Acetaminophen with Chloramphenicol Interaction Details
Brand Names Associated with Chloramphenicol
- Chloramphenicol Injection
- Chloromycetin® Injection
- Mychel-S® Injection
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Feb 25, 2024
Interaction Effect
Chloramphenicol toxicity (vomiting, hypotension, hypothermia)
Interaction Summary
Concomitant use of acetaminophen (greater than or equal to 1 g four times daily) and chloramphenicol (greater than or equal to 500 mg every six hours) has been reported to increase, decrease, and have no change on the chloramphenicol half-life[1].
Severity
Minor
Onset
Delayed
Evidence
Probable
How To Manage Interaction
Monitor chloramphenicol concentrations and adjust dosage of chloramphenicol as necessary.
Mechanism Of Interaction
Unknown
Literature Reports
A) A study reported that the half-life of chloramphenicol increased from 2 to 3 hours to 18 to 24 hours in children who received concomitant acetaminophen therapy and from 3.25 hours to 15 hours in 6 adults similarly tested. Competitive metabolism was the proposed mechanism and a decrease in chloramphenicol dosage was advocated [2].
B) No pharmacokinetic interaction occurred between intravenous chloramphenicol succinate and oral acetaminophen in acutely febrile children during concomitant therapy. It is suggested that acetaminophen and chloramphenicol (succinate) can be given concomitantly in children in currently recommended doses without alterations in chloramphenicol disposition. However, concomitant administration of intravenous chloramphenicol and oral acetaminophen was reported to result in significant increases in the clearance of chloramphenicol with decreases in the peak chloramphenicol serum concentrations and elimination half-life. It is suggested that these effects are related to increased glucuronidation of chloramphenicol. Until further data is available, serum level monitoring is indicated during combined therapy [3][4].
References
1 ) Stein CM, Thornhill DP, Neill P, et al: Lack of effect of paracetamol on the pharmacokinetics of chloramphenicol. Br J Clin Pharmacol 1989; 2:262-264.
2 ) Buchanan N & Moodley BP: Interaction between chloramphenicol and paracetamol. Br Med J 1979; 2:307-308.
3 ) Spika JS, Davis DJ, Martin SR, et al: Interaction between chloramphenicol and acetaminophen. Arch Dis Child 1986; 61:1121-1124.
4 ) Kearns GL, Bocchini JA Jr, Brown RD, et al: Absence of a pharmacokinetic interaction between chloramphenicol and acetaminophen in children. J Pediatr 1985; 107:134-139.
Chloramphenicol Overview
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Chloramphenicol injection is used to treat certain types of serious infections caused by bacteria when other antibiotics cannot be used. Chloramphenicol injection is in a class of medications called antibiotics. It works by stopping the growth of bacteria..
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Antibiotics such as chloramphenicol injection will not work for colds, flu, or other viral infections. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.