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Drug overview for ERYGEL (erythromycin base in ethanol):
Generic name: erythromycin base in ethanol (eh-rith-row-MY-sin)
Drug class: Acne Antibiotics
Therapeutic class: Dermatological
Erythromycin is a macrolide antibiotic.
No enhanced Uses information available for this drug.
Generic name: erythromycin base in ethanol (eh-rith-row-MY-sin)
Drug class: Acne Antibiotics
Therapeutic class: Dermatological
Erythromycin is a macrolide antibiotic.
No enhanced Uses information available for this drug.
DRUG IMAGES
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The following indications for ERYGEL (erythromycin base in ethanol) have been approved by the FDA:
Indications:
Acne vulgaris
Professional Synonyms:
Acne simplex
Common acne
Simple acne
Indications:
Acne vulgaris
Professional Synonyms:
Acne simplex
Common acne
Simple acne
The following dosing information is available for ERYGEL (erythromycin base in ethanol):
No enhanced Dosing information available for this drug.
No enhanced Administration information available for this drug.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| ERYGEL 2% GEL | Maintenance | Adults apply a thin layer to the affected area(s) by topical route 2 times per day in the morning and evening |
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| ERYTHROMYCIN 2% GEL | Maintenance | Adults apply a thin layer to the affected area(s) by topical route 2 times per day in the morning and evening |
The following drug interaction information is available for ERYGEL (erythromycin base in ethanol):
There are 2 contraindications.
These drug combinations generally should not be dispensed or administered to the same patient. A manufacturer label warning that indicates the contraindication warrants inclusion of a drug combination in this category, regardless of clinical evidence or lack of clinical evidence to support the contraindication.
| Drug Interaction | Drug Names |
|---|---|
| Ethyl Alcohol/Disulfiram Derivatives SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: Disulfiram alters the intermediary metabolism of alcohol. Acetaldehyde is produced as a result of an initial metabolism of alcohol in the liver. Acetaldehyde is normally further oxidized by aldehyde dehydrogenase. However, this step is slowed by disulfiram and results in elevated acetaldehyde levels in the blood, which produces the undesirable effects.(1-2) CLINICAL EFFECTS: Patients taking preparations that contain alcohol or using topical preparations that contain alcohol while taking disulfiram or agents related to it may experience throbbing in the head and neck, palpitations, tachycardia, hypotension, sweating, nausea, and vomiting.(3) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer recommends that disulfiram never be administered to a patient who is in a state of alcohol intoxication. Patients should be advised that even small amounts of alcohol may trigger the reaction. U.S. manufacturer states that taking any alcohol containing products during the course of therapy with disulfiram or its derivatives is contraindicated.(2) Patients should be informed about unsuspected sources of alcohol such as elixirs and topical preparations.(2) Alcohol is used to improve docetaxel and paclitaxel solubility. - The quantity of alcohol in paclitaxel injection formulations (0.385-0.396 grams/mL) is similar across manufacturers. A paclitaxel 200 mg dose contains approximately 13 grams of alcohol. - The quantity of alcohol in docetaxel formulations varies approximately 3-fold depending upon the manufacturer. FDA data on alcohol content (13): Product Manufacturer Alcohol/200 mg dose Docetaxel Inj. Pfizer 6.4 grams Docetaxel Inj. Sandoz 5.5 grams Docetaxel Inj. Accord 4.0 grams Taxotere-one vial Sanofi 4.0 grams formulation Docetaxel Inj. Hospira 3.7 grams Docefrez Sun Pharma 2.9 grams Taxotere-two vial Sanofi 2.0 grams formulation DISCUSSION: Disulfiram is used therapeutically in the treatment of alcoholism. The quantity of alcohol required to elicit the interaction varies with individuals.(2,4-5) Consumption of even small doses (e.g., 15 ml may lead to this interaction; therefore, concomitant administration should be avoided. Patients have suffered from this interaction from ingest-ing cough mixtures(6) and using topical preparations such as aftershave lotions(7) and antipsoriatic preparations(8) that contained alcohol. The duration of this interaction varies from 30 to 60 minutes to several hours, depending on the amount of alcohol consumed.(2,9) An overdose of disulfiram and alcohol may have caused a case of severe polyneuritis in one report,(10) and another report attributes the death of a patient to this interaction.(11) This interaction has also been reported in patients who came in contact with other organic solvents (e.g., paint, "mineral spirits") through inhalation; therefore, patients should be advised of this potential hazard as well.(12) |
DISULFIRAM |
