Drug interactions
Chloramphenicol + Ifosfamide
Severity: Major
Chloramphenicol and Ifosfamide: major interaction.
Last updated Sources: US FDA label
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 the CYP3A4 activation and clearance of ifosfamide, altering the balance between active and neurotoxic metabolites. Both drugs also suppress bone marrow, so the risk of myelosuppression is increased.
What this interaction means in plain words
Chloramphenicol and Ifosfamide 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; Ifosfamide belongs to Oncology.
Why it happens
CYP3A4 inhibition altering ifosfamide metabolism combined with additive myelosuppression.
What to do
Avoid the combination if possible and choose another antibiotic. If it is used, monitor blood counts and watch for neurotoxicity and reduced efficacy.
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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References
Other interactions of Chloramphenicol
Other interactions of Ifosfamide
- Adenovirus types 4 and 7 live + Ifosfamide Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine live Contraindicated
- Ifosfamide + Measles mumps rubella and varicella vaccine live Contraindicated
- Ifosfamide + Measles vaccine Contraindicated
- Ifosfamide + Rotavirus oral vaccine live Contraindicated
Frequently asked questions
Can I take Chloramphenicol with Ifosfamide?
MediHelp rates the interaction as major. Chloramphenicol and Ifosfamide 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 the CYP3A4 activation and clearance of ifosfamide, altering the balance between active and neurotoxic metabolites. Both drugs also suppress bone marrow, so the risk of myelosuppression is increased.
How serious is the interaction between Chloramphenicol and Ifosfamide?
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 the combination if possible and choose another antibiotic. If it is used, monitor blood counts and watch for neurotoxicity and reduced efficacy.
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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