Gastroparesis in adults: oral erythromycin

How well does erythromycin work?

Only 4 small studies (which included a total of 48 people) were found that looked at how well erythromycin works for improving symptoms in people with gastroparesis. The people in these studies took erythromycin tablets, capsules or liquid in varying amounts, ranging from 125 mg taken 3 times a day, to 500 mg taken 4 times a day. The length of time that people took erythromycin for also varied, ranging from 2 to 4 weeks.

One study found that erythromycin did not work any better than a dummy tablet for improving symptoms of gastroparesis. A dummy tablet is a tablet that doesn't contain any active ingredient, and is also called a 'placebo'. Another study found that erythromycin worked better than metoclopramide (one of the other possible treatments that can be used for gastroparesis) for improving symptoms. Two studies didn't compare erythromycin with any other treatment, but they found that taking erythromycin did not help make people's symptoms better.

Overall, the 4 studies were of poor quality and do not provide reliable evidence on how well erythromycin works at improving the symptoms of gastroparesis.

What are the possible harms or side effects?

None of the 4 studies looked at how safe it is to use erythromycin, or the possible harms or side effects that using it may cause.

However, it is known that erythromycin can cause unpleasant side effects. Most commonly, it can cause stomach pains, feeling sick (nausea), being sick (vomiting) and diarrhoea. It can also cause more severe side effects, although these are rare, including loss of hearing, allergic reactions, liver problems, heart rhythm problems, and swelling (or inflammation) of the bowel. Erythromycin can also react with a wide variety of other medicines, and there are a number of people who would not be able to take erythromycin, including those taking certain tablets to lower their cholesterol. The treating doctor would need to review the person's current medicines before prescribing erythromycin to ensure that it would be safe for the person to take it.