Erythromycin brotizolam

The metabolism of brotizolam is altered by drugs that inhibit CYP3A4, such as erythromycin and itraconazole. 

Erythromycin 1200 mg/day or placebo for 7 days was given to 14 healthy men in a double-blind, randomized, crossover design (5). On the sixth day they took a single oral dose of brotizolam 0.5 mg and blood samples were taken for 24 hours. Erythromycin significantly increased the Cmax, AUC, and half-life of brotizolam. 

Tokairin T, Fukasawa T, Yasui-Furukori N, Aoshima T, Suzuki A, Inoue Y, Tateishi T, Otani K. Inhibition of the metabolism of brotizolam by erythromycin in humans in vivo evidence for the involvement of CYP3A4 in brotizolam metabolism. Br J Clin Pharmacol 2005 60(2) 172-5. 

A randomised study in healthy subjeets found that erythromycin 400 mg three times daily for 7 days inereased AUC of a single 500-mierogram dose of brotizolam by 2.5-fold. The elimination half-life was also inereased from 9.4 hours to 20.7 hours. However, erythromycin did not affect the affect the changes in psychomotor function associated with bro-tizolam. ... 

Limited information from single-dose studies suggests that erythromycin may increase levels of alprazolam and brotizolam but no pharmacodynamic changes were found. Nevertheless, the manufacturers advise caution if alprazolam is used with a macrolide. ... 

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