Drug Interaction Report

GENERALLY AVOID: The administration of inactivated, killed, or otherwise noninfectious vaccines to patients receiving therapy with chloramphenicol has not been studied but may be associated with diminished or suboptimal immunologic response. Serious and fatal blood dyscrasias (aplastic anemia, hypoplastic anemia, thrombocytopenia, granulocytopenia, and bone marrow depression) have been reported after short-term and long-term systemic therapy with chloramphenicol.

MANAGEMENT: Due to the potential for a diminished or suboptimal immunologic response, the administration of inactivated, killed, or otherwise noninfectious vaccines in patients receiving therapy with chloramphenicol should generally be avoided. Specific recommendations concerning the administration time of vaccines in relation to chloramphenicol therapy are not available. Some authorities consider the administration of chloramphenicol during active immunization as contraindicated. Local immunization guidelines and prescribing information for individual vaccines and chloramphenicol should be consulted for further guidance.

ADJUST DOSING INTERVAL: Coadministration of oral cholera vaccine with food or an oral beverage may impair its efficacy. The formulations of both the inactivated and live, attenuated oral cholera vaccines (Dukoral and Vaxchora, respectively) are acid-labile, and must be administered with a buffer. According to the manufacturer, eating and drinking may interfere with the protective effect of the buffer. However, clinical data are not available.

MANAGEMENT: It is recommended that patients avoid eating or drinking for 60 minutes before and after administration of either Dukoral or Vaxchora oral cholera vaccines.