Can You Take Erythromycin with Alcohol?
Last reviewed: · Source: US FDA drug label database
Avoid alcohol with erythromycin — alcohol may increase erythromycin blood levels and worsens GI side effects which are already very common.
Is it safe to take Erythromycin with Alcohol?
Erythromycin is an older macrolide antibiotic with notoriously high rates of GI side effects (nausea, vomiting, abdominal cramping). Alcohol can worsen these significantly. Additionally, both erythromycin and alcohol are metabolised by CYP3A4 — acute alcohol use inhibits this enzyme, potentially raising erythromycin levels. Erythromycin also prolongs QT interval, and alcohol may compound this concern in heavy drinkers.
How do Erythromycin and Alcohol interact?
Erythromycin is a CYP3A4 inhibitor as well as a CYP3A4 substrate. Acute alcohol use also inhibits CYP3A4, potentially increasing erythromycin plasma concentrations. This pharmacokinetic interaction is more meaningful with erythromycin than with other macrolides. Additionally, erythromycin's GI pro-motility (motilin agonist) effects combined with alcohol's gut irritation create significant GI distress.
Data sourced from the US Food and Drug Administration (FDA) drug label database: OpenFDA erythromycin drug label.
Who should be careful?
Those with pre-existing cardiac conditions (QT concern). Those prone to stomach upset.
What if I've already taken Erythromycin and Alcohol?
If experiencing severe nausea or vomiting on erythromycin, even without alcohol, contact your GP as a different antibiotic may be prescribed.
Not sure if this combination is safe for your specific situation?
Speak to a pharmacist online — get personalised advice in minutes.
Speak to a pharmacist online →Service provided by independent online pharmacy partners.
⭐ Recommended on Amazon
Alcohol-Free Drinks Variety Pack
Great-tasting alternatives so you can still enjoy a drink while on medication.
View on Amazon →Mood Journal Notebook
Track how you feel day-to-day — especially useful when managing medication and lifestyle changes.
View on Amazon →Mindfulness Journal
Practical prompts to support mental wellbeing, especially when cutting back on alcohol.
View on Amazon →Affiliate links below. As an Amazon Associate we earn from qualifying purchases at no extra cost to you.
Frequently Asked Questions
Can I drink on erythromycin?
No. Erythromycin already causes significant GI side effects (nausea, vomiting) which alcohol will worsen. Alcohol may also raise erythromycin blood levels via CYP3A4 inhibition.
Why does erythromycin make me feel sick?
Erythromycin stimulates motilin receptors in the gut, causing stomach contractions. This causes nausea and abdominal cramping. Taking it with food can help.
Can erythromycin and alcohol affect the heart?
Erythromycin can prolong QT interval, which is a concern particularly for people with pre-existing cardiac conditions. Heavy alcohol use can affect cardiac conduction and adds to this concern.
Is erythromycin still used?
Yes, though it is less commonly prescribed than newer macrolides (azithromycin, clarithromycin) due to its side effect profile. It remains useful for certain infections, including as an alternative in penicillin allergy.