ESP

1 What is ESP?

Brand: ESP, Eryzole, Pediazole

Generic: Erythromycin and Sulfisoxazole

ESP is antibiotic used for the management of ear infections in children. It also may apply in the management of other conditions as will be determined by your medical doctor. It however may not be used for colds, flu, or other virus infections.

Erythromycin and sulfisoxazole combination may only be used with the doctor’s prescription. Once a medicine has been approved, it may be found to be useful for other medical conditions. This may not be included in the product label for erythromycin and sulfisoxazole combination in certain patients with the medical conditions.

2 What to Know Before Using

Before using ESP, the risks of using the medicine need to be weighed against the benefits of using the medicine. This is the decision that needs to be reached by both you and your doctor. It is necessary that you inform your medical doctor of potential allergies or allergic reactions you have suffered previously to this medicines or any other.

In addition, also inform your doctor if you have any other allergies to food, dyes, or preservatives. If using nonprescription products, read the label or package ingredients carefully before using these medicines. In children, there have been no age appropriate studies for the effects of triamterene in the pediatric populations. Safety and efficacy studies have also not been performed.

Geriatric information on the relationship of age to the effect of erythromycin and sulfisoxazole combination in geriatric patients has also not been performed. Pregnancy studies have shown an adverse effect and there are no adequate studies in pregnant women or no animal studies have been conducted and there are no adequate studies in pregnant women. There are limited studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Certain medicines may not be used together at all.

However, in other cases, two different medicines may be used together even if an interaction might occur. In these cases, your doctor will make a decision on how soon and when to change the dose, or other precautions as will be necessary. Always consult your medical doctor is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. These drugs include:

  • Amifampridine
  • Astemizole
  • Bepridil
  • Cisapride
  • Colchicine
  • Dihydroergotamine
  • Dronedarone
  • Ergoloid
  • Mesylates
  • Ergonovine
  • Ergotamine
  • Flibanserin
  • Fluconazole
  • Grepafloxacin
  • Levomethadyl
  • Lomitapide
  • Lovastatin
  • Mesoridazine
  • Methenamine
  • Methylergonovine
  • Methysergide
  • Pimozide
  • Piperaquine
  • Posaconazole
  • Saquinavir
  • Simvastatin
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Moreover, use of these medicines with any of these medicines may not be recommended but may be required in some of the cases. When both of the medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. They include:

  • Acecainide
  • Afatinib
  • Ajmaline
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amoxapine
  • Anagrelide
  • Apixaban
  • Apomorphine
  • Aprepitant
  • Aprindine
  • Aripiprazole
  • Arsenic Trioxide
  • Asenapine
  • Atorvastatin
  • Azimilide
  • Azithromycin
  • Bedaquiline
  • Bosutinib
  • Bretylium
  • Brexpiprazole
  • Buserelin
  • Carbamazepine
  • Ceritinib
  • Cerivastatin
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Cilostazol
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clindamycin
  • Clomipramine
  • Clozapine
  • Cobicistat
  • Cobimetinib
  • Crizotinib
  • Cyclobenzaprine
  • Dabrafenib
  • Darunavir
  • Dasabuvir
  • Dasatinib
  • Degarelix
  • Delamanid
  • Desipramine
  • Deslorelin
  • Dibenzepin
  • Digoxin
  • Diltiazem
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Donepezil
  • Doxepin
  • Doxorubicin
  • Doxorubicin Hydrochloride Liposome
  • Droperidol
  • Eliglustat
  • Encainide
  • Enflurane
  • Eplerenone
  • Escitalopram
  • Everolimus
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluoxetine
  • Foscarnet
  • Gatifloxacin
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Hydrocodone
  • Hydroquinidine
  • Hydroxychloroquine
  • Ibrutinib
  • Ibutilide
  • Idelalisib
  • Ifosfamide
  • Iloperidone
  • Imipramine
  • Isoflurane
  • Isradipine
  • Ivacaftor
  • Ketoconazole
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Lidoflazine
  • Lopinavir
  • Lorcainide
  • Lumacaftor
  • Lumefantrine
  • Lurasidone
  • Mefloquine
  • Methotrexate
  • Metronidazole
  • Mifepristone
  • Morphine
  • Morphine
  • Sulfate
  • Liposome
  • Moxifloxacin
  • Nafarelin
  • Naloxegol
  • Nilotinib
  • Nintedanib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olaparib
  • Ondansetron
  • Oxycodone
  • Paliperidone
  • Panobinostat
  • Paritaprevir
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Perflutren Lipid Microsphere
  • Pirmenol
  • Pitavastatin
  • Pixantrone
  • Prajmaline
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Risperidone
  • Romidepsin
  • Sematilide
  • Sertindole
  • Sevoflurane
  • Simeprevir
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sonidegib
  • Sorafenib
  • Sotalol
  • Spiramycin
  • Sulfamethoxazole
  • Sultopride
  • Sunitinib
  • Tacrolimus
  • Tadalafil
  • Tedisamil
  • Telaprevir
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Theophylline
  • Tizanidine
  • Tolvaptan
  • Topotecan
  • Toremifene
  • Trazodone
  • Trifluoperazine
  • Trimethoprim
  • Trimipramine
  • Triptorelin
  • Troleandomycin
  • Vandetanib
  • Vardenafil
  • Vasopressin
  • Vemurafenib
  • Verapamil
  • Vinblastine
  • Vincristine
  • Vincristine Sulfate Liposome
  • Vinflunine
  • Voriconazole
  • Warfarin
  • Zolmitriptan
  • Zotepine