| Ethyl Alcohol/Nifurtimox SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: Nifurtimox may increase the risk of the disulfiram-like reaction. In vitro studies of similar agents including other nitrofurans and nitroheterocyclic compounds demonstrated inhibition of aldehyde dehydrogenase and other alcohol-oxidizing enzymes.(1) This results in the accumulation of acetaldehyde, which is responsible for the disulfiram-like reaction. CLINICAL EFFECTS: Concurrent use of nifurtimox with alcohol may contribute to a disulfiram-type reaction resulting in symptoms of hypotension, tachycardia, nausea, sweating, facial flushing, headache, and vomiting.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients should be advised that concurrent use of nifurtimox and alcohol is contraindicated. Caution patients of the possible effects that may result from ingestion or application of products that contain alcohol while taking nifurtimox.(1) Patients should be informed about unsuspected sources of alcohol such as elixirs and topical preparations. Caution is also warranted when using intravenous preparations containing alcohol solvents in patients receiving nifurtimox. Alcohol is used to improve docetaxel and paclitaxel solubility. - The quantity of alcohol in paclitaxel injection formulations (0.385-0.396 grams/mL) is similar across manufacturers. A paclitaxel 200 mg dose contains approximately 13 grams of alcohol. - The quantity of alcohol in docetaxel formulations varies approximately 3-fold depending upon the manufacturer. FDA data on alcohol content (2): Product Manufacturer Alcohol/200 mg dose Docetaxel Inj. Pfizer 6.4 grams Docetaxel Inj. Sandoz 5.5 grams Docetaxel Inj. Accord 4.0 grams Taxotere-one vial Sanofi 4.0 grams formulation Docetaxel Inj. Hospira 3.7 grams Docefrez Sun Pharma 2.9 grams Taxotere-two vial Sanofi 2.0 grams formulation DISCUSSION: Clinical studies have not been conducted. Concomitant use of nifurtimox with alcohol may increase the incidence and severity of undesirable effects similar to other nitrofurans and nitroheterocyclic compounds.(1) |
LAMPIT |
There are 2 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Ethyl Alcohol/Selected Cephalosporins SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Certain cephalosporins have a methyltetrazolethiol side chain that resembles part of the disulfiram molecule. It has been suggested that the cephalosporins with this side chain interfere with the activity of the alcohol-metabolizing enzyme, aldehyde dehydrogenase, resulting in elevated concentrations of acetaldehyde and a "disulfiram-like" reaction.(1) CLINICAL EFFECTS: A disulfiram-like reaction may occur in patients who ingest alcohol during and after taking some cephalosporins. Symptoms include throbbing in the head and neck, palpitations, tachycardia, hypotension, sweating, nausea, and vomiting. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients receiving cephalosporins with a methyltetrazolethiol side chain should be cautioned about consuming alcohol during and for several days after therapy. Patients should be informed about unsuspected sources of alcohol such as elixirs and topical preparations. Alcohol is used to improve docetaxel and paclitaxel solubility. - The quantity of alcohol in paclitaxel injection formulations (0.385-0.396 grams/mL) is similar across manufacturers. A paclitaxel 200 mg dose contains approximately 13 grams of alcohol. - The quantity of alcohol in docetaxel formulations varies approximately 3-fold depending upon the manufacturer. FDA data on alcohol content (17) : Product Manufacturer Alcohol/200 mg dose Docetaxel Inj. Pfizer 6.4 grams Docetaxel Inj. Sandoz 5.5 grams Docetaxel Inj. Accord 4.0 grams Taxotere-one vial Sanofi 4.0 grams formulation Docetaxel Inj. Hospira 3.7 grams Docefrez Sun Pharma 2.9 grams Taxotere-two vial Sanofi 2.0 grams formulation DISCUSSION: A disulfiram-like reaction has been reported following the ingestion of alcohol by patients receiving cefamandole,(2-4) cefoperazone, (5-7) cefotetan,(8) and moxalactam.(9-11) The reaction has been reported in patients who had been receiving the antibiotic periodically or continuously before alcohol consumption. The reaction occurred within 30 minutes of alcohol consumption.(5-7) In one patient, the reaction occurred after an injection of 15 ml of a 67% alcohol into the paraaortic space for celiac plexus alcohol block.(11) Cefonicid and ceforanide have exhibited these effects in animal studies. (12) However, another study showed that cefonicid did not interact with alcohol.(13) No interaction was found with cefazolin, cefotaxime, cefoxitin, cephalothin, or cephradine in animal studies.(14-15) A study in humans found no interaction with ceftizoxime.(1) These cephalosporins do not have a methyltetrazolethiol side chain. A single case reported a disulfiram-like reaction in a patient taking cefonicid therapy on two separate occasions.(16) |
CEFOTAN, CEFOTETAN |
| Acitretin/Ethyl Alcohol SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Ethanol trans esterifies acitretin into etretinate,(1-3) which is stored in adipose tissue and slowly eliminated.(1) CLINICAL EFFECTS: Ingestion of ethanol, even sporadically, during acitretin usage and for 2 months after discontinuation of acitretin may result in formation of etretinate. Etretinate is also highly teratogenic and is slowly eliminated from the body over several years after discontinuation.(4) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of acitretin states that use of ethanol during or for 2 months after acitretin therapy in females is contraindicated.(4) Females on acitretin therapy should be counseled to avoid consumption and use of ethanol containing products during and for two months after acitretin use.