Usage in Pregnancy: Safety for use in pregnancy has not been established.

The administration of troleandomycin has been associated with an allergic type of cholestatic hepatitis. Some patients receiving troleandomycin for more than two weeks or in repeated courses have shown jaundice accompanied by right upper quadrant pain, fever, nausea, vomiting, eosinophilia, and leukocytosis. These changes have been reversible on discontinuance of the drug. Liver function tests should be monitored in patients on such dosage, and the drug discontinued if abnormalities develop. Reports in the literature have suggested that the concurrent use of ergotamine-containing drugs and troleandomycin may induce ischemic reactions. Therefore, the concurrent use of ergotamine-containing drugs and troleandomycin should be avoided. Troleandomycin should be administered with caution to patients concurrently receiving estrogen containing oral contraceptives.

Studies in chronic asthmatic patients have suggested that the concurrent use of theophylline and troleandomycin may result in elevated serum concentrations of theophylline. Therefore, it is recommended that patients receiving such concurrent therapy be observed for signs of theophylline toxicity, and that therapy be appropriately modified if such signs develop.

Troleandomycin is principally excreted by the liver.

Caution should be exercised in administering the antibiotic to patients with impaired hepatic function.

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