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Drug Interactions between Chloracol and Unipen

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

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Interactions between your drugs

Moderate

chloramphenicol nafcillin

Applies to: Chloracol (chloramphenicol) and Unipen (nafcillin)

MONITOR: Chloramphenicol may inhibit the bactericidal effect of penicillins when used to treat bacterial meningitis and staphylococcal endocarditis. Chloramphenicol acts by inhibiting cellular protein synthesis and can change actively growing bacteria into static ones. Since penicillins work by inhibiting cell wall synthesis, their effectiveness may be reduced. In addition, neurologic toxicity may be enhanced. Data have been conflicting, and no antagonism or synergistic effects have been reported in other types of infections.

MANAGEMENT: Until more information is available, this combination should probably be reserved for conditions where it has been found to be efficacious and avoided in situations where bactericidal activity is necessary, such as certain types of bacterial meningitis or staphylococcal endocarditis. If the combination is necessary, some experts recommend administering the penicillin several hours before the chloramphenicol. Patients should be closely monitored for altered antimicrobial efficacy.

References

  1. Shalit I, Marks MI (1984) "Chloramphenicol in the 1980s." Drugs, 28, p. 281-91
  2. Wallace JF, Smith RH, Garcia M, Petersdorf RG (1967) "Studies on the pathogenesis of meningitis. VI: antagonism between penicillin and chloramphenicol in experimental pneumococcal meningitis." J Lab Clin Med, 70, p. 408-18
  3. Garrod L (1972) "Causes of failure in antibiotic treatment." Br Med J, 4, p. 441
  4. Jawetz E (1968) "The use of combinations of antimicrobial drugs." Annu Rev Pharmacol, 8, p. 151
View all 4 references

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Drug and food interactions

Moderate

nafcillin food

Applies to: Unipen (nafcillin)

ADJUST DOSING INTERVAL: Certain penicillins may exhibit reduced gastrointestinal absorption in the presence of food. The therapeutic effect of the antimicrobial may be reduced.

MANAGEMENT: The interacting penicillin should be administered one hour before or two hours after meals. Penicillin V and amoxicillin are not affected by food and may be given without regard to meals.

References

  1. Neu HC (1974) "Antimicrobial activity and human pharmacology of amoxicillin." J Infect Dis, 129, s123-31
  2. Welling PG, Huang H, Koch PA, Madsen PO (1977) "Bioavailability of ampicillin and amoxicillin in fasted and nonfasted subjects." J Pharm Sci, 66, p. 549-52
  3. McCarthy CG, Finland M (1960) "Absorption and excretion of four penicillins." N Engl J Med, 263, p. 315-26
  4. Cronk GA, Wheatley WB, Fellers GF, Albright H (1960) "The relationship of food intake to the absorption of potassium alpha-phenoxyethyl penicillin and potassium phenoxymethyl penicillin from the gastrointestinal tract." Am J Med Sci, 240, p. 219-25
  5. Klein JO, Sabath LD, Finland M (1963) "Laboratory studies on oxacillin. I: in vitro activity against staphylococci and some other bacterial pathogens. II: absorption and urinary excretion in normal young." Am J Med Sci, 245, p. 399-411
  6. Neuvonen PJ, Elonen E, Pentikainen PJ (1977) "Comparative effect of food on absorption of ampicillin and pivampicillin." J Int Med Res, 5, p. 71-6
View all 6 references

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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.

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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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