(4) Alcohol is used to improve docetaxel and paclitaxel solubility. - The quantity of alcohol in paclitaxel injection formulations (0.385-0.396 grams/mL) is similar across manufacturers. A paclitaxel 200 mg dose contains approximately 13 grams of alcohol. - The quantity of alcohol in docetaxel formulations varies approximately 3-fold depending upon the manufacturer. FDA data on alcohol content (6): Product Manufacturer Alcohol/200 mg dose Docetaxel Inj. Pfizer 6.4 grams Docetaxel Inj. Sandoz 5.5 grams Docetaxel Inj. Accord 4.0 grams Taxotere-one vial Sanofi 4.0 grams formulation Docetaxel Inj. Hospira 3.7 grams Docefrez Sun Pharma 2.9 grams Taxotere-two vial Sanofi 2.0 grams formulation DISCUSSION: In a 2-way cross-over study in 10 subjects, consumption of a single dose of acitretin (100 mg) during ethanol ingestion (1.4 g/kg) resulted in formation of etretinate in all 10 subjects. The levels of etretinate formed were comparable to a 5 mg dose of etretinate. There was no detectable etretinate levels in any subject during administration of acitretin without ethanol.(4) In a study in 10 subjects treated with acitretin (30 mg daily for 3 months), 7 patients had detectable etretinate levels, 4 of which were teratogenic. Consumption of ethanol was linked to the formation of etretinate.(1) In a study in 86 patients treated with acitretin, 30 patients had detectable levels of etretinate. No etretinate was found in 20 subjects who reported no ethanol intake. Etretinate was found in all 16 subjects with an average weekly alcohol consumption of greater than 200 g (approximately 15 servings/week). Etretinate was found in 15 of 50 patients with an average weekly ethanol intake less than 200 g.(5) The half-life of etretinate has been estimated at 120 days (range 84-168 days). In a study of 47 patients treated with etretinate, 5 had detectable etretinate levels 2.1 years to 2.9 years after discontinuation of therapy. However, one patient who reported sporadic ethanol intake had detectable etretinate levels 52 months after discontinuation of acitretin.(4) |
ACITRETIN |
There are 1 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Ethyl Alcohol/Levoketoconazole; Ketoconazole SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: The exact mechanism of action of this reaction is unknown. Like metronidazole, ketoconazole contains a methylated imidazole ring. Due to their structural similarity, it has been suggested that alcohol dehydrogenase inhibition like that caused by metronidazole may occur.(1) Levoketoconazole is an enantiomer of ketoconazole.(2) CLINICAL EFFECTS: Concurrent use of ketoconazole with alcohol has been associated with a disulfiram-like reaction resulting in symptoms of flushing, rash, peripheral edema, nausea, and headache. Symptoms generally resolve within a few hours.(2,3) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients receiving levoketoconazole or ketoconazole should be instructed to use caution if drinking alcohol and to avoid excessive alcohol while taking levoketoconazole or ketoconazole.(2,3) Patients should be advised of the possible affects that may result from ingestion or application of products that contain alcohol while taking levoketoconazole or ketoconazole. Caution is also warranted when using intravenous preparations containing alcohol solvents in patients receiving levoketoconazole or ketoconazole. Alcohol is used to improve docetaxel and paclitaxel solubility. - The quantity of alcohol in paclitaxel injection formulations (0.385-0.396 grams/mL) is similar across manufacturers. A paclitaxel 200 mg dose contains approximately 13 grams of alcohol. - The quantity of alcohol in docetaxel formulations varies approximately 3-fold depending upon the manufacturer. FDA data on alcohol content (4): Product Manufacturer Alcohol/200 mg dose Docetaxel Inj. Pfizer 6.4 grams Docetaxel Inj. Sandoz 5.5 grams Docetaxel Inj. Accord 4.0 grams Taxotere-one vial Sanofi 4.0 grams formulation Docetaxel Inj. Hospira 3.7 grams Docefrez Sun Pharma 2.9 grams Taxotere-two vial Sanofi 2.0 grams formulation DISCUSSION: Ketoconazole has been associated with disulfiram-like reactions in patients who used alcohol. An 82-year old male with a history of alcohol abuse received a 1-week course of ketoconazole for esophageal candidiasis and had symptoms of nausea, vomiting and facial flushing. These symptoms were assumed to be due to alcohol ingestion.(1) |
KETOCONAZOLE, RECORLEV |
The following contraindication information is available for ERYGEL (erythromycin base in ethanol):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 0 contraindications.
There are 0 severe contraindications.
There are 1 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| No disease contraindications |
The following adverse reaction information is available for ERYGEL (erythromycin base in ethanol):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 0 severe adverse reactions.
There are 6 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Dry skin Pruritus of skin Skin irritation Stinging of skin |
Abnormal desquamation Erythema |
| Rare/Very Rare |
|---|
| None. |
The following precautions are available for ERYGEL (erythromycin base in ethanol):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
Safe use of erythromycin topical preparations during pregnancy has not been established.
Safe use of erythromycin topical preparations during lactation has not been established.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for ERYGEL (erythromycin base in ethanol):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for ERYGEL (erythromycin base in ethanol)'s list of indications:
| Acne vulgaris | |
| L70.0 | Acne vulgaris |
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