E.S.P. (Oral)

Erythromycin and sulfisoxazole is a combination antibiotic that treats ear infections in children. It may also be used for other issues as decided by your doctor. It will not work for colds, flu, or other viral infections.

Erythromycin and sulfisoxazole combination is available only with a doctor's prescription.

It is very important for your doctor to check you regularly for any blood problems that this medicine may cause, especially if you will be taking it for a long time.

If your symptoms do not get better within a few days, or if they get worse, talk to your doctor.

Erythromycin and sulfisoxazole may make your skin more sensitive to sunlight than usual. Even brief exposure to sunlight may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you start taking this medicine:

• Stay out of direct sunlight, especially between 10:00 a.m. and 3:00 p.m., if possible.
• Wear protective clothing, including a hat. Also, wear sunglasses.
• Use a sun block product with a skin protection factor (SPF) of at least 15. Some patients may need a product with a higher SPF, especially if they have a fair complexion. If you have questions about this, ask your health care professional.
• Use a sun block lipstick with an SPF of at least 15 to protect your lips.
• Do not use a sunlamp or tanning bed or booth.

If you have a severe reaction to the sun, talk to your doctor.

The combination of erythromycin and sulfisoxazole may cause blood problems. These issues could lead to a higher chance of infection, slower healing, and bleeding gums. Therefore, you should be cautious when using regular toothbrushes, dental floss, and toothpicks. Dental work should be postponed until your blood counts return to normal. Talk to your medical doctor or dentist if you have any questions about proper oral hygiene (mouth care) during treatment.

In deciding to use a medication, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your clinician will make. For this medicine, the following should be considered:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other drugs. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

This medication has been tested in children over the age of 2 months and has not been shown to cause different adverse effects or problems than it does in adults. This drug should not be given to infants under 2 months of age unless directed by the child's clinician, since it may cause unwanted effects.

Geriatric

This drug is intended for use in children and is not generally used in adult patients.

Breast Feeding

Studies in women suggest that this drug poses minimal chance to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your physician may want to change the dose, or other precautions may be necessary. When you are using this medicine, it is especially critical that your healthcare professional know if you are using any of the medications listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medication with any of the following drugs is not advised. Your doctor may decide not to treat you with this medication or change some of the other medications you take.

• Astemizole
• Bepridil
• Cisapride
• Colchicine
• Dihydroergotamine
• Dronedarone
• Eliglustat
• Ergotamine
• Flibanserin
• Fluconazole
• Grepafloxacin
• Levoketoconazole
• Levomethadyl
• Lomitapide
• Lovastatin
• Mesoridazine
• Methenamine
• Pimozide
• Piperaquine
• Posaconazole
• Saquinavir
• Simvastatin
• Sparfloxacin
• Terfenadine
• Thioridazine
• Ziprasidone

Using this medication with any of the following medicines is usually not advised, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how frequently you use one or both of the medicines.

