Chloromycetin

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|Chloromycetin

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CHLORAMPHENICOL (Systemic)

Some commonly used brand names are:

In the U.S.—

  • Chloromycetin

In Canada—

  • Chloromycetin
  • Novochlorocap

Generic name product 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, in the following dosage forms:

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

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For chloramphenicol, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to chloramphenicol. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or 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—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of chloramphenicol in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking chloramphenicol, it is especially important that your health care professional know 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 presence of other medical problems may affect the use of chloramphenicol. Make sure you tell your doctor if you have any other medical problems, especially:

  • 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 be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of chloramphenicol. If your dose is different, do 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. Do not double doses.

Storage—To store this medicine:

  • 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 occur, if they do occur they may need medical attention.

Stop taking this medicine and get emergency help immediately if any of the following side effects occur:

Rare—in babies only

Bloated stomach; drowsiness; gray skin color; low body temperature; uneven breathing; unresponsiveness

Also, check with your doctor immediately if any of the following side effects occur:

Less common

Pale skin; sore throat and fever; unusual bleeding or bruising; unusual tiredness or weakness (the above side effects may also occur up to weeks or months after you stop taking this medicine)

Rare

Confusion, delirium, or headache; eye pain, blurred vision, or loss of vision; numbness, tingling, burning pain, or weakness in the hands or feet; skin rash, fever, or difficulty in breathing

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Less common

Diarrhea; nausea or vomiting

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 06/20/1995

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