Selected Immunosuppressants/Chloramphenicol Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
It is unclear how chloramphenicol leads to high blood levels of cyclosporine, everolimus, sirolimus, tacrolimus, or temsirolimus. Chloramphenicol may slow down how quickly your body processes your immunosuppressant, or it may increase the amount of immunosuppressant that your body absorbs.
What might happen:
Your blood levels of cyclosporine, everolimus, sirolimus, tacrolimus, or temsirolimus may increase and cause toxic effects that may harm your kidneys.
What you should do about this interaction:
Make sure that your doctor knows all of the medicines that you are taking.Tell your doctor if you have any kidney problems. If you experience any shortness of breath, unusual swelling, changes in the color or amount of your urine, or changes in how often you urinate, contact your doctor.The amount of cyclosporine, everolimus, sirolimus, tacrolimus, or temsirolimus in your blood may need to be checked more often and the dosage adjusted when you first start or stop taking chloramphenicol.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Sparkes T, Lemonovich TL. Interactions between anti-infective agents and immunosuppressants-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019 Feb 28; e13510.
- 2.Prograf (tacrolimus) US prescribing information. Astellas Pharma US, Inc. August, 2023.
- 3.Mathis AS, Shah N, Knipp GT, Friedman GS. Interaction of chloramphenicol and the calcineurin inhibitors in renal transplant recipients. Transpl Infect Dis 2002 Sep;4(3):169-74.
- 4.Bui L, Huang DD. Possible interaction between cyclosporine and chloramphenicol. Ann Pharmacother 1999 Feb;33(2):252-3.
- 5.Schulman SL, Shaw LM, Jabs K, Leonard MB, Brayman KL. Interaction between tacrolimus and chloramphenicol in a renal transplant recipient. Transplantation 1998 May 27;65(10):1397-8.
- 6.Taber DJ, Dupuis RE, Hollar KD, Strzalka AL, Johnson MW. Drug-drug interaction between chloramphenicol and tacrolimus in a liver transplant recipient. Transplant Proc 2000 May;32(3):660-2.
- 7.Bakri R, Breen C, Maclean D, Taylor J, Goldsmith D. Serious interaction between tacrolimus FK506 and chloramphenicol in a kidney-pancreas transplant recipient. Transpl Int 2003 Jun;16(6):441-3.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.