Gastrointestinal disturbances are the most frequent adverse effect but are usually mild and less frequent than with erythromycin. Smell and taste disturbances, stomatitis, glossitis, tongue and tooth discoloration, and headache have occurred. Transient elevations of liver enzyme value, cholestatic jaundice, and hepatitis have been reported. Headache and rashes from mild skin eruption to, rarely, Steven-Johnson Syndrome have occurred. There have also been reports of transient central nervous system effects such as anxiety, dizziness, insomnia, hallucinations, and confusion. Hearing loss has been reported occasionally and is usually reversible. Other adverse effects include arthralgia, myalgia, hypoglycemia, leucopenia, and thrombocytopenia, interstitial nephritis and renal failure have been reported rarely.