Drug Info: E: Erythromycin (Topical)

In the U.S.—

In Canada—

• Antiacne agent, topical
• Antibacterial, topical

Erythromycin ( eh-rith-roe-MYE-sin) belongs to the familyof medicines called antibiotics. Erythromycin topicalpreparations are used on the skin to help control acne. Theymay be used alone or with one or more other medicines thatare applied to the skin or taken by mouth for acne. They mayalso be used for other problems, such as skin infections, asdetermined by your doctor.

Erythromycin is available only with your doctor'sprescription, in the following dosage forms:

• Topical
• Gel (U.S.)
• Ointment (U.S.)
• Pledgets (U.S.)
• Solution (U.S. and Canada)

In deciding to use a medicine, the risks of taking themedicine must be weighed against the good it will do. This isa decision you and your doctor will make. For topicalerythromycin, the following should be considered:

Allergies—Tell your doctor if you haveever had any unusual or allergic reaction to this or any ofthe other erythromycins. Also tell your health careprofessional if you are allergic to any other substances,such as preservatives or dyes.

Pregnancy—Topical erythromycin has notbeen studied in pregnant women. However, this medication hasnot been shown to cause birth defects or other problems inanimal studies.

Breast-feeding—It is not known whethertopical erythromycin passes into the breast milk.Erythromycin, given by mouth or by injection, does pass intothe breast milk. However, erythromycin topical preparationshave not been reported to cause problems in nursingbabies.

Children—Erythromycin topical solutionhas been tested in children 12 years of age and older and, ineffective doses, has not been shown to cause different sideeffects or problems than it does in adults.

Older adults—Many medicines have notbeen studied specifically in older people. Therefore, it maynot be known whether they work exactly the same way they doin younger adults. Although there is no specific informationcomparing use of topical erythromycin in the elderly with usein other age groups, this medicine is not expected to causedifferent side effects or problems in older people than itdoes in younger adults.

Other medicines—Although certainmedicines should not be used together at all, in other casestwo different medicines may be used together even if aninteraction might occur. In these cases, your doctor may wantto change the dose, or other precautions may be necessary.Tell your health care professional if you are using any othertopical prescription or nonprescription (over-the-counter[OTC]) medicine that is to be applied to the same area of theskin.

Before applying this medicine, thoroughly wash theaffected area with warm water and soap, rinse well, and patdry. After washing or shaving, it is best to wait 30 minutesbefore applying the pledget (swab), topical gel, or topicalliquid form. The alcohol in them may irritate freshly washedor shaved skin.

This medicine will not cure your acne. However, to helpkeep your acne under control, keep using this medicine for the full time oftreatment, even if your symptoms begin to clear up aftera few days. You may have to continue using this medicineevery day for months or even longer in some cases. If youstop using this medicine too soon, your symptoms may return. It is important that you do not miss any doses.

Dosing—

The dose of topical erythromycin will be different fordifferent patients. Follow your doctor's orders or the directions on thelabel. The following information includes only theaverage doses of topical erythromycin. If your dose is different, do not change it unlessyour doctor tells you to do so.

• For acne:
  • For gel dosage form:
    • Adults—Apply to the affected area(s) of theskin two times a day, morning and evening.
    • Children—Dose must be determined by yourdoctor.
  • For ointment dosage form:
    • Adults, teenagers, and children—Apply to theaffected area(s) of the skin two times a day, morningand evening.
  • For pledgets dosage form:
    • Adults, teenagers, and children—Apply to theaffected area(s) of the skin two times a day.
  • For topical solution dosage form:
    • Adults, teenagers, and children 12 years of age andover—Apply to the affected area(s) of the skintwo times a day, morning and evening.
    • Children up to 12 years of age—Dose must bedetermined by your doctor.

Missed dose—

If you miss a dose of this medicine, apply it as soon aspossible. However, if it is almost time for your next dose,skip the missed dose and go back to your regular dosingschedule.

For patients using the pledget (swab), topical gel, ortopical liquid form of erythromycin:

• These forms contain alcohol and are flammable. Do not use near heat, near open flame, or whilesmoking.
• It is important that you do not use this medicine moreoften than your doctor ordered. It may cause your skin tobecome too dry or irritated.
• Also, you should avoid washing the acne-affected areastoo often. This may dry your skin and make your acne worse.Washing with a mild, bland soap 2 or 3 times a day shouldbe enough, unless you have oily skin. If you have anyquestions about this, check with your doctor.
• To use:
  • The topical liquid form of this medicine may come ina bottle with an applicator tip, which may be used toapply the medicine directly to the skin. Use theapplicator with a dabbing motion instead of a rollingmotion (not like a roll-on deodorant, for example). Ifthe medicine does not come in an applicator bottle, youmay moisten a pad with the medicine and then rub the padover the whole affected area. Or you may also apply thismedicine with your fingertips. Be sure to wash themedicine off your hands afterward.
  • Apply a thin film of medicine, using enough to coverthe affected area lightly. You should apply the medicine to the whole areausually affected by acne, not just to the pimplesthemselves. This will help keep new pimples frombreaking out.
  • The pledget (swab) form should be rubbed over thewhole affected area. You may use extra pledgets (swabs),if needed, to cover larger areas.
  • Since these medicines contain alcohol, they may stingor burn. Therefore, do not get these medicines in the eyes, nose, mouth,or on other mucous membranes. Spread the medicineaway from these areas when applying. If these medicinesdo get in the eyes, wash them out immediately, butcarefully, with large amounts of cool tap water. If youreyes still burn or are painful, check with yourdoctor.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longerneeded. Be sure that any discarded medicine is out of thereach of children.

If your acne does not improve within 3 to 4 weeks, or ifit becomes worse, check with your health care professional.However, treatment of acne may take up to 8 to 12 weeksbefore you see full improvement.

For patients using the pledget (swab), topical gel, ortopical liquid form of erythromycin:

• If your doctor has ordered another medicine to beapplied to the skin along with this medicine, it is best towait at least 1 hour before you apply the second medicine.This may help keep your skin from becoming too irritated.Also, if the medicines are used too close together, theymay not work properly.
• After application of this medicine to the skin, mildstinging or burning may be expected and may last up to afew minutes or more.
• This medicine may also cause the skin to becomeunusually dry, even with normal use. If this occurs, checkwith your doctor.
• You may continue to use cosmetics (make-up) while youare using this medicine for acne. However, it is best touse only ``water-base'' cosmetics. Also, it is best not touse cosmetics too heavily or too often. They may make youracne worse. If you have any questions about this, checkwith your doctor.

Along with its needed effects, a medicine may cause someunwanted effects. The following side effects may go awayduring treatment as your body adjusts to the medicine.

However, check with your doctor if any of the followingside effects continue or are bothersome:

• For erythromycin ointment
  • Less common
    • Peeling; redness
    
    

• For erythromycin pledget (swab), topical gel, ortopical liquid form
  • More common
    • Dry or scaly skin; irritation; itching;stinging or burning feeling
    
    
  • Less common
    • Peeling; redness
    
    

Other side effects not listed above may also occur in somepatients. If you notice any other effects, check with yourdoctor.