Drug Interaction Report

Nisoldipine and Erythromycin: Interaction Details

A pharmacist-reviewed analysis of the Nisoldipine and Erythromycin interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Erythromycin

Erythrocin Stearate
+

Nisoldipine

Sular Sular®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 86 documented Nisoldipine interactions, 54 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

An increased calcium channel blocker that are CYP3A4 substrate exposure, an increased calcium channel blocker that are CYP3A4 substrate-related adverse reactions and an increased risk of hypotension

Interaction Deep Dive

Coadministration of erythromycin and a calcium channel blocker that are CYP3A4 substrates may increase the exposure of calcium channel blockers, cause hypotension and cause serious adverse reactions. Dosage adjustments may be considered, and when possible, monitor closely for CYP3A4 substrate exposure concurrently receiving erythromycin123.

Why it happens (mechanism)

Inhibition of CYP3A4-mediated metabolism by erythromycin

Common questions

Can I take Nisoldipine and Erythromycin together?

An increased calcium channel blocker that are CYP3A4 substrate exposure, an increased calcium channel blocker that are CYP3A4 substrate-related adverse reactions and an increased risk of hypotension Always confirm with your pharmacist or prescriber before making any change.

How serious is the Nisoldipine and Erythromycin interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Nisoldipine or Erythromycin need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (3)

  1. Product Information: Erythromycin Lactobionate IV injection lyophilized powder for solution, erythromycin lactobionate IV injection lyophilized powder for solution. Nexus Pharmaceuticals (per DailyMed), Lincolnshire, IL, 2024.
  2. Product Information: Erythromycin oral delayed-release capsules, erythromycin oral delayed-release capsules. Dr. Reddy's Laboratories Inc. (per DailyMed), Princeton, NJ, 2025. DailyMed
  3. Product Information: ERYTHROMYCIN ETHYLSUCCINATE oral suspension granule, erythromycin ethylsuccinate oral suspension granule. ANI Pharmaceuticals, Inc (per DailyMed), Baudette, MN, 2025. DailyMed
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Erythromycin

Keep reading about Erythromycin

All Erythromycin interactions (186)
Also serious with: Dihydroergotamine Injection Colchicine Ketoconazole Topical Lovastatin
Nisoldipine

Keep reading about Nisoldipine

All Nisoldipine interactions (86) Nisoldipine drug information
Also serious with: Ketoconazole Ensitrelvir Levoketoconazole Itraconazole
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Erythromycin + Activated Charcoal American Hellebore Arsenic Beer Cesium Ephedra Grapefruit Oleander + 196 more
Nisoldipine + Activated Charcoal American Hellebore American Mistletoe Coleus Grapefruit St. John's Wort Tyramine Acacia Rigidula + 224 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.