DDInter351 DDInter998
An antibiotic first isolated from cultures of _Streptomyces venezuelae_ in 1947 but now produced synthetically. It has a relatively simple structure and was the first broad-spectrum antibiotic to be discovered. It acts by interfering with bacterial protein synthesis and is mainly bacteriostatic. (From Martindale, The Extra Pharmacopoeia, 29th ed, p106) The FDA has withdrawn all oral drug products containing chloramphenicol, due to the high risk of fatal aplastic anemia associated with this specific route of administration.[L43942,L44022]
Ivermectin is a semi-synthetic antiparasitic medication derived from avermectins, a class of highly-active broad-spectrum antiparasitic agents isolated from the fermentation products of _Streptomyces avermitilis_. Ivermectin itself is a mixture of two avermectins, comprising roughly 90% 5-O-demethyl-22,23-dihydroavermectin A<sub>1a</sub> (22,23-dihydroavermectin B<sub>1a</sub>) and 10% 5-O-demethyl-25-de(1-methylpropyl)-22,23-dihydro­-25-(1-methylethyl)avermectin A<sub>1a</sub> (22,23-dihydroavermectin B<sub>1b</sub>). Ivermectin is mainly used in humans in the treatment of onchocerciasis, but may also be effective against other worm infestations (such as strongyloidiasis, ascariasis, trichuriasis and enterobiasis). Applied topically, it may be used in the treatment of head lice infestation. With the advent of 2020 and the COVID-19 pandemic, ivermectin began garnering notoriety due to its off-label use for the prophylaxis and treatment of COVID-19. While studies are still ongoing, much of the evidence for ivermectin in COVID-19 relies on pre-print _in vitro_ data, and the clinical utility of this data remains unclear. Due to a number of factors - for example, the relatively low number of patients per trial and the speed at which these trials were conducted - studies on the use of ivermectin in COVID-19 have been fraught with statistical errors and accusations of plagiarism.[L36763,A238929] In addition, the use of aggregate patient data in large-scale meta-analyses (as opposed to individual patient data (IPD)) has been shown to disguise otherwise blatant data errors, such as extreme terminal digit bias and the duplication of blocks of patient records. Until high-quality, peer-reviewed data regarding both the safety and efficacy of ivermectin for COVID-19 in humans becomes available, the use of ivermectin for these purposes should be avoided in favour of thoroughly-vetted therapies (e.g. COVID-19 vaccines like [Comirnaty](https://go.drugbank.com/drugs/DB15696)).
Chloramphenicol {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) is bound by {v} (Compound) Ivermectin
Chloramphenicol {u} (Compound) upregulates {v} (Gene) IKBKB
IKBKB {u} (Gene) is upregulated by {v} (Compound) Ivermectin
Chloramphenicol {u} (Compound) downregulates {v} (Gene) JMJD6
JMJD6 {u} (Gene) is downregulated by {v} (Compound) Ivermectin
Chloramphenicol {u} (Compound) causes {v} (Side Effect) Dermatitis
Dermatitis {u} (Side Effect) is caused by {v} (Compound) Ivermectin
Chloramphenicol {u} (Compound) binds {v} (Gene) CYP3A4
CYP3A4 {u} (Gene) interacts with {v} (Gene) PGRMC1
PGRMC1 {u} (Gene) is downregulated by {v} (Compound) Ivermectin
Chloramphenicol {u} (Compound) upregulates {v} (Gene) IKBKB
IKBKB {u} (Gene) is regulated by {v} (Gene) MAPKAPK5
MAPKAPK5 {u} (Gene) is upregulated by {v} (Compound) Ivermectin
Chloramphenicol {u} (Compound) downregulates {v} (Gene) JMJD6
JMJD6 {u} (Gene) is regulated by {v} (Gene) XBP1
XBP1 {u} (Gene) is upregulated by {v} (Compound) Ivermectin
Chloramphenicol {u} (Compound) downregulates {v} (Gene) CCNB2
CCNB2 {u} (Gene) regulates {v} (Gene) TRAPPC6A
TRAPPC6A {u} (Gene) is upregulated by {v} (Compound) Ivermectin
Chloramphenicol {u} (Compound) downregulates {v} (Gene) RPS4Y1
RPS4Y1 {u} (Gene) is regulated by {v} (Gene) ABCB1
ABCB1 {u} (Gene) is bound by {v} (Compound) Ivermectin
Chloramphenicol {u} (Compound) upregulates {v} (Gene) IKBKB
IKBKB {u} (Gene) interacts with {v} (Gene) EPRS
EPRS {u} (Gene) is upregulated by {v} (Compound) Ivermectin
Chloramphenicol (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) is bound by Ivermectin (Compound)
Chloramphenicol (Compound) upregulates IKBKB (Gene) and IKBKB (Gene) is upregulated by Ivermectin (Compound)
Chloramphenicol (Compound) downregulates JMJD6 (Gene) and JMJD6 (Gene) is downregulated by Ivermectin (Compound)
Chloramphenicol (Compound) causes Dermatitis (Side Effect) and Dermatitis (Side Effect) is caused by Ivermectin (Compound)
Chloramphenicol (Compound) binds CYP3A4 (Gene) and CYP3A4 (Gene) interacts with PGRMC1 (Gene) and PGRMC1 (Gene) is downregulated by Ivermectin (Compound)
Chloramphenicol (Compound) upregulates IKBKB (Gene) and IKBKB (Gene) is regulated by MAPKAPK5 (Gene) and MAPKAPK5 (Gene) is upregulated by Ivermectin (Compound)
Chloramphenicol (Compound) downregulates JMJD6 (Gene) and JMJD6 (Gene) is regulated by XBP1 (Gene) and XBP1 (Gene) is upregulated by Ivermectin (Compound)
Chloramphenicol (Compound) downregulates CCNB2 (Gene) and CCNB2 (Gene) regulates TRAPPC6A (Gene) and TRAPPC6A (Gene) is upregulated by Ivermectin (Compound)
Chloramphenicol (Compound) downregulates RPS4Y1 (Gene) and RPS4Y1 (Gene) is regulated by ABCB1 (Gene) and ABCB1 (Gene) is bound by Ivermectin (Compound)
Chloramphenicol (Compound) upregulates IKBKB (Gene) and IKBKB (Gene) interacts with EPRS (Gene) and EPRS (Gene) is upregulated by Ivermectin (Compound)