Chloramphenicol
- Atc Codes:D06AX02#D10AF03#G01AA05#J01BA01#S01AA01#S03AA08
- CAS Codes:56-75-7#982-57-0
- PHARMGKB ID:56-75-7#982-57-0
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Chloramphenicol, Halomycetin; Belgium: Chloramphenicol; Bulgaria: Chlornitromycin; Cyprus: Medophenicol; Czech Republic: Chloramphenicol; Denmark: Kloramfenicol; Estonia: Oftan-Akvakol; Finland: Chloromycetin, Minins Chloramphenicol, Oftan-Akvakol, Oftan Chlora, Oftan Kloramfenikol; Germany: Chloramphenicol, Chloro-Sleecol, Chloromycetin, Parkefelin, Posifenicol C; Greece: Chloramphenicol, Chloromyk, Urso-Fenol; Ireland: Chloramphenicol, Chloromycetin; Italy: Chemicetina, Cloramf, Mycetin, Sificetina, Vitamfenicolo; Latvia: Oftan-Akvakol, Sintomicīna; Malta: Chloramphenicol, Chloromycetin, Kemicetine, Posifenicol C, Vitamfenicolo; Poland: Cusi Cloramfenicol, Detreomycyna; Portugal: Cloranfenicol, Clorocil, Micetinoftalmina; Romania: Cloramfenicol; Slovakia: Chloramphenicol; Slovenia: Chloramphenicol; Spain: Oftamolosa Cusi Cloramfenicol; Sweden: Chloromycetin, Kloramfenicol; UK: Chloramphenicol, Kemicetine, Minins Chloramphenicol.
North America
Canada: AK Chlor Liq, Chloromycetin, Chloroptic, Diochloram, Pentamycetin; USA: Chloramphenicol.
Latin America
Argentina: Bioticaps, Chloromycetin, Cloranfenicol, Farmicetina, Plusclorán, Poenfenicol, Quemicetina; Brazil: Arifenicol, Clorafenil Colirio, Cloranfenicol, Neo Fenicol, Profenicol, Quemicetina, Sintomicetina, Uni Fenicol, Visalmín, Vixmicina; Mexico: Abefen, Brocil, Cloramfeni, Cloramfenicol, Clorampler, Cloran, Cloranmicron, Clorazin, Clorfenil, Clorofunon, Clorotan, Diarman, Enteromicin, Estreptopal, Exacol, Fenicol Oftálmico, Fenisol, Lebrocetin, Leclor A, Oftadil, Omycet, Palmiclor, Palmifer, Palmisol, Procloril, Pronicol, Quemicetina, Solvaris, Uniclor.
Asia
Japan: Chlomy, Chloramphenicol, Chloromycetin, Hysetin.
Drug combinations
Chloramphenicol and Collagenase
Chloramphenicol and Dexamethasone
Chloramphenicol and Hydrocortisone
Chloramphenicol and Prednisolone
Chloramphenicol, Betamethasone, and Tetrahydrozoline
Chloramphenicol, Dexamethasone, and Phenylephrine
Chloramphenicol, Dexamethasone, and Tetracaine
Chloramphenicol, Ephedrine, and Tripelennamine
Chloramphenicol, Neomycin, and Hydrocortisone
Chloramphenicol, Neomycin, and Phenylephrine
Chloramphenicol, Resorcinol, and Salicylic Acid
Chemistry
Chloramphenicol: C~11~H~12~Cl~2~N~2~O~5~. Mw: 323.13. (1) Acetamide, 2,2-dichloro-N-[2-hydroxy-1-(hydroxymethyl)-2-(4-nitrophenyl)ethyl]-, [R-(R*,R*)]-; (2) D-threo-(-)-2,2-Dichloro-N-[β-hydroxy-α-(hydroxymethyl)-p-nitrophenethyl]acetamide. CAS-56-75-7.
Chloramphenicol Sodium Succinate: C~15~H~15~Cl~2~N~2~NaO~8~. Mw: 445.18. Butanedioic acid, mono[2-[(2,2-dichloroacetyl)amino]-3-hydroxy-3-(4-nitrophenyl)propyl] ester, monosodium salt, [R-(R*,R*)]-. CAS-982-57-0.
Pharmacologic Category
Antibacterials; Chloramphenicol. (ATC-Code: D06AX02; D10AF03; G01AA05; J01BA01; S01AA01; S03AA08).
Mechanism of action
Inhibits protein synthesis in susceptible organisms and rapidly proliferating mammalian cells by reversible binding to 50S ribosomal subunits. May cause reversible bone marrow depression due to inhibition of protein synthesis in mitochondria of bone marrow cells. Active against Gram-positive aerobes such as Streptococcus pneumoniae and other streptococci. Also active in vitro against Bacillus anthracis. Active against Gram-negative aerobes such as some strains of Brucella, Burkholderia mallei, B. cepacia, Francisella tularensis, Haemophilus influenzae, Neisseria meningitidis, Proteus mirabilis, Salmonella, Shigella, Vibrio cholerae, and Yersinia pestis. Active against anaerobes such as Bacteroides fragilis, Clostridium, Fusobacterium, Prevotella melaninogenica, and Veillonella. Active against other organisms such as Rickettsia, Chlamydia, and Mycoplasma. Inactive against fungi and viruses. Resistance reported in staphylococci, S. pneumoniae, Escherichia coli, H. influenzae, Neisseria meningitidis, Salmonella, and Shigella.
Therapeutic use
Serious infections due to organisms resistant to other less toxic antibiotics.
Pregnancy and lactiation implications
Crosses the placenta. No reports of fetal harm related to use of chloramphenicol in pregnancy. Gray syndrome has occurred in premature infants and newborns receiving chloramphenicol. Enters breast milk (use with caution).
Unlabeled use
Anthrax (anthrax meningoencephalitis). Brucellosis. Infections caused by Burkholderia cepacia. Glanders caused by B. mallei. Melioidosis caused by B. pseudomallei. Psittacosis (ornithosis) caused by Chlamydia psittaci. Infections caused by Clostridium perfringens. Ehrlichiosis caused by Ehrlichia chaffeensis. Plague caused by Yersinia pestis. Rat-bite fever. Cholera (Vibrio cholerae). Tularemia (Francisella tularensis).
Contraindications
Hypersensitivity to chloramphenicol or any component of the formulation. Treatment of trivial or viral infections. Bacterial prophylaxis.
Warnings and precautions
May cause serious and fatal blood dyscrasias (aplastic anemia, hypoplastic anemia, thrombocytopenia, and granulocytopenia). Should not be used for minor infections or when less potentially toxic agents are effective. Risk of Gray syndrome if serum levels ≥50 µg/mL (caution if impaired hepatic or renal function). Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Caution in G6PD deficiency. Caution in neonates. May cause false-positive results in urine glucose tests when using cupric sulfate.