• Abametapir
• Acalabrutinib
• Acecainide
• Adagrasib
• Afatinib
• Ajmaline
• Alfentanil
• Alprazolam
• Amiodarone
• Amisulpride
• Amitriptyline
• Amlodipine
• Amoxapine
• Anagrelide
• Apixaban
• Apomorphine
• Aprepitant
• Aprindine
• Aripiprazole
• Aripiprazole Lauroxil
• Arsenic Trioxide
• Ascorbic Acid
• Asenapine
• Atazanavir
• Atorvastatin
• Avapritinib
• Azimilide
• Azithromycin
• Bedaquiline
• Benzhydrocodone
• Berotralstat
• Betrixaban
• Bosutinib
• Bretylium
• Brexpiprazole
• Brigatinib
• Buprenorphine
• Buserelin
• Carbamazepine
• Ceritinib
• Cerivastatin
• Chloral Hydrate
• Chloroquine
• Chlorpromazine
• Cholera Vaccine, Live
• Cilostazol
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clindamycin
• Clofazimine
• Clomipramine
• Clothiapine
• Clozapine
• Cobicistat
• Cobimetinib
• Codeine
• Conivaptan
• Crizotinib
• Cyclobenzaprine
• Dabigatran Etexilate
• Dabrafenib
• Daridorexant
• Darunavir
• Dasatinib
• Deflazacort
• Degarelix
• Delamanid
• Desipramine
• Deslorelin
• Deutetrabenazine
• Dexmedetomidine
• Dibenzepin
• Digoxin
• Dihydrocodeine
• Diltiazem
• Disopyramide
• Dofetilide
• Dolasetron
• Domperidone
• Donepezil
• Doxepin
• Doxorubicin
• Doxorubicin Hydrochloride Liposome
• Droperidol
• Edoxaban
• Efavirenz
• Elacestrant
• Elexacaftor
• Encainide
• Encorafenib
• Enflurane
• Entrectinib
• Eplerenone
• Escitalopram
• Etrasimod
• Everolimus
• Fedratinib
• Felodipine
• Fentanyl
• Fexinidazole
• Finerenone
• Fingolimod
• Flecainide
• Fluoxetine
• Formoterol
• Fosaprepitant
• Foscarnet
• Fosnetupitant
• Fostemsavir
• Gatifloxacin
• Gemifloxacin
• Gepirone
• Glasdegib
• Gonadorelin
• Goserelin
• Granisetron
• Halofantrine
• Haloperidol
• Halothane
• Histrelin
• Hydrocodone
• Hydroquinidine
• Hydroxychloroquine
• Hydroxyzine
• Ibrutinib
• Ibutilide
• Ifosfamide
• Iloperidone
• Imipramine
• Infigratinib
• Inotuzumab Ozogamicin
• Isoflurane
• Isradipine
• Itraconazole
• Ivabradine
• Ivacaftor
• Ivosidenib
• Ketoconazole
• Lapatinib
• Larotrectinib
• Lefamulin
• Lemborexant
• Leniolisib
• Lenvatinib
• Leuprolide
• Levofloxacin
• Lidoflazine
• Lofexidine
• Lopinavir
• Lorcainide
• Lumacaftor
• Lumateperone
• Lumefantrine
• Lurasidone
• Lurbinectedin
• Macimorelin
• Mavacamten
• Mefloquine
• Meperidine
• Methadone
• Methotrexate
• Metronidazole
• Mifepristone
• Mirtazapine
• Mitapivat
• Mobocertinib
• Morphine
• Morphine Sulfate Liposome
• Moxifloxacin
• Nafarelin
• Naloxegol
• Neratinib
• Netupitant
• Nifedipine
• Nilotinib
• Nirmatrelvir
• Norfloxacin
• Nortriptyline
• Octreotide
• Ofloxacin
• Olanzapine
• Olaparib
• Omaveloxolone
• Ondansetron
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Oxycodone
• Ozanimod
• Pacritinib
• Paliperidone
• Palovarotene
• Panobinostat
• Paroxetine
• Pasireotide
• Pazopanib
• Pemigatinib
• Pentamidine
• Pentazocine
• Pexidartinib
• Pimavanserin
• Pirmenol
• Pitavastatin
• Pitolisant
• Pixantrone
• Ponesimod
• Porfimer
• Prajmaline
• Pralsetinib
• Probucol
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Protriptyline
• Quetiapine
• Quinidine
• Quinine
• Quizartinib
• Ranolazine
• Relugolix
• Ribociclib
• Rimegepant
• Risperidone
• Ritonavir
• Rivaroxaban
• Selpercatinib
• Selumetinib
• Sematilide
• Sertindole
• Sertraline
• Sevoflurane
• Simeprevir
• Siponimod
• Sirolimus Protein-Bound
• Sodium Phosphate
• Sodium Phosphate, Dibasic
• Sodium Phosphate, Monobasic
• Solifenacin
• Sonidegib
• Sorafenib
• Sotalol
• Sparsentan
• Spiramycin
• Sufentanil
• Sulfamethoxazole
• Sulpiride
• Sultopride
• Sunitinib
• Tacrolimus
• Tadalafil
• Tazemetostat
• Tedisamil
• Telaprevir
• Telavancin
• Telithromycin
• Tenofovir Alafenamide
• Tetrabenazine
• Tezacaftor
• Theophylline
• Tolvaptan
• Toremifene
• Tramadol
• Trazodone
• Triclabendazole
• Trifluoperazine
• Trimethoprim
• Trimipramine
• Triptorelin
• Troleandomycin
• Ubrogepant
• Vandetanib
• Vardenafil
• Vemurafenib
• Venetoclax
• Venlafaxine
• Verapamil
• Vilanterol
• Vinblastine
• Vincristine
• Vincristine Sulfate Liposome
• Vinflunine
• Voclosporin
• Voriconazole
• Warfarin
• Zanubrutinib
• Zolmitriptan
• Zolpidem
• Zotepine
• Zuclopenthixol

Using this drug with any of the following medicines may cause an increased chance of certain side effects, but using both drugs may be the best therapy for you. If both medicines are prescribed together, your doctor may change the dose or how frequently you use one or both of the medicines.

