Erythromycin Eye Ointment: Uses, Side Effects and Interactions

Young asian woman using eyes ointment suffering from dry eyes
Medically reviewed by Dr. Ola Tarabzuni

Key Takeaways

  • Erythromycin eye ointment is a topical medication for treating bacterial eye infections such as conjunctivitis
  • The ointment is applied to the affected eye(s) one to three times daily for a duration determined by your doctor, typically lasting 7-10 days.
  • Even if your symptoms improve before the treatment is done, you should still take complete dose.

Overview

Your eyes are sensitive organs that need special care, mainly when bacterial infections occur. This antibiotic eye drop is a member of the macrolide class and works by killing off the bacteria that cause infections in your eye. Bacterial conjunctivitis and keratitis can be treated using the macrolide antibiotic erythromycin eye ointment. This detailed guide examines the benefits and risks of erythromycin eye ointment.

What is erythromycin ophthalmic ointment used for?

Your doctor may prescribe erythromycin eye ointment in packaging 1g of 0.5% or 3g of 0.5% for treating eye infections. When applied topically, the ointment helps to eradicate infection in the eye area.

  1. Erythromycin ophthalmic ointment is effective in treating pink eye, also known as bacterial conjunctivitis. Typical signs of this condition include: 
  • Eye redness
  • Itching
  • Discharge

The bacterial infection of the eye can be treated with erythromycin ophthalmic ointment, and the symptoms can be relieved. Because of how well it works, doctors prescribe it frequently for both pediatric and adult patients.

  1. Inflammation of the cornea (keratitis) and the eyelids (blepharitis) can occur when sensitive bacteria enter the body. When applied directly to the infected eye, the ointment’s antimicrobial and analgesic effects help alleviate the symptoms.
  1. Newborns are given erythromycin ophthalmic ointment into their eyes as a preventive measure. If this ointment is put in a newborn’s eyes right after birth, the baby will be protected from eye infections caused by Gonorrhea if the mother has the infection at the time of the delivery. To prevent harm to newborns and complications, ointment is routinely used as a preventive measure in many hospitals.

Do not apply erythromycin ophthalmic ointment to any body area other than the eyes.

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How to apply Erythromycin ophthalmic ointment? 

If your doctor prescribes erythromycin ophthalmic ointment, use it exactly as directed. Generally how to use the ointment is shared below.

  1. Before applying the ointment or touching your eyes, wash your hands thoroughly with soap and water. This reduces the chance of foreign bacteria contaminating the eye.
  1. Carefully flush out the affected eye(s). If there is any discharge or debris, you can wipe it away with a damp cloth or flush it with a sterile saline solution.
  2. Do not wear contact lenses in your infected eye; seek professional advice about when to wear them again.
  1. Remove the cap, and don’t let the tube’s tip touch anything, including your skin.
  1. Pull your lower eyelid down while tilting your head back.
  2. Don’t touch your eye directly. Put a dab of ointment in the crease below your eye.
  3. When you blink, the ointment will spread across your eye.
  4. Always replace the cap tightly after using the ointment to ensure its continued sterility.
  1. Use the ointment as directed, which may include more than once daily application if prescribed by your doctor.

How much you should use erythromycin for eye infection? 

A commonly recommended dosage is to insert a thin strip of ointment about 0.4 inches (1 centimeter) long into the lower eyelid pocket about six times a day for adults. For newborns, use the same amount once a day only.

Don’t use more or lesser than the recommended. Using too little may not effectively treat the infection, whereas using too much may increase the risk of side effects while providing no additional benefits.

Read More: Pink Eye in Newborns: Symptoms, Causes and Treatment

What are the side effects of erythromycin eye ointment?

Like any medication, erythromycin eye ointment can cause unwanted side effects in some people. While not everyone experiences side effects, being aware of potential reactions is essential. Here are some possible side effects associated with erythromycin eye ointment:

Mild eye irritation & redness

The most common side effect is temporary eye irritation, including stinging, burning, itching, or redness. This is usually mild and subsides on its own without intervention.

Allergic reactions

It’s possible that erythromycin, or a component of it, could trigger an allergic reaction in some people. Allergic reactions can manifest in various ways, including itching, swelling, redness, rash, and respiratory distress. Get checked out right away if you’re experiencing any of these signs.

While rare, severe side effects can occur:

  • Severe eye pain or discomfort
  • Vision changes or blurred vision
  • Swelling or redness of the eyelids or face
  • Worsening eye irritation or persistent discharge

It’s crucial to follow the prescribed dosage and duration of treatment and inform your healthcare professional about any pre-existing medical conditions or medications you are currently taking. 

