Medication·Interactions & depletion·Reviewed June 9, 2026
Erythromycin interactions.
Erythromycin has 5 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Vitamin K. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Erythromycin at a glance.
A quick, data-grounded summary. The full tables are below.
Erythromycin has 5 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. Prolonged use is also associated with lower Vitamin K. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with erythromycin.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| St. John's Wort | Conflict | St. John's Wort is a potent inducer of CYP3A4 and intestinal P-glycoprotein. Erythromycin is metabolized by CYP3A4 and is a P-gp substrate, so... |
| Berberine | Caution | Berberine inhibits CYP3A4 and P-glycoprotein. Erythromycin is itself a CYP3A4 substrate and inhibitor that can prolong the QT interval; adding... |
| Vitamin K1 | Caution | Prolonged Erythromycin therapy can contribute to reduced vitamin K status in susceptible patients by altering gut flora, with higher concern in poor... |
| Calcium | Timing Sensitive | Polyvalent cations such as calcium can bind to some oral antibiotics and reduce absorption. While erythromycin is less prone to cation chelation... |
| Probiotics | Timing Sensitive | Erythromycin can suppress or kill bacterial probiotic organisms if taken at the same time, although selected probiotics may lower... |
What erythromycin can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Vitamin K | Mild | Like most broad-spectrum oral antibiotics, erythromycin can suppress vitamin K-producing colonic bacteria. In patients with already marginal vitamin... | Vitamin K | Prothrombin time / INR (especially in patients on warfarin) |
The full erythromycin profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common erythromycin questions.
Quick answers drawn from the tables above.
What interacts with Erythromycin?
In the NutriStack database, Erythromycin has 5 documented interactions. The most notable include St. John's Wort, Berberine, Vitamin K1, Calcium, and Probiotics. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Erythromycin?
Erythromycin is flagged against 1 substance in the database, including St. John's Wort. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Does Erythromycin deplete any nutrients?
Erythromycin is associated with lowering Vitamin K with prolonged use. Useful biomarkers to monitor include Prothrombin time / INR (especially in patients on warfarin). Ask your prescriber before adding any replacement supplement.
Is it safe to take St. John's Wort with Erythromycin?
NutriStack classifies the St. John's Wort and Erythromycin pairing as conflict: St. John's Wort is a potent inducer of CYP3A4 and intestinal P-glycoprotein. Erythromycin is metabolized by CYP3A4 and is a P-gp substrate, so concomitant use can lower... Avoid combining St. John's Wort with a course of erythromycin. If an antidepressant or mood supplement is needed, discuss alternatives with the... Always confirm with your prescriber.
Check your whole stack
See how erythromycin fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.