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Chloromycetin Ophthalmic (chloramphenicol ophthalmic) Disease Interactions

There is 1 disease interaction with Chloromycetin Ophthalmic (chloramphenicol ophthalmic):

Major

Chloramphenicol (Includes Chloromycetin Ophthalmic) ↔ Bone Marrow Suppression

Severe Potential Hazard, Low plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

Chloramphenicol may cause bone marrow depression and other hematologic toxicities, which can be irreversible or reversible. The former type is independent of dose and results in aplastic anemia with a high rate of mortality, generally from hemorrhage or infection. It has been reported following both systemic and topical administration of chloramphenicol and has an estimated incidence of 1 in 25,000 to 1 in 40,000 courses of therapy. Bone marrow aplasia or hypoplasia may occur after a single dose but more often develops weeks or months after the drug has been discontinued. A reversible myelosuppression occurs much more frequently and is characterized by anemia, vacuolation of red blood cells, decreased reticulocyte count, leukopenia, thrombocytopenia, increased serum iron concentrations, and increased serum iron-binding capacity. It is dose-dependent, occurring regularly at chloramphenicol dosages exceeding 4 g/day (in adults) or at plasma drug concentrations >= 25 mcg/mL, and usually responds to withdrawal of the drug. Therapy with chloramphenicol should be administered cautiously, if at all, in patients with preexisting blood dyscrasias and/or bone marrow depression. Complete blood counts and differential reticulocyte counts should be performed in all patients prior to initiating therapy and approximately every 2 days during therapy. Marked depression of blood counts and/or development of other hematologic abnormalities may be indication for withdrawal of chloramphenicol therapy.

References

  1. Fraunfelder FT, Bagby GC, Kelly DJ "Fatal aplastic anemia following topical administration of ophthalmic chloramphenicol." Am J Ophthalmol 93 (1982): 356-60
  2. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  3. Doona M, Walsh JB "Use of chloramphenicol as topical eye medication: time to cry halt? bone marrow aplasia also occurs with ocular use." BMJ 310 (1995): 1217-8
View all 10 references

Chloromycetin Ophthalmic (chloramphenicol ophthalmic) drug Interactions

There are 4 drug interactions with Chloromycetin Ophthalmic (chloramphenicol ophthalmic)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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