If you have concerns or questions about erythromycin eye ointment’s side effects, consult your doctor for personalized advice.

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What may interact with erythromycin?

Like other medications, Erythromycin may interact with certain substances or drugs, reducing its effectiveness or causing adverse reactions. Some notable substances that may interact with erythromycin include:

Other antibacterial agents

Some antibiotics, like clarithromycin and azithromycin, may not work as well when combined with erythromycin, and using erythromycin may increase the risk of side effects.

Blood thinners (anticoagulants)

Erythromycin can interact with anticoagulant medications such as warfarin, potentially increasing the risk of bleeding.

Inhibitors of CYP3A4

The enzyme CYP3A4 is responsible for erythromycin metabolism. Certain antifungals, antivirals, and protease inhibitors, which inhibit this enzyme, can raise erythromycin levels in the body and cause toxicity.

Grapefruit juice

It contains compounds that inhibit the same enzyme (CYP3A4) that metabolizes erythromycin. Grapefruit juice consumption while taking erythromycin may raise medication levels and increase the risk of side effects.

Pre-existing Medical Conditions

Inform your doctor if you have any pre-existing medical conditions, particularly liver or kidney disease, as these can affect how erythromycin is metabolized and may necessitate dosage adjustments.

Allergies

If you have a history of allergies to erythromycin or other macrolide antibiotics, inform your doctor to avoid any allergic reactions.

What should I tell my care team before I take this medication?

Communicating with your care team and providing them with pertinent information before taking erythromycin is critical. Here are some key points to bring up with your healthcare provider:

Medical Background 

Inform your medical team about your medical history, including any pre-existing conditions like liver or kidney disease, gastrointestinal disorders, or heart conditions. This information assists them in determining whether erythromycin is appropriate for your situation.

Allergies

Tell your doctor about any known allergies, especially if you’ve had allergic reactions to erythromycin or other macrolide antibiotics. Allergies can range from mild skin reactions to life-threatening anaphylaxis, and your care team must be aware to keep you safe.

Medications

List all the medications you are currently taking, including prescription, over-the-counter, supplements, and herbal products. This includes any eye drops or ointments you use. Certain medications may interact with erythromycin, necessitating dosage changes or alternative treatment options.

Pregnancy and Breastfeeding

You should let your healthcare providers know if you are pregnant, trying to get pregnant, or already breastfeeding. They will determine whether or not erythromycin treatment is in the best interest of you and your child.

Other Factors to Consider

Inform your care team about any other relevant factors, such as recent surgeries or procedures, ongoing treatments, or any other serious health issues you are experiencing. They rely on this information to give you personalized advice, make appropriate treatment decisions, and reduce the risk of complications or interactions.

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FAQs About Erythromycin Eye Ointment

Does erythromycin ophthalmic ointment expire?

Yes, like any medication, erythromycin ophthalmic ointment has an expiration date.

How many days do you use erythromycin ointment?

The duration of use for erythromycin ophthalmic ointment can vary depending on the specific condition being treated and the instructions provided by your healthcare provider.

In case of an overdose, what should I do?

In the event of an erythromycin overdose, immediate medical attention is required. Contact a doctor or the poison control center in your area.

Do you need a prescription for erythromycin eye ointment?

Yes, it requires a prescription from a healthcare professional.

How many days should you use erythromycin eye ointment?

Typically the treatment will last for 7-10 days. There is no specific time duration for using erythromycin ointment.

Can you put erythromycin ophthalmic ointment on your eyelid?

Yes, you can apply a tiny dab of ointment on each eyelid is fine.

Can you apply eye ointment with your finger?

Try to apply the ointment directly without using your finger and prevent the tip of the tube from touching your eye.

How fast does erythromycin work for pink eye?

Your pink eye should improve within 3-4 days of starting the antibiotic.

How long does it take for erythromycin eye ointment to work?

Yes, it may take up to 2 to 3 days for erythromycin ointment to work.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Mayo Clinic. Erythromycin (Ophthalmic Route)
  • Medline Plus. Erythromycin Ophthalmic
  • Medscape. erythromycin ophthalmic (Rx)
  • Gurevitz SL. Erythromycin: drug interactions. J Dent Hyg. 1997 Summer;71(4):159-61. PMID: 9470569.
  • Farzam K, Nessel TA, Quick J. Erythromycin. [Updated 2022 Dec 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532249/
  • Moussa F, Alaswad B, Garcia J. Erythromycin eye ointment: effect on gastrointestinal motility. Am J Gastroenterol. 2000 Mar;95(3):826. doi: 10.1111/j.1572-0241.2000.01893.x. PMID: 10710093.

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