Drug interactions
Chloramphenicol + Irinotecan liposomal
Severity: Major
Chloramphenicol and Irinotecan liposomal: major interaction.
Last updated Sources: UK SmPC
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
Irinotecan and its active metabolite SN-38 are affected by CYP3A4 and UGT1A1 pathways. Inhibition may raise exposure, increasing the risk of severe diarrhea and neutropenia.
What this interaction means in plain words
Chloramphenicol and Irinotecan liposomal 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.
Why it happens
Chloramphenicol inhibits CYP3A4 and may inhibit UGT1A1, altering irinotecan and SN-38 disposition.
What to do
Avoid if possible and choose another antibiotic. If combined, monitor blood counts and diarrhea closely and reduce the irinotecan dose 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?
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References
- Chloramphenicol Capsules BP 250 mg - SmPC sections 4.3/4.5 (class statement: Cytotoxic agents; "- Cytotoxic agents") — electronic medicines compendium (UK SmPC)
Other interactions of Chloramphenicol
Frequently asked questions
Can I take Chloramphenicol with Irinotecan liposomal?
MediHelp rates the interaction as major. Chloramphenicol and Irinotecan liposomal 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. Irinotecan and its active metabolite SN-38 are affected by CYP3A4 and UGT1A1 pathways. Inhibition may raise exposure, increasing the risk of severe diarrhea and neutropenia.
How serious is the interaction between Chloramphenicol and Irinotecan liposomal?
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 if possible and choose another antibiotic. If combined, monitor blood counts and diarrhea closely and reduce the irinotecan dose 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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