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Drug Interactions between cabozantinib and chloramphenicol ophthalmic

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

chloramphenicol ophthalmic cabozantinib

Applies to: chloramphenicol ophthalmic and cabozantinib

GENERALLY AVOID: Coadministration of topical chloramphenicol with other agents that can cause bone marrow depression, aplastic anemia, or agranulocytosis may increase the risk and/or severity of hematologic toxicity. Chloramphenicol may be absorbed systemically from the eye, ear, and vagina. Bone marrow hypoplasia, including aplastic anemia and death, has been reported following topical use of chloramphenicol. However, systemic absorption following topical, ophthalmic, otic, and vaginal administration is generally minimal, and data concerning the incidence of blood dyscrasias following the use of topical chloramphenicol are not available.

MANAGEMENT: Concurrent use of topical chloramphenicol formulations with other bone marrow depressing agents should generally be avoided. If concomitant use on a long-term or intermittent basis is considered necessary, patients should be monitored for the development of hematologic adverse effects. Monitoring via full blood counts before and periodically during therapy may also be advisable.

References (7)
  1. Sim SM, Back DJ, Breckenridge AM (1991) "The effect of various drugs on the glucuronidation of zidovudine (azidothymidine; AZT) by human liver microsomes." Br J Clin Pharmacol, 32, p. 17-21
  2. Burger DM, Meenhorst PL, Koks CH, Beijnen JH (1993) "Drug interactions with zidovudine." AIDS, 7, p. 445-60
  3. Cerner Multum, Inc. "Australian Product Information."
  4. Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
  5. Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
  6. (2023) "Product Information. Chloramphenicol Ophthalmic (chloramphenicol ophthalmic)." Martindale Pharmaceuticals Ltd
  7. (2019) "Product Information. Chloramphenicol Otic (chloramphenicol otic)." Martindale Pharmaceuticals Ltd

Drug and food interactions

Moderate

cabozantinib food

Applies to: cabozantinib

ADJUST DOSING INTERVAL: Food may alter the oral bioavailability of cabozantinib. When healthy subjects were given a single 140 mg oral dose with a high-fat meal, cabozantinib peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 41% and 57%, respectively, relative to administration under fasting conditions. In clinical studies, patients were administered cabozantinib without food.

GENERALLY AVOID: Coadministration with grapefruit juice is likely to increase the plasma concentrations of cabozantinib, which is primarily metabolized by CYP450 3A4. However, the interaction has not been studied. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit.

MANAGEMENT: Cabozantinib should be administered at least one hour before or two hours after a meal. The consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit extract should be avoided.

References (1)
  1. (2012) "Product Information. Cometriq (cabozantinib)." Exelixis Inc

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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