Dear Sir,myself Sanjay from Jalgaon I underwent mitral valve replaced in May 2003,and took penidure 10lac until 2010,when i suffered gluteal hematoma due to mistake by nurse while injecting needle.doctor advised not to take injection on buttocks since then I stopped but after year I started took erythromycine tablet 500mg daily.but I am not regular on it. And stopped it since Feb 2016. unfortunately I am also suffering from mysthania gravis and currently on immunosuppressive drugs 1000mg and omnacortil 5mg daily and ACITROM 2mg.my 2decho done in Dec 2014 shows all normal parameters like lvf 60℅lvd 44mm,lvds 24mm,aortic root 31mm,left atrium 32mm,no cloy,vegetation,intact ias and IVs,normal LA ..NOW PLEASE SUGGEST IF IT NECESSARILY TO GET PENIDURE INJECTION on buttock ,but I could not take it OR thereANY SUBSTITUTE TABLET FOR IT .if yes please suggest how long shall I take this medication