Drug interactions
Chloramphenicol + Hydrocodone
Severity: Major
Chloramphenicol and Hydrocodone: 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, the main route of hydrocodone clearance, so hydrocodone exposure may rise. This can cause excess sedation and respiratory depression.
What this interaction means in plain words
Chloramphenicol and Hydrocodone 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; Hydrocodone belongs to Musculoskeletal.
Why it happens
Chloramphenicol inhibits CYP3A4-mediated metabolism of hydrocodone, increasing plasma concentrations.
What to do
Monitor closely for sedation and respiratory depression and reduce the hydrocodone dose if needed. Take care when chloramphenicol is stopped, as hydrocodone levels will fall.
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?
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Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Other interactions of Chloramphenicol
Frequently asked questions
Can I take Chloramphenicol with Hydrocodone?
MediHelp rates the interaction as major. Chloramphenicol and Hydrocodone 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, the main route of hydrocodone clearance, so hydrocodone exposure may rise. This can cause excess sedation and respiratory depression.
How serious is the interaction between Chloramphenicol and Hydrocodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor closely for sedation and respiratory depression and reduce the hydrocodone dose if needed. Take care when chloramphenicol is stopped, as hydrocodone levels will fall.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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