Drug interactions
Chloramphenicol + Zonisamide
Severity: Moderate
Chloramphenicol and Zonisamide: moderate 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 inhibits hepatic CYP3A4, which is a main route of zonisamide metabolism, so zonisamide exposure may rise. This could increase dose-related adverse effects such as somnolence, dizziness, ataxia and cognitive slowing. The clinical effect is predicted and not well documented.
What this interaction means in plain words
Chloramphenicol and Zonisamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Chloramphenicol belongs to Anti Bacterial; Zonisamide belongs to Central Nervous System.
Why it happens
Chloramphenicol inhibits CYP3A4-mediated metabolism of zonisamide, reducing its clearance.
What to do
Monitor for zonisamide toxicity (sedation, ataxia, confusion) while chloramphenicol is given and consider reducing the zonisamide dose if symptoms occur. Re-check tolerability when chloramphenicol is stopped.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Chloramphenicol
Other interactions of Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide Moderate
Frequently asked questions
Can I take Chloramphenicol with Zonisamide?
MediHelp rates the interaction as moderate. Chloramphenicol and Zonisamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Chloramphenicol inhibits hepatic CYP3A4, which is a main route of zonisamide metabolism, so zonisamide exposure may rise. This could increase dose-related adverse effects such as somnolence, dizziness, ataxia and cognitive slowing. The clinical effect is predicted and not well documented.
How serious is the interaction between Chloramphenicol and Zonisamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for zonisamide toxicity (sedation, ataxia, confusion) while chloramphenicol is given and consider reducing the zonisamide dose if symptoms occur. Re-check tolerability when chloramphenicol is stopped.
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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