Kloraxin Drug Interactions

By inhibiting microsomal enzymes, Chloramphenicol may interfere with the metabolism or dicumarol, phenytoin, tolbutamide and chlorpropamide.
Phenytoin and acetaminophen (paracetamol) may interfere with the metabolism of Chloramphenicol, causing toxic serum concentration. However, in a recent study, no interaction was noted with acetaminophen.
Phenobarbital and rifampin are known microsomal liver enzyme inducers, causing subtherapeutic concentrations of Chloramphenicol and, therefore, requiring dosage adjustments.
In vivo and in vitro studies of chloramphenicol used in conjunction with other antimicrobials reveal the possibility of antagonism: for example with β- lactams against Klebsiella pneumoniae, aminoglycosides against Escherichia coli, ampicillin against certain strains of Salmonella, penicillin against pneumococcus. This antagonism may be associated with the treatment failures and relapses.
Diuretics, such as mannitol, ethacrynic acid, and hydrochlorothiazide, increase the renal excretion of Chloramphenicol and its metabolites. These changes are clinically insignificant.