Chloramphenicol Inj/Oral

Chloramphenicol · Chloramphenicol

Indications

Typhoid fever, H. influenzae meningitis, severe infections when careful clinical assessment indicates no other antibiotics are effective.

Dosage

ORAL: Adults: 50 mg/kg daily in divided doses six hourly. Children: Under 2 wk, half adult dose; over 2 wk, same as adult. INJECTION: Septicaemia: IV: Adults & Children: 50-100 mg/kg/day given every 6 hr. Infants: 25 mg/kg/day given every 6 hr.

Administration

IV: Infuse via direct IV over 3-5 min; intermittent infusion over 30-60 min. IM: Do not administer IM. Compatibility: Stable in dextran 6% in dextrose, dextran 6% in NS, D5LR, D5¼NS, D5½NS, D5NS, D5W, D10W, fat emulsion 10%, LR, ½NS, NS. At Y-site administration incompatible with fluconazole. In syringe, incompatible with glycopyrrolate, metoclopramide. When admixed, incompatible with chlorpromazine, hydroxyzine, phenytoin, polymyxin B sulphate, prochlorperazine edisylate, prochlorperazine mesylate, promethazine, vancomycin. Stability: Store at room temperature prior to reconstitution, reconstituted solutions remain stable for 30 days, use only clear solutions, frozen solutions remain stable for 6 months.

Adverse Effects

Blood disorders including reversible and irreversible aplastic anaemia (with reports of resulting leukaemia), peripheral neuritis, optic neuritis, erythema multiforme, nausea, vomiting, glossitis, stomatitis, diarrhoea, nocturnal haemoglobinuria reported; grey syndrome (abdominal distension, pallid cyanosis, circulatory collapse) may follow excessive doses in neonates with immature hepatic metabolism.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Porphyria. History of previous hypersensitivity to and/or toxicity from chloramphenicol. Precautions: Avoid repeated courses and prolonged treatment, reduce dose in hepatic/renal impairment; blood counts required before and periodically during treatment; monitor plasma-chloramphenicol concentrations in neonates. Serious and fatal blood dyscrasias. Blood dyscrasias have occurred after both short term and prolonged therapy. Chloramphenicol must not be used when less potentially dangerous agents are effective. It must not be used in treatment of trivial infections, infections other than those indicated or as a prophylactic agent to prevent bacterial infection.

Interactions

Rifampicin, warfarin, sulphonylureas, phenobarbital, phenytoin, cyclosporin, tacrolimus, anticoagulants, anticonvulsants, hypoglycaemic agents, penicillins, paracetamol, barbiturates, hydroxocobalamin, myelosuppressants, vaccines.

Advice to Patient

After administration through intravenous route, you may feel bitter taste but after some time it will disappear. Contact prescriber if there is constant rash, fever, pain, diarrhoea, burning, numbness of ankles/hands/feet, petechiae, sore throat, fatigue, weakness, unusual bruising or bleeding, sores in mouth, vaginal discharge or itching, dark urine, discoloration of stool (blue), yellowing of eyes or skin, acute headache, nightmares or if there is worsening of condition or no improvement. Patients who take an oral contraceptive should use an additional contraceptive method during therapy. Keep follow-up appointments with prescriber.

Pharmacokinetics

Metabolism: Chloramphenicol: Hepatic. Chloramphenicol succinate: Liver, kidney and lungs. Bioavailability: Chloramphenicol: Oral: Approx. 80%. Chloramphenicol succinate: IV: Approx. 70%; highly variable. Half-life elimination: Neonates 1-2 days: 24 hrs. 10-16 days: 10 hrs. Chloramphenicol: Infants: Significantly prolonged. Children: 4-6 hrs. Adults: Approx. 4 hrs. Hepatic disease: Prolonged. Excretion: Urine.

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.