chloramphenicol (Chloromycetin): Drug Facts and Side Effects (original) (raw)

GENERIC NAME: chloramphenicol

BRAND NAME: Chloromycetin, Econochlor, Ocu-Chlor (These are discontinued brands in the US)

DRUG CLASS AND MECHANISM: Chloramphenicol is a man-made antibiotic. It slows growth of bacteria by preventing them from producing important proteins that they need to survive. Chloramphenicol is effective against S. typhi, H. influenzae, E. coli, Neisseria species, Staphylococcus and Streptococcusspecies, Rickettsia, and lymphogranuloma-psittacosis group of organisms. The FDA approved chloramphenicol in December 1950.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Chloramphenicol is available in 0.5% sterile eye drops and 1% eye ointment. Eye drops are available in 2.5 ml and 15 ml drop-containers. Ointments are available in 3.5 g tubes.

Chloramphenicol sodium succinate is available as 1 gram/10 ml per vial powder for intravenous injection form.

STORAGE: Chloramphenicol eye drops are refrigerated until dispensed. Chloramphenicol ointments are stored between 46 F and 80 F. Chloramphenicol vials for IV reconstitution are stored between 20 C and 25 C (68 F and 77 F).

PRESCRIBED FOR: Chloramphenicol treats various infections caused by susceptible strains of S. yphi, H. influenzae, E. coli, Neisseria species, Staphylococcus and Streptococcusspecies, Rickettsia, lymphogranuloma-psittacosis group of organisms, and other bacteria that cause bacteremia (bacteria in blood) and meningitis.

DOSING:

Eye drop solution:

• Mild disease: Instill 1 to 2 drops into the affected eye(s) up to 4 times a day
• Severe disease: Instill 2 hours into the affected eye(s) every hour until improvement.
• Eye ointment: Apply a small amount to the affected lower conjunctival sac(s) at bedtime as a supplement to the drops.

Intravenous (IV):

• Adults: 50 to 100 mg/kg IV every 6 hours.
• Children: 50 mg/kg IV every 6 hours; may increase to 100 mg/kg IV every 6 hours in severe illness.
• Newborn infants: 25 mg/kg IV every 6 hours. Newborns over 2 weeks old may receive 50 mg/kg every 6 hours.

DRUG INTERACTIONS: Chloramphenicol should not be used with lurasidone (Latuda) because chloramphenicol significantly lowers lurasidone's metabolism and increases its levels in the body.

Chloramphenicol should be used cautiously with red yeast rice, warfarin(Coumadin), and vilazodone (Viibryd) because chloramphenicol lowers their metabolism and increases those drug levels in the body.

PREGNANCY: There are no adequate studies done on chloramphenicol to determine safe and effective use in pregnant women.

NURSING MOTHERS: Chloramphenicol enters breast milk. Therefore, it should not be used in nursing mothers.

SIDE EFFECTS: Side effects of chloramphenicol are headache, mental confusion, fever, rash, diarrhea, and optic atrophy.

Chloramphenicol may cause Gray syndrome and serious, fatal blood dyscrasias. Gray syndrome occurs in pre-mature infants and neonates. It involves abdominal distention, pallid cyanosis, and vasomotor collapse leading to death. Blood dyscrasias are reductions in blood cells leading to aplastic anemia, thrombocytopenia, and granulocytopenia.

Summary

Chloramphenicol (Chloromycetin, Econochlor, Ocu-Chlor [These are discontinued brands in the US]) is an antibiotic prescribed to treat a variety of infections. Side effects, drug interactions, dosage, storage, and pregnancy safety information should be reviewed prior to using this medication.

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Related Disease Conditions

• Typhus Typhus is disease caused by Rickettsia bacteria. Symptoms include fever, headache, nausea, vomiting, diarrhea, and rash. Antibiotics are recommended as the treatment for endemic and epidemic typhus infections.
• Plague (Black Death) Plague is an infectious disease caused by the bacteria Yersinia pestis. Transmission to humans occurs via fleas that have bitten infected rodents. There are three forms of plague that infect humans: bubonic, septicemic, and pneumonic. Antibiotics are the standard treatment for plague.
• E. coli (0157:H7) Infection There are many types of E. coli (Escherichia coli). E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburgers or raw milk or dairy products.
• Typhoid Fever Typhoid fever is an illness caused by the Salmonella typhi bacteria. The illness is contracted by ingesting the bacteria in contaminated water or food. Symptoms include headaches, fever, diarrhea, lethargy, aches and pains, and poor appetite. Treatment focuses on killing the Salmonella bacteria with antibiotics.
• Rocky Mountain Spotted Fever (RMSF) Rocky Mountain spotted fever is a tick-borne disease that causes symptoms and signs such as fever, rash, headache, and muscle aches. The antibiotic doxycycline is the standard treatment for Rocky Mountain spotted fever.
• Enterovirulent E. coli (EEC) Enterovirulent Escherichia coli (E. coli) are strains of related bacteria that have a strong propensity to cause gastrointestinal tract infections. Examples of strains include EHEC (enterohemorrhagic E. coli), ETEC (enterotoxigenic E. coli), EPEC (enteropathogenic E. coli), EIEC (enteroinvasive E. coli), EAEC (enteroadherent E. coli), and EAggEC (enteroaggregative E. coli). Symptoms may vary depending on the strain the individual contracts. Infection is spread generally through contaminated food or drink.

Treatment & Diagnosis

Medications & Supplements

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Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

References

FDA Prescribing Information.