Erythromycin and sulfisoxazole (Oral)

Erythromycin and sulfisoxazole is a combination antibiotic used to treat 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 virus infections.

The erythromycin and sulfisoxazole combination is available only with your 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 worsen, contact your doctor.

Erythromycin and sulfisoxazole may make your skin more sensitive to sunlight than usual. Even brief exposure to sunlight may lead to 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, and sunglasses.
• Use a sunblock 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 fair skin. If you have questions about this, ask your healthcare professional.
• Use a sunblock 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, contact your doctor.

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

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

Allergies

Inform your clinician if you have ever had any unusual or allergic reaction to this medication or any other medicines. Additionally inform 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 drug has been tested in children over the age of 2 months and has not been shown to cause different side effects or issues than it does in adults. This medicine 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 typically used in adult patients.

Breast Feeding

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

Interactions with Drugs

Although certain drugs 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 doctor may want to change the dose, or other precautions may be necessary. When you are taking this drug, it is especially important that your healthcare professional know if you are using any of the medicines 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 medications is not recommended. Your physician may decide not to treat you with this medicine or change some of the other medicines 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 drug with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your physician may change the dose or how often 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 drugs 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 medicines 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 medications may as well 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 drug. Make sure you inform your physician if you have any other medical problems, especially:

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

• Heart disease—High doses of erythromycin and sulfisoxazole may raise the chance of adverse 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, this medicine may cause some unwanted effects. Not all side effects may happen, but if they do, you might need medical attention.

Check with your doctor right away if you notice any of the following side effects:

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 the front part of the neck

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

More common

• Increased sensitivity to sunlight

Some side effects may happen that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your health care professional may also be able to suggest ways to prevent or lessen some of these side effects. Check with your health care professional if any of the following side effects continue, 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 happen 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?