Drug Interaction Report
2 potential interactions and/or warnings found for the following 2 drugs:
- butalbital
- Chloromycetin Sodium Succinate (chloramphenicol)
Interactions between your drugs
chloramphenicol butalbital
Applies to: Chloromycetin Sodium Succinate (chloramphenicol), butalbital
MONITOR: Barbiturates may increase the hepatic metabolism of chloramphenicol. Serum chloramphenicol levels and effectiveness may be decreased. Coadministration also may enhance the pharmacologic effect of barbiturates. The proposed mechanism is induction of chloramphenicol metabolism by barbiturates and inhibition of barbiturate metabolism by chloramphenicol.
MANAGEMENT: The effectiveness of chloramphenicol should be monitored, and plasma levels should be checked as clinically appropriate. Dosage should be increased as needed. The patient also should be monitored for barbiturate toxicity.
References (9)
- Smith AL, Weber A (1983) "Pharmacology of chloramphenicol." Pediatr Clin North Am, 30, p. 209-36
- Ambrose PJ (1984) "Clinical pharmacokinetics of chloramphenicol and chloramphenicol succinate." Clin Pharmacokinet, 9, p. 222-38
- Koup JR, Gibaldi M, McNamara P, et al. (1978) "Interaction of chloramphenicol with phenytoin and phenobarbital." Clin Pharmacol Ther, 24, p. 571-5
- Kearns GL, Bocchini JA, Brown RD, et al. (1985) "Absence of a pharmacokinetic interaction between chloramphenicol and acetaminophen in children." J Pediatr, 107, p. 134-9
- Palmer DL, Despopoulos A, Rael ED (1972) "Induction of chloramphenicol metabolism by phenobarbital." Antimicrob Agents Chemother, 1, p. 112-5
- Mulhall A, de Louvois J, Hurley R (1983) "The pharmacokinetics of chloramphenicol in the neonate and young infant." J Antimicrob Chemother, 12, p. 629-39
- Krasinski K, Kusmiesz H, Nelson JD (1982) "Pharmacologic interactions among chloramphenicol, phenytoin and phenobarbital." Pediatr Infect Dis, 1, p. 232-5
- Bloxham RA, Durbin GM, Johnson T, Winterborn MH (1979) "Chloramphenicol and phenobarbitone--a drug interaction." Arch Dis Child, 54, p. 76-7
- Cerner Multum, Inc. "Australian Product Information."
Drug and food interactions
butalbital food
Applies to: butalbital
GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.
MANAGEMENT: The combination of ethanol and barbiturates should be avoided.
References (5)
- Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
- Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
- Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
- Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
- Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102
Therapeutic duplication warnings
No duplication 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
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
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