Why it's used

Chloramphenicol is used to treat life-threatening infections, especially those caused by Haemophilus influenza, typhoid fever, and severe infections such as meninges inflammation and blood poisoning. It is a prescription medicine. This medicine works by blocking bacterial protein synthesis.
When not to use
Chloramphenicolshould not be used to treat non-severe (trivial) infections.
Antibacterials
Chloramphenicol belongs to a class of medicines called Antibacterials. Antibacterials, also known as Antibiotics, are widely used in the treatment and prevention of diseases caused by bacteria. It destroys or slows down the growth of bacteria.

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How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Chloramphenicol. If you have any questions related to this medicine, ask your doctor or pharmacist. Consume this medicine as recommended by your doctor.

Typical Dosage

The typical dose ofChloramphenicolis 500 mg after every 6 hours (50 mg/kg (22.72 mg/lb) bodyweight in 4 equal doses every day).
For intravenous use, the solution of 10% (100 mg/ml) injected to the patient at the interval of at least one minute. The solution is prepared by adding 10 ml of an aqueous diluent such as water or by adding 5% dextrose.
If you have any kidney disease, the dose ofChloramphenicolshould be reduced, and blood level monitoring should be done in patients with kidney dysfunction. If you have issues with the health of your liver, the dose ofChloramphenicolshould be reduced, and blood level monitoring should be done in patients with liver disease.

Use in Children

The safety and effectiveness of usingChloramphenicolin children has not been established. It is not recommended in children for oral use, but for intravenous use, the dose should be 50 mg/kg (22.72 mg/lb) in 4 equal doses daily after every 6 hours.

Lab Tests

Your doctor may request that specific lab tests be performed before you start using Chloramphenicol. You may need to have Antibiotic Susceptibility test. In the case of injectable forms, this test helps the doctor in selecting a various effective antimicrobial agent.

Storage

You should store Chloramphenicol below 25°C for the capsule and at 15°C to 25°C (59° to 77°F) for injection. Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Chloramphenicol for conditions for which it was not prescribed. Do not giveChloramphenicolto other people who might have the same conditions or symptoms that you have. Self-medication may harm them.

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How to take Chloramphenicol

Your dose and how often you take Chloramphenicol will depend on the following factors:
  • weight
  • the health of the patient's liver
  • the health of the patient's kidneys

Chloramphenicol Dosage

Dosage for life-threatening infections

Adult
  • Recommended: 500 mg after every 6 hours (50 mg/kg or 22.72 mg/lb bodyweight in 4 equal doses every day) and in severe infections (meninges inflammation, blood poisoning) the starting dose may be doubled initially.

Forms

Capsule
Strength: 250 mg
Ointment
Strength: 1%, 0.2%,10 mg, 10 mg/1000 mg
Liquid
Strength: 0.4%, 0.5%
Powder, for solution
Strength: 1000 mg
Solution
Strength: 0.5%, 2.5 mg, 5 mg
Solution/drops
Strength: 0.2%, 0.5%, 5%

Overdose

What to do if you overdose on Chloramphenicol?
In case of overdose, blood purification should be done outside the body to remove poison by increasing the clearance of Chloramphenicol.
Symptoms of an overdose of Chloramphenicol
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • Chloramphenicol accumulation in newborn
  • allergy
If you think you have overdosed on Chloramphenicol, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Chloramphenicol

Before you use Chloramphenicol, tell your doctor of your medical and health history including the following:
  • allergic reaction
  • minor infections
  • nerve or skin problems
  • serious blood disorders
Before you use Chloramphenicol, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.

Use when Pregnant

Chloramphenicol is not safe for use in women who are pregnant. If you are pregnant or planning to become pregnant, you should discuss the impact on the fetus with your doctor before you start using this medicine.Chloramphenicolshould not be used during pregnancy.

If Breastfeeding

Chloramphenicol is not safe for use in women who are breastfeeding. If you are breastfeeding, discuss with your doctor if you should either discontinue breastfeeding, or stop using this medicine during this period.Chloramphenicolshould not be used during breastfeeding as it passes in human milk. Due to this, the mother takingChloramphenicolshould not breastfeed their baby.

Side-effects in Children

Younger patients may have a higher incidence of side-effects with Chloramphenicol. Younger patients may see an increased risk of accumulation ofChloramphenicolin newborn.

What precautions should be taken during Pregnancy and Nursing, and administeringChloramphenicolto Children or the Older Adults?

Pregnant Women

Contraindicated or Not Recommended
Warning: Chloramphenicol should not be recommended for pregnant women.

Breastfeeding

Contraindicated or Not Recommended
Warning: Chloramphenicol should not be used during breastfeeding as it passes in human milk. Due to this, the mother takingChloramphenicolshould not breastfeed their baby.

Younger Adults Population

Management or monitoring precaution
Warning: WhenChloramphenicolis given through the vein, at the recommended dose, precaution should be taken. It is done to avoid accumulation ofChloramphenicoldue to immature metabolic processes in children. Adjust the dose accordingly. Determine the blood level at a suitable interval.

Older Adults Population

Precaution
Warning: Dose reduction ofChloramphenicoland blood level monitoring is needed in elderly patients.