• Acetohexamide
• Aminolevulinic Acid
• Anisindione
• Avanafil
• Bexarotene
• Budesonide
• Buspirone
• Cyclosporine
• Diazepam
• Dicumarol
• Methylprednisolone
• Midazolam
• Phenprocoumon
• Roflumilast
• Sildenafil
• Sirolimus
• Suvorexant
• Tolterodine
• Triazolam
• Trimetrexate
• Valproic Acid
• Zafirlukast

Interactions with Food/Tobacco/Alcohol

Certain medications should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Issues

The presence of other medical issues may affect the use of this medication. Make sure you tell your doctor if you have any other medical problems, especially:

• Anemia or other blood problems or
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency—Erythromycin and sulfisoxazole may raise the chance of blood problems

• Heart disease—High doses of erythromycin and sulfisoxazole may raise the chance of side effects in patients with a history of an irregular heartbeat

• Kidney disease or
• Liver disease—Patients with liver or kidney disease may have an increased chance of side effects

• Loss of hearing—High doses of erythromycin and sulfisoxazole may raise the chance for hearing loss in some patients

• Porphyria—Erythromycin and sulfisoxazole may raise the chance of a porphyria attack

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Itching
• skin rash

Less common

• Aching of joints and muscles
• difficulty in swallowing
• nausea or vomiting
• pale skin
• redness, blistering, peeling, or loosening of skin
• skin rash
• sore throat and fever
• severe stomach pain
• unusual bleeding or bruising
• unusual tiredness or weakness
• yellow eyes or skin

Rare

• Blood in urine
• dark or amber urine
• irregular or slow heartbeat
• temporary loss of hearing (with kidney disease and high doses)
• lower back pain
• pain or burning while urinating
• pale stools
• recurrent fainting
• severe stomach pain
• swelling of front part of neck

Check with your doctor as soon as possible if any of the following side effects occur:

More common

• Increased sensitivity to sunlight

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Abdominal or stomach cramping and discomfort
• diarrhea
• headache
• loss of appetite
• nausea or vomiting

Less common

• Sore mouth or tongue

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• E.S.P.
• Eryzole
• Pediazole

Chemical Class: Erythromycin

Erythromycin and sulfisoxazole combination is best taken with extra amounts of water and may be taken with food. Additional amounts of water should be taken several times every day, unless otherwise directed by your doctor. Drinking extra water will help to prevent some unwanted effects (e.g., kidney stones) of sulfa medicines.

Do not give this medicine to infants under 2 months of age, unless otherwise directed by your doctor. Sulfa medicines may cause liver problems in these infants.

Use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.

Do not use after the expiration date on the label. The medicine may not work properly after that date. Check with your pharmacist if you have any questions about this.

To help clear up your infection completely, keep taking this medicine for the full time of treatment, even if you begin to feel better after a few days. If you stop taking this medicine too soon, your symptoms may return.

This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take the doses at evenly spaced times, day and night. For example, if you are to take 4 doses a day, the doses should be spaced about 6 hours apart. If this interferes with your sleep or other daily activities, or if you need help in planning the best times to take your medicine, check with your health care professional.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (suspension): For infections caused by bacteria: Adults and teenagers—This medicine is used only in children. Children up to 2 months of age—Use is not recommended. Children 2 months of age and older—Dose is based on body weight: For the four-times-a-day dosing schedule Children weighing less than 8 kilograms (kg) (under 18 pounds): Dose must be determined by your doctor. Children weighing 8 to 16 kg (18 to 35 pounds): 1/2 teaspoonful (2.5 milliliters [mL]) every six hours for ten days. Children weighing 16 to 24 kg (35 to 53 pounds): 1 teaspoonful (5 mL) every six hours for ten days. Children weighing 24 to 32 kg (53 to 70 pounds): 1 1/2 teaspoonfuls (7.5 mL) every six hours for ten days. Children weighing more than 32 kg (over 70 pounds): 2 teaspoonfuls (10 mL) every six hours for ten days. For the three-times-a-day dosing schedule Children weighing less than 6 kg (under 13 pounds): Dose must be determined by your doctor. Children weighing 6 to 12 kg (13 to 26 pounds): 1/2 teaspoonful (2.5 mL) every eight hours for ten days. Children weighing 12 to 18 kg (26 to 40 pounds): 1 teaspoonful (5 mL) every eight hours for ten days. Children weighing 18 to 24 kg (40 to 53 pounds): 1 1/2 teaspoonfuls (7.5 mL) every eight hours for ten days. Children weighing 24 to 30 kg (53 to 66 pounds): 2 teaspoonfuls (10 mL) every eight hours for ten days. Children weighing more than 30 kg (over 66 pounds): 2 1/2 teaspoonfuls (12.5 mL) every eight hours for ten days.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store in the refrigerator. Do not freeze.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

• What drugs should be avoided with a sulfa allergy?