This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Carl E. Stafstrom, MD, PhD; Virinder Nohria, MD, PhD; Heidi Loganbill, MD; Robert Nahouraii, MD; Rose-Mary Boustany, MD; G. Robert DeLong, MD
Durham, NC

Arch Pediatr Adolesc Med. 1995;149(1):99-101.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Carbamazepine is frequently prescribed for the control of generalized and partial seizures in children. Erythromycin is a macrolide antibiotic often used in children with minor bacterial infections, especially in those with an allergy to penicillin. Multiple case reports^1-7 and pharmacokinetic studies in humans and animals^8-10 have established that erythromycin causes carbamazepine toxicity when the two drugs are administered concurrently. Erythromycin interferes with liver microsomal metabolism of carbamazepine, causing decreased carbamazepine clearance, an elevated serum carbamazepine level, and clinical toxicity. Erythromycin-induced carbamazepine toxicity usually manifests as drowsiness, lethargy, ataxia, vomiting, and nystagmus. More serious adverse effects have included heart block¹¹ and severe liver and kidney failure.¹²

Despite an extensive literature about the adverse interaction between these two drugs, physicians continue to prescribe both medications. During a recent 6-month period, we encountered three cases of carbamazepine toxicity in children for whom erythromycin or clarithromycin (methylerythromycin, a new macrolide . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?