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CHLORAMPHENICOL

Brand Name(s) : Brochlor, Chloromycetin Redidrops, Kemicetine, Minims
Warnings
Uses
Side Effects
Precautions
Interactions
Overdose

CHLORAMPHENICOL WARNINGS

Chloramphenicol eye drops and ointment should be used with caution (check with your doctor first if the following applies) by:

  • People with eyesight problems
  • People with severe pain wihtin the eye
  • People who are sensitive to light (photophobia)
  • People who have inflamed eyes and a rash on the scalp or face
  • People with eyes that look cloudy
  • People with pupils that look unusual
  • Peopel who may have a foreign body in the eye
  • People who have had eye infections previously
  • People with glaucoma (increased eye pressure)
  • People with dry eye syndrome
  • People who have had any eye surgery or laser treatment in past 6 months
  • People with any eye injury
  • People using any other eye drops or treatment
  • People using contact lens

Chloramphenicol capsules or injection should be used with caution by:

  • People with or a history of liver disease
  • People with or a history of kidney disease
  • People who have been vaccinated recently
  • People using other medicines such as some drugs to thin the blood (anticoagulants), tolbutamide (used to treat diabetes), phenytoin and phenobarbital (used to treat epilepsy) and rifampicin, an antibiotic.

It should not be used in:

  • Children under 2 years (eye drops and eye ointment)
  • People allergic to chloramphenicol or any of the ingredients
  • People who have ever had bone marrow or blood disorders
  • People with a family history of blood disorders known as dyscrasias
  • People wearing contact lens during eye treatment ( soft contact lens should not be worn for at least 24 hours after the last use)
  • People using any medicines that cause bone marrow suppression such as cytotoxic drugs used to treat cancer or immunosuppressants such as azathioprine
  • Also see list of precautions and interactions

STORAGE

Eye drops - Store this medicine in a refrigerator between 2ºC and 8 ºC. Store it in the original package to protect from light.

Injection - Do not store above 25ºC.

CHLORAMPHENICOL USES

What is it used for?

  • Chloramphenicol is used to treat bacterial eye infections. It is also used to treat serious life-threatening bacterial infections such as typhoid fever when given orally or intravenously.
  • It is an antibiotic, sometimes known as a broad spectrum antibiotic as is effective against a wide variety of bacteria.
  • It is used to treat infections caused by certain types of bacteria by stopping the growth of bacteria.
  • In general this drug is used to treat bacterial eye infections (acute bacterial conjunctivitis) using eye drops and/or eye ointment. Signs of bacterial infection include inflamed, sore eye with sticky discharge or crusting on the eyelids. Chloramphenicol is only used to treat serious life threatening infections when taken orally or intravenously as serious side effects can arise when chloramphenicol enters the bloodstream.
  • Benefits of being on this drug can include stopping the growth of sensitive bacteria leading to control of the infection and bringing relief from the symptoms of the infection.

Listed below are the typical uses of chloramphenicol.

  • Bacterial eye infections (acute bacterial conjunctivitis)
  • Bacterial ear infections (otitis externa)
  • Serious and life threatening infections such as meningitis, septicaemia or typhoid fever (oral or intravenous administration)

On occasion your doctor may prescribe this medicine to treat a condition not on the above list. Such conditions are listed below.

HOW TO USE/TAKE

How often do I take it?

  • Chloramphenicol eye drops and eye ointment are applied directly to the infected eye. One eye drop should be put into the infected eye every 2 hours for the first 48 hours and then every 4 hours. Use this medication for five days even if symptoms improve. See your doctor if your symptoms do not improve within 48 hours or if they worsen.It may take up to five days before the full benefit of this drug takes effect and the infection is fully cleared.
  • Chloramphenicol may be given orally or intravenously to treat serious infections. The capsules should usually be taken four-times daily, with or without food. Injection into a vein or muscle or an infusion will be given by a doctor or nurse.
  • Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

  • Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

  • Chloramphenicol eye treatment can cause blurred vision when just applied. If you are affected, you should avoid driving or operating machinery until you feel safe to do so. Consult your doctor or pharmacist for more details.

When can I stop?

  • Always complete the full course as prescribed by your doctor.

CHLORAMPHENICOL SIDE EFFECTS

Eye drops and ointment, ear drops:

About 1 in 10 of the people treated with the ear ointment are likely to have a reaction to the propylene glycol contained in the ointment.

Capsules or injection:

  • Decreases in white blood cell count
  • Decreases in red blood cell count
  • Tiredness
  • Dry mouth
  • Nausea
  • Vomiting
  • Diarrhoea
  • Headache
  • Feeling depressed
  • Itchy rash
  • Numbness or tingling feeling
  • Muscle pain or weakness
  • Blurred vision
  • Inflammed eyes
  • Temporary loss of vision
  • Increased infections (due to effect on white blood cell count)
  • Thrush (fungal infection of vagina or mouth)
  • Grey syndrome (a condition with grey skin in new born infants where the infant is also weak)
  • Serious allergic reaction (see below)

If any of these persist or you consider them severe then stop taking and inform doctor or pharmacist.

Tell your doctor immediately if you develop any of the following symptoms:

  • Severe tiredness or unusual easy bruising as these may be signs of bone marrow suppression. Bone marrow suppression has led to serious conditions including reversible and irreversible aplastic anaemia (loss of red blood cells).

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.

CHLORAMPHENICOL PRECAUTIONS

Before taking chloramphenicol, tell your doctor or pharmacist if you are allergic to it; or to other antibiotics; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have:

  • A bone marrow or blood disorder
  • A family history of blood disorders known as dyscrasias

Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following Previous eye infections

  • Glaucoma (increased eye pressure)
  • Dry eye syndrome
  • Had any eye surgery or laser treatment in past 6 months
  • Any eye injury
  • Use any other eye drops or treatment
  • Use contact lenses

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

  • Alcohol intake is not known to affect chloramphenicol.

The elderly: chloramphenicol can be used in the elderly.

Pregnancy and breastfeeding - please ensure you read the detailed information below

PREGNANCY

Chloramphenicol is not safe to take if you are, or are planning to become, pregnant.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

Chloramphenicol is not safe to take if you are breastfeeding.

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

CHLORAMPHENICOL INTERACTIONS

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

There are medicines that are known to interact with chloramphenicol and your doctor may well have considered this, however if you are taking any of the following medicines please make sure your doctor or pharmacist is aware of this.

  • Any medicines that cause bone marrow suppression such as cytotoxic drugs used to treat cancer or immunosuppressants such as azathioprine

Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:

  • Medicines used to thin the blood (anticoagulants) such as warfarin
  • Tolbutamide used to treat diabetes
  • Phenytoin used to treat epilepsy
  • Phenobarbital used to treat epilepsy
  • Rifampicin which is an antibiotic.

This information does not contain all possible interactions. Therefore, before using chloramphenicol, tell your doctor or pharmacist of all the products you use.

CHLORAMPHENICOL OVERDOSE

Overdosage with the eye drops or ointment is unlikely to constitute a hazard and no specific treatment is required.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of chloramphenicol or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.

MISSED DOSE

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

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Source: Selected from data included with permission and copyrighted by Boots UK Limited or TicTac Communications Ltd. This copyrighted material is sourced from a licensed data provider and is not for distribution, except as may be authorised by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse events, nor should it be construed to indicate that use of a particular medicine is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any medicine, changing any diet, or discontinuing any course of treatment.

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