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Use with caution in patients with preexisting liver disease; hepatocellular and/or cholestatic hepatitis, with or without jaundice, hepatic necrosis, failure and death have occurred. Discontinue immediately if symptoms of hepatitis occur (malaise, nausea, vomiting, abdominal colic, fever).
Allergic (hypersensitivity) reactions (eg. angioedema, anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS)) have been reported (rare), including fatalities.
May mask or delay symptoms of incubating gonorrhea or syphilis, so appropriate culture and susceptibility tests should be performed prior to initiating a treatment regimen.
Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD); CDAD has been observed >2 months post-antibiotic treatment.
Use caution with renal dysfunction.
Macrolides (especially erythromycin) have been associated with rare QTc prolongation and ventricular arrhythmias including torsade de pointes.
