Cimetidine can almost double the
serum levels of
erythromycin, although this has only been seen in a single dose study. A single case report describes reversible deafness attributed to this interaction.
Evidence for this interaction is very limited. However, it may be prudent to be alert for
erythromycin adverse effects (nausea, vomiting, diarrhoea, abdominal dis- comfort). Ranitidine is a possible non-interacting alternative, as are
azithromycin and
clarithromycin.