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(tel ith roe mye' sin)Telithromycin may cause worsening of symptoms, including breathing problems, when taken by people with myasthenia gravis (a disease that causes muscle weakness). These breathing problems may be severe or life-threatening and may cause death. Tell your doctor if you have myasthenia gravis. You should not take telithromycin if you have this condition.
Before taking telithromycin,
- tell your doctor and pharmacist if you are allergic to telithromycin, azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac, no longer available in the U.S.), erythromycin (E.E.S., E-Mycin, Erythrocin), troleandomycin (TAO, no longer available in the U.S.), or any other medications.
- do not take telithromycin if you are taking cisapride (Propulsid, no longer available in the U.S.) or pimozide (Orap).
- tell your doctor if you have had hepatitis (swelling of the liver) or jaundice (yellowing of the skin or eyes) while taking telithromycin or azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac, no longer available in the U.S.), erythromycin (E.E.S., E-Mycin, Erythrocin), or troleandomycin (TAO, no longer available in the U.S.). Your doctor will tell you not to take telithromycin.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); carbamazepine (Tegretol); cholesterol-lowering medications such as atorvastatin (Lipitor, in Caduet), lovastatin (Altoprev, Mevacor, in Advicor), and simvastatin ( Zocor, in Vytorin); cyclosporine (Neoral, Sandimmune); digoxin (Lanoxin); diuretics ('water pills'); ergot-type medications such as bromocriptine (Parlodel), cabergoline (Dostinex), dihydroergotamine (D.H.E. 45, Migranal), ergoloid mesylates (Germinal, Hydergine), ergonovine (Ergotrate), ergotamine (Bellergal-S, Cafergot, Ergomar, Wigraine), methylergonovine (Methergine), methysergide (Sansert), and pergolide (Permax); medications for irregular heartbeat, including amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), procainamide (Procanbid), quinidine, or sotalol (Betapace); metoprolol (Lopressor, Toprol XL); midazolam (Versed); phenobarbital (Luminal, Solfoton); phenytoin (Dilantin); repaglinide (Prandin); rifabutin (Mycobutin); rifampin (Rifadin, Rimactane); sirolimus (Rapamune); tacrolimus (Prograf); and triazolam (Halcion). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- if you are taking theophylline (Theo-24, Theobid, Theo-Dur, others), take it 1 hour before or after telithromycin.
- tell your doctor if you or anyone in your family has or has had a heart problem that may cause fainting and a slow or irregular heartbeat, or heart disease; or if you have low blood levels of potassium or magnesium; or kidney or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking telithromycin, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking telithromycin.
- you should know that telithromycin may cause dizziness or fainting. If you feel lightheaded and have severe nausea or vomiting, do not drive a car, operate machinery or participate in dangerous activities. If you faint, call your doctor before taking another dose of telithromycin.
- You should know that antibiotics, including telithromycin, may cause an infection in the intestines with symptoms of watery diarrhea, diarrhea that does not go away, or bloody stools; stomach cramps; or fever. Call your doctor if you have these symptoms. These symptoms can occur up to two months after finishing treatment.
- you should know that telithromycin may cause liver damage, which may be severe or life-threatening. This reaction may happen at any time while you are taking telithromycin or right after you finish taking this medication. Stop taking telithromycin and call your doctor right away if you have any of the following symptoms: tiredness, lack of energy, unusual bleeding or bruising, loss of appetite, nausea, itchy skin, dark urine, light-colored stools, yellowing of your skin or eyes, pain or tenderness in the upper right part of your stomach, swelling of the abdomen, or flu-like symptoms.
- you should know that telithromycin may cause vision problems, including blurred vision, difficulty focusing, and seeing double. These problems usually happen after the first or second dose and last for a few hours. To avoid these problems, avoid quick changes in looking from things far away to things close by. Do not drive a car, operate machinery, or participate in dangerous activities until you know how this medication affects you. If you have vision problems while taking telithromycin, call your doctor before taking another dose.
- rapid, irregular, or pounding heartbeat
- difficulty breathing or swallowing
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs