Chloramphenicol Injection and Tetanus Toxoid: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Chloramphenicol Injection
Tetanus Toxoid
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Inhibition of the immunologic response to the tetanus toxoid
Interaction Deep Dive
The immunologic response to tetanus toxoid was inhibited in eight of ten patients who were receiving chloramphenicol 4 grams daily, and in six of 12 patients treated with chloramphenicol 2 grams daily. Chloramphenicol is capable of inhibiting newly directed protein synthesis and of suppressing antibody formation, presumably by blocking the ribosomal binding sites for messenger RNA1.
Why it happens (mechanism)
Suppression of antibody formation by chloramphenicol
Literature reports
1 report — tap to read
a) Four groups were studied to determine the effect of chloramphenicol administration on a tetanus toxoid booster dose. All subjects had previously been immunized with tetanus toxoid, and a single 0.5 mL dose of aluminum phosphate adsorbed tetanus toxoid was administered as the antigenic stimulus. Ten subjects received chloramphenicol 4 grams daily, beginning the day before immunization and continuing for 14 days. Twelve subjects were given chloramphenicol 2 grams daily, following the same treatment schedule as the previous group. The third group (control group) consisted of ten patients treated with sulfisoxazole or not receiving antibiotics. All patients in the first three groups were hospitalized with quadriplegia or paraplegia. The last group was made up of 11 normal volunteers who were not receiving chloramphenicol. Serum antitoxoid levels were determined by passive hemagglutination, and changes of 2 hemagglutinating units were considered to be evidence of effective antibody response. Ten of the 11 normal volunteers and 9 of the 10 subjects in the control group showed antitoxoid increments of more than 2 units, which represented a greater than four-fold increase in the dilution titer. Only two of the ten patients who received chloramphenicol 4 grams daily exhibited a normal rise in antibody titer, while the remaining eight subjects manifested no rises of more than 2 hemagglutinating units. Of the subjects who were given chloramphenicol 2 grams daily, six patients had a normal antitoxoid response, and the other six subjects did not exceed 2 hemagglutinating units 1.
Common questions
Can I take Chloramphenicol Injection and Tetanus Toxoid together?
Inhibition of the immunologic response to the tetanus toxoid Always confirm with your pharmacist or prescriber before making any change.
How serious is the Chloramphenicol Injection and Tetanus Toxoid interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Chloramphenicol Injection or Tetanus Toxoid need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Daniel TM, Suhrland LG, & Weisberger AS: Suppression of the anamnestic response to tetanus toxoid in man by chloramphenicol. N Engl J Med 1965; 273:367-369. PubMed
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Keep reading about Tetanus Toxoid
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