic): Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: Canada
  • Odan-Erythromycin [DSC];
  • PDP-Erythromycin
Pharmacologic Category
  • Antibiotic, Macrolide;
  • Antibiotic, Ophthalmic
Dosing: Adult
Ocular infections, superficial

Ocular infections, superficial: Ophthalmic: Instill ~1 cm ribbon into affected eye(s) up to 6 times daily, depending on the severity of the infection.

Blepharitis: Instill ~1 cm ribbon into affected eye(s) one or more times daily or at bedtime (Ref).

Conjunctivitis: Instill ~1 cm ribbon into affected eye(s) 4 times daily for 7 days (Ref).

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Erythromycin (ophthalmic): Pediatric drug information")

General dosing, superficial ocular infections: Infants, Children, and Adolescents: Ophthalmic: Instill 1 cm ribbon into affected eye(s) up to 6 times daily depending on the severity of the infection.

Blepharitis

Blepharitis: Limited data available: Children and Adolescents: Ophthalmic: Instill ~1 cm ribbon into affected eye(s) 1 or more times daily or at bedtime (Ref).

Conjunctivitis

Conjunctivitis: Infants, Children, and Adolescents: Ophthalmic: Instill ~1 cm ribbon into affected eye(s) 4 times daily for 7 days (Ref).

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

Frequency not defined.

Ocular: Hypersensitivity, minor ocular irritation, redness

Contraindications

Hypersensitivity to erythromycin or any component of the formulation.

Warnings/Precautions

Concerns related to adverse effects:

• Superinfection: Prolonged use may result in fungal or bacterial superinfection. If superinfection is suspected, institute appropriate alternative therapy.

Dosage form specific issues:

• For ophthalmic use only. Avoid contamination. Do not touch tip of applicator or let tip of applicator touch eye.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Ointment, Ophthalmic:

Generic: 5 mg/g (1 g, 3.5 g)

Generic Equivalent Available: US

Yes

Pricing: US

Ointment (Erythromycin Ophthalmic)

5 mg/g (per gram): $8.70 - $20.04

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Ointment, Ophthalmic:

Generic: 5 mg/g (1 g, 3.5 g)

Administration: Adult

Ophthalmic: For ophthalmic use only. Avoid contact of tip of ophthalmic ointment tube with affected eye or skin.

Administration: Pediatric

For ophthalmic use only. Contact lenses should not be worn during treatment of ophthalmic infections. Avoid contact of tip of ophthalmic ointment tube with affected eye or skin.

Ophthalmia neonatorum prophylaxis: Do not flush ointment from eye following instillation; use a new ointment tube for each neonate.

Use: Labeled Indications

Ocular infections (superficial): Treatment of superficial ocular infections involving the conjunctiva or cornea caused by organisms susceptible to erythromycin ophthalmic ointment

Ophthalmia neonatorum: Prophylaxis of ophthalmia neonatorum due to N. gonorrhoeae or C. trachomatis

Medication Safety Issues
Sound-alike/look-alike issues:

Erythromycin may be confused with azithromycin

Metabolism/Transport Effects

None known.

Drug Interactions

There are no known significant interactions.

Pregnancy Considerations

Adverse events were not observed in animal reproduction studies. The amount of erythromycin available systemically following ophthalmic application is not known. However, erythromycin ophthalmic is considered acceptable for use in pregnant patients (Robert 2001).

Breastfeeding Considerations

It is not known if erythromycin is present in breast milk following ophthalmic application. The amount of erythromycin available systemically following ophthalmic application is not known. Although the manufacturer recommends that caution be exercised when administering erythromycin ophthalmic ointment to breastfeeding patients, erythromycin ophthalmic is considered acceptable for use while breastfeeding (Robert 2001).

Mechanism of Action

Inhibits RNA-dependent protein synthesis at the chain elongation step; binds to the 50S ribosomal subunit resulting in blockage of transpeptidation

  1. Amescua G, Akpek EK, Farid M, et al; American Academy of Ophthalmology Preferred Practice Pattern Cornea and External Disease Panel. Blepharitis preferred practice pattern®. Ophthalmology. 2019;126(1):P56-P93. doi:10.1016/j.ophtha.2018.10.019 [PubMed 30366800]
  2. Azari AA, Barney NP. Conjunctivitis: a systematic review of diagnosis and treatment. JAMA. 2013;310(16):1721-1729. doi:10.1001/jama.2013.280318 [PubMed 24150468]
  3. Erythromycin ophthalmic ointment [prescribing information]. Bridgewater, NJ: Bausch & Lomb Americas Inc; September 2022.
  4. Robert PY, Adenis JP. Comparative review of topical ophthalmic antibacterial preparations. [PubMed 11270936]
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