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
- anthrax
- bacteremia
- Chlamydia sp.
- Chlamydophila psittaci
- cystic fibrosis
- Francisella tularensis
- Haemophilus influenzae (beta-lactamase negative)
- Haemophilus influenzae (beta-lactamase positive)
- meningitis
- murine typhus
- plague
- psittacosis
- Q fever
- Rickettsia rickettsii
- Rickettsia sp.
- Rocky Mountain spotted fever
- Salmonella sp.
- Salmonella typhi
- tularemia
- typhoid fever
- Yersinia pestis
Side Effects
- acute generalized exanthematous pustulosis (AGEP)
- anaphylactoid reactions
- anemia
- angioedema
- aplastic anemia
- bone marrow suppression
- confusion
- cyanosis
- delirium
- depression
- diarrhea
- enterocolitis
- fever
- glossitis
- gray-baby syndrome
- headache
- interstitial nephritis
- leukopenia
- maculopapular rash
- nausea
- neutropenia
- optic neuritis
- pancytopenia
- peripheral neuropathy
- stomatitis
- thrombocytopenia
- urticaria
- vesicular rash
- vitamin B12 deficiency
- 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
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- Alfuzosin
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Almotriptan
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- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Apalutamide
- Aprepitant, Fosaprepitant
- Aripiprazole
- Artemether; Lumefantrine
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- Aspirin, ASA; Oxycodone
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- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
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- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpropamide
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- Clindamycin
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