From the Research
For gastroparesis, erythromycin is typically prescribed at a dose of 250 mg three to four times daily, taken 30 minutes before meals and at bedtime, as this dosage has been shown to be effective in improving gastric emptying and reducing symptoms 1.
Dosage and Administration
The dosage of erythromycin for the treatment of gastroparesis can vary, but the most commonly recommended dose is 250 mg three to four times daily. This dose has been shown to be effective in improving gastric emptying and reducing symptoms in patients with gastroparesis 2, 3. Lower doses of 40-125 mg may also be effective with fewer side effects, but the optimal dose and duration of treatment should be determined on an individual basis 1.
Mechanism of Action
Erythromycin works as a motilin receptor agonist, stimulating gastric contractions and improving gastric emptying. This mechanism of action makes it an effective treatment option for patients with gastroparesis, particularly those with diabetic gastroparesis 2, 3.
Common Side Effects
Common side effects of erythromycin include nausea, abdominal cramping, and diarrhea. Patients should be aware that effectiveness may decrease over time due to tachyphylaxis, and periodic breaks from the medication may help maintain efficacy 1. Patients should also be monitored for QT prolongation, especially if taking other medications that affect cardiac conduction.
Special Considerations
For patients with severe symptoms, intravenous erythromycin at 3 mg/kg every 8 hours may be used in hospital settings for acute management 4. The medication should be taken on an empty stomach for optimal absorption, and treatment duration varies, but is often used for 2-4 weeks initially, with possible long-term use in some patients 2, 3.