Composition
Cap 250 mg: Chloramphenicol base 250 mg. Susp: Per 5 ml: Chloramphenicol palmitate equiv to 125 mg chloramphenicol base. Inj1 gm: Chloramphenicol (as sodium succinate) 1 gm; powder in vi
Indications & Dosage
Life threatening infections particularly those caused by Haemophilus infuenzae, Typhoid fever, Septicaemia, Meningitis: ORAL: Adult: 50 mg/kg in divided doses every 6 hours; Children less than 2 week: 25 mg/kg in divided doses every 6 hours; over 2 week: same as adult. Dose can be doubled for severe infections such as septicaemia and meningitis, providing high doses reduced as soon as clinically indicated. BY IV INJ: 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, D51/4NS, D51/2NS, DSNS, D5W, D10W, fat emulsion 10%, LR, 1/2 NS, NS. At Y-site administration incompatible with fluconazole; In syringe; incompatible with glycoapyrrolate, metoclopramide; When admixed; incompatible with chlorpromazine, hydroxyzine, phenytoin, polymyxinsulphate, 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.
Contraindications
Acute porphyria, history of previous hypersensitivity or toxicity with chloramphenicol, severe renal impairment
Precautions
Avoid repeated courses and prolonged treatment, reduce dose in hepatic and renal impairment, blood counts required before and periodically during treatment, monitor plasma-chloramphenicol concentrations in neonates, risk of serious and fatal blood dyscrasias. Chloramphenicol must not be used when less potentially dangerous agents are effective Associated with serious haematological side-effects when given systemically and should therefore be reserved for the treatment of life-threatening infections.
Interactions
Rifampicin, warfarin, sulphonylureas, phenobarbital, phenytoin, cyclosporin, tacrolimus.
Pregnancy
Contraindicated in pregnancy.
Lactation
Contraindicated, avoid
Side Effects
Blood disorders, depression, diarrhoea, dry mouth, erythema multiforme, glossitis, headache, nausea, nocturnal haemoglobinuria, optic neuritis, peripheral neuritis, reversible and irreversible aplastic anaemia (with reports of resulting leukaemia),stomatitis, urticaria, vomiting