Chloramphenicol Side-effects

The following side-effects may commonly occur in children when using Chloramphenicol. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • accumulation ofChloramphenicolin newborn
Rarely, the use ofChloramphenicolmay cause the following side-effects:
  • inflammation of the mouth and lips
  • inflammation of the tongue
  • nausea
The following severe side-effects may also occur when using Chloramphenicol:
  • Vascular disorders
    Symptoms: heart failure
  • Ear and labyrinth disorders
    Symptoms: damage to the inner ear
  • Eye disorders
    Symptoms: inflammation of the optic nerve blindness
  • Immune system disorders
    Symptoms: allergic skin reactions
  • Blood and lymphatic system disorders
    Symptoms: increase in bleeding time
  • Stomach and intestinal disorders
    Symptoms: vomiting, diarrhea inflammation of the digestive tract
  • Pregnancy related disorders (leads to constriction or dilation of blood vessels, irregular respiration, and fatality)
    Symptoms: accumulation ofChloramphenicolin baby
Your doctor has prescribed this Chloramphenicol because they have judged that the benefits outweigh the risks posed by side-effects. Many people using this medicine do not have serious side-effects. This is not a complete list of possible side-effects for Chloramphenicol.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions ofChloramphenicolby Severity and Frequency

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Side-effects in Children

Following are the side-effects of this medicine in young patients:
  • accumulation ofChloramphenicolin newborn

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
  • allergic skin reaction
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Non-Severe (Trivial) Infections

Chloramphenicol should not be used for the treatment of non-severe (trivial) infections.Chloramphenicolshould only be used if other medicines are ineffective. Its use should always be monitored carefully.

Bone Marrow Depression

Avoid repeated courses ofChloramphenicoland combined therapy with other drugs known to cause a decrease in white blood cells, red blood cells, and platelets (bone marrow depression).

Prolonged or Repeated Use

Determine regular blood profile before treatment and repeat blood studies at suitable intervals, particularly during prolonged or repeated treatment. The drug use should be stopped if proof of a significant harmful effect is seen or lowering of the blood elements appears to be attributable to Chloramphenicol.

Liver or Kidney Damage

Patient with liver or kidney damage and elders are at an increased risk while taking Chloramphenicol. Dose reduction and blood level monitoring may be needed in patients with liver and kidney damage, in the elderly and in patients having a combination of drugs.

Interactions with Chloramphenicol

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Chloramphenicol. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Ciclosporin and Tacrolimus

Your doctor's guidelines may need to be followed while taking this medicine along with calcineurin inhibitors (ciclosporin and tacrolimus), which are used to prevent activity of the immune system. Therapy with Chloramphenicol probably increases the blood levels of tacrolimus and ciclosporin.

Anticonvulsants and Anticoagulants

Chloramphenicol interacts with anticonvulsants, which are used to treat epileptic seizures and anticoagulants, which are used to treat coagulation of blood. If anticonvulsants and anticoagulants are used in combination withChloramphenicolthen their doses may need to be adjusted.

Penicillins and Rifampicin

There may be an interaction of Chloramphenicol with penicillins and rifampicin, which are used to treat bacterial infections. The combined use of Chloramphenicol with penicillin and rifampicin may decrease or increase the blood level of these drugs. Monitoring ofChloramphenicolblood levels should be done with the combined use of penicillins and rifampicin.

Paracetamol

Chloramphenicol may interact with paracetamol, which is used to treat pain and fever. When Chloramphenicol is used in combination with paracetamol, there is a prolongation of the time taken byChloramphenicolto get eliminated by 50% from the blood. The use ofChloramphenicolin patients taking paracetamol should be avoided.

Warfarin, Phenytoin, Sulphonylureas and Tolbutamide

Special instructions need to be followed while taking this medicine along with warfarin, which is used to treat blood clot or phenytoin, which is used to treat seizures, and sulphonylureas or tolbutamide, which are used to treat high sugar levels. Chloramphenicol prolongs the process of elimination and increases the blood level of drugs including warfarin, sulphonylureas, phenytoin and tolbutamide.

Hydroxocobalamin

Chloramphenicol interacts with hydroxocobalamin, which is used to treat vitamin B12 deficiency.Chloramphenicollessens the response to hydroxocobalamin when both are used in combination.

Drugs Causing Lowering of Granulocytes

Special instructions need to be followed while taking this medicine along with drugs causing a low level of white blood cells. Chloramphenicol should not be used in patients using drugs (carbamazepine, sulphonamides, etc.) which are likely to suppress bone marrow function.

Estrogens

There may be an interaction of Chloramphenicol with estrogens, which are used for the development of the female reproductive system. Chloramphenicol may reduce the birth controlling effect of estrogens.

Barbiturates

Chloramphenicol may interact with barbiturates, which are used to treat anxiety and insomnia. The absorption of Chloramphenicol is stimulated by barbiturates (phenobarbitone), leading to reduced blood levels. There is a decrease in the absorption of phenobarbitone with combined use of Chloramphenicol.

Interactions ofChloramphenicolby Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When shouldChloramphenicolbe not used?

Allergic Reactions

Chloramphenicol should not be used in patients having a previous history of allergic reactions toChloramphenicolor to any of its excipients.

Minor Infections

Chloramphenicolshould not be used for the prevention and treatment of minor infections.

Active Immunization

Chloramphenicolshould not be used in patients exposed to a microbe or other antigens who have no pre-made antibodies for defense (active immunization).

Nerve or Skin Problems

Chloramphenicol should not be used in patients having nerve or skin problems.

Blood Disorder

Chloramphenicol should not be used in patients with a blood disorder in which the body stops producing sufficient amount of new blood cells.

Pregnancy

Chloramphenicolshould not be given during pregnancy.

Breastfeeding

Chloramphenicolshould not be given during breastfeeding as it passes in breast milk. It may increase the risk of fetal/infant damage.

Bone Marrow Suppression

Chloramphenicol should not be recommended for the patients using medicines which are likely to suppress the function of bone marrow.

Non-severe (Trivial) Infections

Chloramphenicol should not be recommended for the use in trivial infections.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expiredChloramphenicolis unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Chloramphenicol .
Typhoid Fever
Bacterial Infections
Fungal Infections
Blood Poisoning

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