Chloramphenicol

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Chloramphenicol Brand Names

AK-Chlor | Chloromycetin | Chloroptic | Chloroptic S.O.P. | Ocu-Chlor

What is Chloramphenicol

In 1947, chloramphenicol was isolated from Streptomyces venezuelae, but it is now available synthetically for therapeutic use as either chloramphenicol, chloramphenicol palmitate, or chloramphenicol sodium succinate.

Chloramphenicol palmitate is hydrolyzed in the GI tract to chloramphenicol; chloramphenicol sodium succinate is hydrolyzed to free chloramphenicol in vivo.

Oral chloramphenicol was removed from the US market in July 2012 due to safety concerns, primarily bone marrow suppression and aplastic anemia, which may have a higher risk with the oral formulation; intravenous chloramphenicol continues to be an approved formulation.

Chloramphenicol was approved by the FDA in 1950.

Indications

  1. anthrax
  2. bacteremia
  3. Chlamydia sp.
  4. Chlamydophila psittaci
  5. cystic fibrosis
  6. Francisella tularensis
  7. Haemophilus influenzae (beta-lactamase negative)
  8. Haemophilus influenzae (beta-lactamase positive)
  9. meningitis
  10. murine typhus
  11. plague
  12. psittacosis
  13. Q fever
  14. Rickettsia rickettsii
  15. Rickettsia sp.
  16. Rocky Mountain spotted fever
  17. Salmonella sp.
  18. Salmonella typhi
  19. tularemia
  20. typhoid fever
  21. Yersinia pestis

Side Effects

  1. acute generalized exanthematous pustulosis (AGEP)
  2. anaphylactoid reactions
  3. anemia
  4. angioedema
  5. aplastic anemia
  6. bone marrow suppression
  7. confusion
  8. cyanosis
  9. delirium
  10. depression
  11. diarrhea
  12. enterocolitis
  13. fever
  14. glossitis
  15. gray-baby syndrome
  16. headache
  17. interstitial nephritis
  18. leukopenia
  19. maculopapular rash
  20. nausea
  21. neutropenia
  22. optic neuritis
  23. pancytopenia
  24. peripheral neuropathy
  25. stomatitis
  26. thrombocytopenia
  27. urticaria
  28. vesicular rash
  29. vitamin B12 deficiency
  30. vomiting

Monitoring Parameters

  • CBC
  • hemoglobin/hematocrit
  • LFTs
  • reticulocyte count
  • serum chloramphenicol concentrations
  • serum creatinine/BUN

Contraindications

  • bone marrow suppression
  • breast-feeding
  • children
  • colitis
  • dental disease
  • dental work
  • diarrhea
  • G6PD deficiency
  • geriatric
  • GI disease
  • hepatic disease
  • infants
  • inflammatory bowel disease
  • influenza
  • intramuscular injections
  • labor
  • neonates
  • porphyria
  • pregnancy
  • pseudomembranous colitis
  • renal impairment
  • ulcerative colitis

Interactions

  • Abemaciclib
  • Acalabrutinib
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetohexamide
  • Ado-Trastuzumab emtansine
  • Alfuzosin
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Almotriptan
  • Alprazolam
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Apalutamide
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Artemether; Lumefantrine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Avanafil
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  • Azelastine; Fluticasone
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  • Cariprazine
  • Ceritinib
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpropamide
  • Citalopram
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