Chloromycetin

CHLORAMPHENICOL (Systemic)

Some frequently used brand names are:

In the U.S.—

• Chloromycetin

In Canada—

• Chloromycetin
• Novochlorocap

Generic medicine may be available in the U.S.

Category

• Antibacterial, systemic

Description

Chloramphenicol (klor-am-FEN-i-kole) is used in the treatment of infections caused by bacteria. It works by killing bacteria or preventing their growth.

Chloramphenicol is used to treat serious infections in different parts of the body. It is sometimes given with other antibiotics. However, chloramphenicol should not be used for colds, flu, other virus infections, sore throats or other minor infections, or to prevent infections.

Chloramphenicol should only be used for serious infections in which other medicines do not work. This medicine may cause some serious side effects, including blood problems and eye problems. Symptoms of the blood problems include pale skin, sore throat and fever, unusual bleeding or bruising, and unusual tiredness or weakness. You and your doctor should talk about the good this medicine will do as well as the risks of taking it .

Chloramphenicol is available only with your doctor's prescription (RX medicine), in the dosage form provided belows:

• Oral
• Capsules (U.S. and Canada)
• Oral suspension (U.S.)

• Parenteral
• Injection (U.S. and Canada)

Before Using This Medicine

When deciding if it's worth using a medicine, the risk of taking it must be carefully weighed against the benifit it can do. This is the decision you and your doctor are to make together. Concerning chloramphenicol, the following aspects should be taken into account:

Allergies—Inform your doctor if you have ever experienced any unusual or allergic reaction to chloramphenicol. Also tell your doctor if you are allergic to any other substances, like foods, preservatives, dyes.

Pregnancy—Chloramphenicol has not been shown to cause birth defects in humans. However, use is not recommended within a week or two of your delivery date. Chloramphenicol may cause gray skin color, low body temperature, bloated stomach, uneven breathing, drowsiness, pale skin, sore throat and fever, unusual bleeding or bruising, unusual tiredness or weakness, or other problems in the infant.

Breast-feeding—Chloramphenicol passes into the breast milk and has been shown to cause unwanted effects, such as pale skin, sore throat and fever, unusual bleeding or bruising, unusual tiredness or weakness, or other problems in nursing babies. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children—Newborn infants are especially sensitive to the side effects of chloramphenicol because they cannot remove the medicine from their body as well as older children and adults.

Older adults—There are many medicines that have not been studied specifically in older people. Consequently, it may not be known if they work exactly the same way they do in younger adults or if they cause other side effects or problems in elderly people. There is no specific information comparing use of chloramphenicol in the elderly with use in other age groups.

Other medicines—Although some medicines should not be used together at all, there are cases when 2 different medicines maybe used together even if an interaction might occur. In such cases, your doctor may advise you to change the dose, or other precautions may be required. When you are taking chloramphenicol, it is essential to tell your health care professional if you are taking any of the following:

• Alfentanil or
• Antidiabetics, oral (diabetes medicine you take by mouth) or
• Phenobarbital or
• Warfarin (e.g., Coumadin)—Use of chloramphenicol with these medicines may increase the chance of side effects of these medicines

• Amphotericin B by injection (e.g., Fungizone) or
• Antineoplastics (cancer medicine) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Colchicine or
• Cyclophosphamide (e.g., Cytoxan) or
• Ethotoin (e.g., Peganone) or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Mephenytoin (e.g., Mesantoin) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Phenytoin (e.g., Dilantin) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• X-ray treatment—Use of chloramphenicol with any of these medicines or with x-ray treatment may increase the risk of blood problems

• Clindamycin (e.g., Cleocin) or
• Erythromycins (medicine for infection) or
• Lincomycin (e.g., Lincocin)—Use of chloramphenicol with any of these medicines may decrease the effectiveness of these medicines

• Phenytoin (e.g., Dilantin)—Use of chloramphenicol with phenytoin may increase the chance of blood problems or increase the side effects of phenytoin

Other medical problems—The existence of other medical problems may influence the use of /chloramphenicol. You should tell your doctor if you have any other medical problems, in particular::

• Anemia, bleeding, or other blood problems—Chloramphenicol may cause blood problems

• Liver disease—Patients with liver disease may have an increased risk of side effects

Proper Use of This Medicine

Chloramphenicol is best taken with a full glass (8 ounces) of water on an empty stomach (either 1 hour before or 2 hours after meals), unless otherwise directed by your doctor.

For patients taking the oral liquid form of this medicine:

• Use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.

To help clear up your infection completely, keep taking this medicine for the full time of treatment , even if you begin to feel better after a few days. Do not miss any doses .

Dosing—The dose of chloramphenicol will vary for different patients. Adhere to the orders of your doctor or the instructions on the label . The information below includes only the average doses of chloramphenicol. If your dose differs, you should not change it unless your doctor tells you to do so.

The number of capsules or teaspoonfuls of suspension that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking chloramphenicol .

• For infections caused by bacteria:
  • For oral dosage forms (capsules and suspension):
    • Adults and teenagers—Dose is based on body weight. The usual dose is 12.5 milligrams (mg) per kilogram (kg) (5.7 mg per pound) of body weight every six hours.
    • Children—
      • Infants up to 2 weeks of age: Dose is based on body weight. The usual dose is 6.25 mg per kg (2.8 mg per pound) of body weight every six hours.
      • Infants 2 weeks of age and older: Dose is based on body weight. The usual dose is 12.5 mg per kg (5.7 mg per pound) of body weight every six hours; or 25 mg per kg (11.4 mg per pound) of body weight every twelve hours.
  • For injection dosage form:
    • Adults and teenagers—Dose is based on body weight. The usual dose is 12.5 mg per kg (5.7 mg per pound) of body weight every six hours.
    • Children—
      • Infants up to 2 weeks of age: Dose is based on body weight. The usual dose is 6.25 mg per kg (2.8 mg per pound) of body weight every six hours.
      • Infants 2 weeks of age and older: Dose is based on body weight. The usual dose is 12.5 mg per kg (5.7 mg per pound) of body weight every six hours; or 25 mg per kg (11.4 mg per pound) of body weight every twelve hours.

Missed dose—If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. You should not double doses.

Storage—To store this medicine properly, follow the instructions below:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the capsule form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the oral liquid form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

It is very important that your doctor check you at regular visits for any blood problems that may be caused by this medicine.

Chloramphenicol may cause blood problems. These problems may result in a greater chance of infection, slow healing, and bleeding of the gums. Therefore, you should be careful when using regular toothbrushes, dental floss, and toothpicks. Dental work, whenever possible, should be done before you begin taking this medicine or delayed until your blood counts have returned to normal. Check with your medical doctor or dentist if you have any questions about proper oral hygiene (mouth care) during treatment.

For diabetic patients:

• This medicine may cause false test results with urine sugar tests . Check with your doctor before changing your diet or the dosage of your diabetes medicine.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some serious unwanted effects. Although not all of these side effects may happen, if they do happen they may require medical attention.

Other side effects that may occur generally do not require any medical attention. These side effects may disappear in the course of treatment as your body gets used to the medicine. Nevertheless, inform your doctor if any of the side effects below persist or became annoying:

Other side effects not mentioned above may also happen in some patients. If you notice any other effects, tell your doctor about it.

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