The use of this medicines with any of the following medicines may cause an increased risk of certain side effects. Using both drugs may also be the best treatment for you. When both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. They include:

  • Acetohexamide
  • Alfentanil
  • Alprazolam
  • Anisindione
  • Avanafil
  • Bexarotene
  • Budesonide
  • Buspirone
  • Cyclosporine
  • Diazepam
  • Dicumarol
  • Methylprednisolone
  • Midazolam
  • Phenprocoumon
  • Roflumilast
  • Salmeterol
  • Sildenafil
  • Sirolimus
  • Tolterodine
  • Triazolam
  • Trimetrexate
  • Valproic Acid
  • Zafirlukast

Other form of interactions may also occur when used at or around times of eating certain types of foods since the interactions may occur. Similarly, alcohol or tobacco with certain medicines may also occur. The following interactions have been selected on the basis of their potential significance and may not be all inclusive. The presence of other medical problems may not affect the use of this medicine.

Make sure you tell your doctor if you have any other medical problem.  Conditions such as anemia, blood problems, or glucose 6 phosphate dehydrogenase (G6PD) deficiency.  Use of the combination of Erythromycin and sulfisoxazole may increase the chance of the blood problems, heart diseases. In addition, high doses of erythromycin and sulfisoxazole may increase the chance of side effects. Loss of hearing may also be felt. It may also cause an increased chance of suffering from porphyria attack.

3 Proper Usage

To use ESP correctly, you must follow all instructions given by your doctor.

Erythromycin and sulfisoxazole combination is best taken with extra amounts of water and may be taken with food. It is recommended that extra amounts of water needs to be taken with the medicine several times a day unless otherwise instructed by your doctor. Using excess water will help to prevent the unwanted effects such as kidney stones of sulfa medicines.

Never give these medicines to infants under 2 months of age unless otherwise instructed by a medical doctor. It is also known that sulfa medicine may cause liver problems in the infants. Only use a marked measuring spoon or other devices so as to measure each of the doses accurately. The average household may not hold the right amount of the liquid. The medicine needs to be disposed after the expiry date and must never be used. This is because they may not work properly after the expiry date.

In case of any questions, consult your pharmacist or your medical doctor. Take the medicine to the full term of the treatment, even after you start to feel better after a few days. In case you stop to take the medicine too soon, your symptoms may return. The medicines also work best when supplied with a constant amount in blood. To sustain the effect of the drug, do not miss any of the doses. It is also anticipated the medicine can be spread out evenly during the day and night.

In case the target is to take 4 doses a day, they can be spaced out to 6 hours apart. Consult your medical doctor to help you in planning for the best times to use the medicines. The dose of the medicine may also vary from one patient to another. Stick to your doctors instructions or those provided on the label. The average doses of the medicines are provided in this article and must not be used as a reference dose unless otherwise advised by your medical doctor.

The amount of the medicine that you consume varies and depends on the strength of the medicine. It also relies on the doses that are consumed every day, time allowed between doses and length of time you need to take the medicines which varies and depends on the nature of the medical problems for which you are using the medicine.

When using the oral dosage form of the medicine in the management of the infections cause by bacteria in adults and teenagers. This medicine is only used by children. It is not recommended for children less than 2 months of age. In children that are 2 months old and above, the dose is based on the body weight. They are required to use the medicines 4 times a day as a dosing schedule.

