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Drug Interactions between Chloroptic S.O.P. and fosphenytoin

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

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Moderate

chloramphenicol ophthalmic fosphenytoin

Applies to: Chloroptic S.O.P. (chloramphenicol ophthalmic) and fosphenytoin

GENERALLY AVOID: Chloramphenicol often markedly increases serum phenytoin levels. Toxicity has been reported. Also, phenytoin has been reported both to increase and to decrease serum chloramphenicol levels. Significant systemic absorption of otic or ophthalmic chloramphenicol products is unlikely. However, the clinician should be aware of the possibility of a drug interaction. Similar effects may occur with other hydantoins.

MANAGEMENT: This combination usually should be avoided if possible. Patients should be closely observed for signs of hydantoin toxicity if these drugs must be given concurrently and serum phenytoin concentrations should be monitored. Patients should be advised to notify their physician if they experience symptoms of toxicity, including drowsiness, visual disturbances, change in mental status, seizures, nausea, or ataxia. The hydantoin dose may need to be decreased.

References

  1. Koup JR, Gibaldi M, McNamara P, et al. "Interaction of chloramphenicol with phenytoin and phenobarbital." Clin Pharmacol Ther 24 (1978): 571-5
  2. Christensen LK, Skovsted L "Inhibition of drug metabolism by chloramphenicol." Lancet 2 (1969): 1397-9
  3. Rose JQ, Choi HK, Schentag JJ, et al. "Intoxication caused by interaction of chloramphenicol and phenytoin." JAMA 237 (1977): 2630-1
  4. Saltiel M, Stephens NM "Phenytoin-chloramphenicol interaction." Drug Intell Clin Pharm 14 (1980): 221
  5. Harper JM, Yost RL, Stewart RB, Ciezkowski J "Phenytoin-chloramphenicol interaction: a retrospective study." Drug Intell Clin Pharm 13 (1979): 425-9
  6. Powell DA, Nahata MC, Durrell DC, et al. "Interactions among chloramphenicol, phenytoin, and phenobarbital in a pediatric patient." J Pediatr 98 (1981): 1001-3
  7. Krasinski K, Kusmiesz H, Nelson JD "Pharmacologic interactions among chloramphenicol, phenytoin and phenobarbital." Pediatr Infect Dis 1 (1982): 232-5
View all 7 references

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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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