Drug & supplement interaction

Oleander + Erythromycin Stearate

Erythromycin Stearate brand names: Erythro-S, Erythrocin, Ethril.

Major Interaction
Medically reviewed by · Updated September 2026
The bottom line Major

Oleander has a major interaction with Erythromycin Stearate. Theoretically, macrolide antibiotics may increase the risk of oleander toxicity.

Read the full interaction report
SeverityMajor
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Oleander and Erythromycin Stearate

Here is the interaction we found between these two, with the evidence behind it.

Major

MACROLIDE ANTIBIOTICS

Why this applies to Erythromycin Stearate

Erythromycin Stearate falls under MACROLIDE ANTIBIOTICS — the group Oleander interacts with.

Theoretically, macrolide antibiotics may increase the risk of oleander toxicity.
Macrolide antibiotics reduce levels of bacteria in the gut that break down digoxin to inactive metabolites, increasing digoxin bioavailability. Theoretically, this same process could increase the bioavailability of cardiac glycosides in oleander, increasing its toxicity.
Severity Major Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

First, a strong word of caution: oleander is genuinely toxic, and I would never recommend taking it. Every part of the plant carries heart-poisoning compounds that act a lot like digoxin, and even tiny amounts have caused deaths. So please don't use it at all.

Now, the specific concern with Erythromycin Stearate: this antibiotic can lower the gut bacteria that normally break down heart glycosides. In theory, that lets more of oleander's poisons get absorbed, making toxicity worse. That could mean dangerously slow or irregular heartbeats, nausea, vomiting, and confusion. This link is theoretical (based on how the drugs work, not direct studies), but the stakes are high. Please talk with your pharmacist or doctor before combining anything with oleander.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Ellenhorn MJ, et al. Ellenhorn's Medical Toxicology: Diagnoses and Treatment of Human Poisoning. 2nd ed. Baltimore, MD: Williams & Wilkins, 1997.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Oleander Also Interacts With Other Medications

Oleander has 132 major, 23 moderate known drug interactions in our database — the Erythromycin Stearate one above is one of them. If you take anything else, check it against the full list below.

Major 132 Moderate 23 No known interaction 2,675 (incl. Erythromycin Stearate)
Taking anything else?

Check Another of Your Medications Against Oleander

Covers the 2,830 medications we’ve checked against Oleander. Pick one to open its full report.

From our Q&A

Questions About Oleander or Erythromycin Stearate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Oleander or Erythromycin Stearate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Erythromycin Stearate

This page covers Oleander only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Erythromycin Stearate page lists 204 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Beer (major) and Cesium (major).

By severity: 11 major · 153 moderate · 40 minor.

From our pharmacist’s overview on the Erythromycin Stearate page

“Erythromycin stearate (Erythrocin, Ethril) is an antibiotic that asks for real vigilance around supplements. It blocks the body's main drug-clearing enzyme, so the largest share of this list is herbs whose blood levels can climb while you take it.”

Reviewed by 2 · Jul 18, 2026

Open the Erythromycin Stearate interaction page

How much people look this up

Where Oleander and Erythromycin Stearate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Oleander
Steady interest

#1,135 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Erythromycin Stearate
Top half

#970 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Oleander

What is Oleander?

  • Heart failure (traditional)
  • Cancer (investigational)
  • Skin conditions
  • Asthma (folk use)
  • Pain relief (folk use)

Oleander is a highly poisonous ornamental plant, and every part of it can cause life-threatening heart and nervous system effects, even in small amounts. There is no proven safe dose for self-use, and serious poisonings and deaths have occurred from teas, extracts, and accidental ingestion. We strongly advise against using oleander as a supplement.

Read the full Oleander monograph & all interactions
Medication

About Erythromycin

What Is Erythromycin Used For?

Brand names: Erythro-S, Erythrocin, Ethril

Erythromycin treats bacterial infections caused by susceptible organisms. Oral and intravenous forms are used for upper and lower respiratory tract infections, skin and soft-tissue infections, pertussis (whooping cough), Legionnaires' disease, sexually transmitted infections (gonorrhea, syphilis, chlamydia), listeriosis, and other conditions. Erythrocin Lactobionate IV and erythromycin lactobionate injection are specifically for patients who cannot take oral medication or who need rapid, high blood levels due to severe infection — IV therapy should be switched to oral as soon as appropriate.

Erythromycin topical solution 2% and Ery 2% Pads (swabs) are indicated only for the topical treatment of acne vulgaris (acne) and are applied directly to the skin — they are not used for internal infections.

See full Erythromycin drug information
Keep checking

Other Drugs & Oleander

Browse every other medication we’ve checked against Oleander — both the ones with a known interaction and the ones without. Select any drug for the full detail.

132Major
23Moderate
0Minor
2,674No known interaction
132 Major 23 Moderate 2,674 No interaction
Major

132 interactions

Showing 60 of 132 major interactions — see all 132 on the Oleander page.

Moderate

23 interactions

No interaction 2,674 drugs checked — show the list

We also checked Oleander against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,674 medications checked with no known interaction — see the full Oleander list.

See the full Oleander interactions page
See every supplement checked against Erythromycin Stearate, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Oleander monograph › Uses, safety, and every drug interaction in one place Erythromycin Stearate supplement interactions › Every supplement checked against Erythromycin Stearate, ranked by severity Erythromycin drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Oleander and Erythromycin Stearate Together: Common Questions

Can you take Oleander with Erythromycin Stearate?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Oleander and Erythromycin Stearate interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Erythromycin Stearate and Oleander?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.