When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to any type of erythromycin. You should not use this medicine together with astemizole (Hismanal®), cisapride (Propulsid®), pimozide (Orap®), terfenadine (Seldane®), or ergot medicines (such as dihydroergotamine, ergotamine, D.H.E.® 45, Ergomar®, Ergostat®, or Migranal®).

How to Use This Medicine:
Delayed Release Capsule, Liquid, Tablet, Delayed Release Tablet, Coated Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Best taken on an empty stomach, but may be taken with food if stomach upset occurs.
• Shake the oral liquid before each use. Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• Swallow the coated tablet, delayed-release tablet, or delayed-release capsule whole. Do not crush, break, or chew it.
• Take all of the medicine in your prescription to clear up your infection, even if you feel better after the first few doses.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using colchicine, digoxin (Lanoxin®), theophylline (Theo-Dur®), certain blood pressure medicines (such as amlodipine, diltiazem, verapamil, Calan®, Cardizem®, Isoptin®, Norvasc®, or Verelan®), medicine for nerves or sleeping (such as alprazolam, midazolam, triazolam, Halcion®, Versed®, or Xanax®), medicine to lower cholesterol (such as atorvastatin, lovastatin, simvastatin, Altocor®, Lipitor®, Mevacor®, or Zocor®), or a blood thinner (such as warfarin, Coumadin®).
• Make sure your doctor knows if you are also taking seizure medicines (such as carbamazepine, phenytoin, valproate, Depakene®, Dilantin®, or Tegretol®), alfentanil (Alfenta®), bromocriptine (Parlodel®), cilostazol (Pletal®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), disopyramide (Norpace®), hexobarbital, quinidine (Cardioquin®, Quinaglute®), methylprednisolone (Medrol®), rifabutin (Mycobutin®), sildenafil (Viagra®), vinblastine (Velban®), or tacrolimus (Prograf®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart rhythm problems (such as QT prolongation), myasthenia gravis (severe muscle weakness), or stomach problems.
• Check with your doctor right away if you or your child have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.
• This medicine may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you or your child stop taking this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. If you have any questions or if mild diarrhea continues or gets worse, check with your doctor.
• Tell your doctor right away if your child has irritability with feeding or vomiting. These could be symptoms of a serious stomach problem called infantile hypertrophic pyloric stenosis (IHPS).
• This medicine can cause changes in heart rhythms, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you or your child have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Contact your doctor right away if you or your child develop a skin rash or itching while taking this medicine.
• Call your doctor if your symptoms do not improve or if they get worse.
• Do not take this medicine for any other infection. This medicine will not work for colds, flu, or other viral infections.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash.
• Bloody or cloudy urine, decrease in how much or how often you urinate.
• Convulsions (seizures).
• Dark-colored urine or pale stools.
• Difficulty with breathing.
• Fast, slow, pounding, or uneven heartbeat.
• Hearing loss.
• Lightheadedness, dizziness, or fainting.
• Muscle pain, tenderness, or weakness.
• Nausea, vomiting, loss of appetite, or pain in your upper stomach.
• Severe diarrhea (watery and may be bloody).
• Severe vomiting, irritability (in children).
• Sudden and severe stomach pain.
• Swelling of the face, throat, or lips.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Diarrhea, stomach pain, or upset stomach.
• Sores on the mouth or tongue.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088