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Drug interactions

Chloramphenicol + Cobimetinib

Severity: Major

Chloramphenicol and Cobimetinib: major interaction.

Last updated

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Chloramphenicol can inhibit CYP3A4 and may raise cobimetinib concentrations. Higher exposure may increase adverse effects such as hemorrhage, rhabdomyolysis, serous retinopathy, liver injury and cardiomyopathy.

What this interaction means in plain words

Chloramphenicol and Cobimetinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Chloramphenicol belongs to Anti Bacterial; Cobimetinib belongs to Oncology.

Evidence level: Moderate

Why it happens

Chloramphenicol inhibits CYP3A4-mediated metabolism of cobimetinib, a CYP3A substrate.

What to do

Avoid chloramphenicol in patients on cobimetinib and choose an antibiotic without CYP3A inhibition. If unavoidable, reduce the cobimetinib dose per labeling guidance for CYP3A inhibitors and monitor closely for toxicity.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Chloramphenicol with Cobimetinib?

MediHelp rates the interaction as major. Chloramphenicol and Cobimetinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Chloramphenicol can inhibit CYP3A4 and may raise cobimetinib concentrations. Higher exposure may increase adverse effects such as hemorrhage, rhabdomyolysis, serous retinopathy, liver injury and cardiomyopathy.

How serious is the interaction between Chloramphenicol and Cobimetinib?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid chloramphenicol in patients on cobimetinib and choose an antibiotic without CYP3A inhibition. If unavoidable, reduce the cobimetinib dose per labeling guidance for CYP3A inhibitors and monitor closely for toxicity.

What other medicines interact with Chloramphenicol?

MediHelp also lists interactions of Chloramphenicol with, for example, Adagrasib, Avapritinib, Bcg vaccine live. The full list is on the Chloramphenicol page.

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