  • In children less than 8 kilograms (Kg) under 18 pounds, the dose must be determined by your medical doctor.
  • Children weighing 8-16 kg (18 to 35 pounds): a half of a tea spoonful (2.5 milliliters (ml) every six hours for ten days is recommended.
  • In children weighing 16 to 24 kgs (35 to 53 pounds): one teaspoonful (5 ml) every six hours for ten days is recommended.
  • In children weighing 24-32 kg(53 to 70 pounds): one and half teaspoon full (7.5 ml) every six hours for ten days is recommended for 10 days.
  • For children over the weight of 32 Kg (over 70 pounds): 2 tea spoonful’s (10 ml) every six hours for ten days is allowed. This will consume a maximum of three times a day dosing.
  • In children weighing less than 6 kg (under 13 pounds): the dose of the medicine will need to be determined by your medical doctor.
  • Children weighing 6 to 12 kg (13 to 26 pounds): 1/2 teaspoonful (2.5 mL) every eight hours for ten days.
  • Children weighing 12 to 18 kg (26 to 40 pounds): 1 teaspoonful (5 mL) every eight hours for ten days.
  • Children weighing 18 to 24 kg (40 to 53 pounds): 1 1/2 teaspoonful’s (7.5 mL) every eight hours for ten days.
  • Children weighing 24 to 30 kg (53 to 66 pounds): 2 teaspoonful’s (10 mL) every eight hours for ten days.
  • Children weighing more than 30 kg (over 66 pounds): 2 1/2 teaspoonful’s (12.5 mL) every eight hours for ten days.

In case of missed doses, take the medicine as soon as possible. However, when it is almost time for the next dosing, skip the dose and resume the regular dosing of the medicine. Never date double doses.  The medicine can be stored in a refrigerator and must never be frozen.  Store the medicine out of reach of children. Dispose all the outdated medicines since they are no longer needed.

4 Precautions to Take

In using ESP, you must be careful and take some precautions as advised by your doctor.

Regular medical checkup by your doctor during regular visits is important for screening of any of the blood problems which may be caused by the use of this medicine. When the symptoms do not get better in a few days or if they become worse, check with your doctor. Erythromycin and sulfisoxazole may cause your skin to be more sensitive to the sunlight than it is normally. Exposure to sunlight even for short periods of time may cause a skin rash to form, itching, redness or other discoloration of the skin, severe sunburn.

When you start using this medicine, stay out of direct sunlight especially between 10.00 am and 3.00 pm. It is recommended that you should wear protective clothing including a hat. Put on sun glasses. Apply a sun block product that has a skin protection factor (SPF) of at least 15. Some of the patients may also require that a product of more SPF number can be used more especially if they are of a fair complexion. In case of any questions, ask your medical doctor for better direction. You can also apply a sun block lipstick that has an SPF of at least 15 to protect your lips. Do not use a sunlamp or tanning bed or booth.

In case of severe reactions from the sun, visit your medical doctor for proper medication. Note that the use of erythromycin and sulfisoxazole combination has potential of causing problems in the blood. The problems may increase the chance of getting an infection, slow healing, and bleeding gums. Therefore, one should be careful when using regular toothbrushes, dental floss, and toothpicks. In many cases, dental works needs to be delayed until when the blood counts are back to normal. Check with your doctor if you have any questions about good oral dental/oral hygiene during the regular visits.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with ESP. When they occur, they will require medical attention. Visit your medical doctor immediately when any of the side effects occur.

The most common side effects include:

  • Itching and Skin rash

The less common:

  • Aching of joints and muscles
  • Difficulty in swallowing
  • Nausea or Vomiting
  • Pale skin
  • Redness, Blistering, Peeling, or Loosening of skin, rash
  • Sore throat and fever
  • Stomach pain, severe
  • Unusual bleeding or bruising
  • Unusual tiredness or weakness
  • Yellow eyes or skin

Rare side effects include:

  • Blood in urine
  • Dark or Amber urine
  • Irregular or Slow heartbeat temporary
  • Loss of hearing (with kidney disease and high doses)
  • Lower back pain
  • Pain or Burning while urinating
  • Pale stools
  • Recurrent fainting
  • Severe stomach pain
  • Swelling of front, part of neck

Check with your doctor as soon as possible. The more common side effects include the sensitivity to sunlight. Some of the side effects may occur and may not need medical attention. The side effects eventually go away during treatment as the body adjusts to the medicine. Your medical doctor may also be able to tell you ways of reducing some of the side effects of using these drugs.

Moreover, also check with your medical doctor if some of the medical effects persist or become bothersome. Other side effects are not listed here but may present after using this medicines. When you notice any of the other effects, inform your healthcare professional. Call your doctor for medical advice about the side effects. You can also report the side effects to the FDA at 1-800-FDA-1088.

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