Cloranfenicol

Cloranfenicol Uses, Dosage, Side Effects, Food Interaction and all others data.

Cloranfenicol inhibits bacterial protein synthesis by binding to 50s subunit of the bacterial ribosome, thus preventing peptide bond formation by peptidyl transferase. It has both bacteriostatic and bactericidal action against H. influenzae, N. meningitidis and S. pneumoniae.

Cloranfenicol is a broad-spectrum antibiotic that was derived from the bacterium Streptomyces venezuelae and is now produced synthetically. Cloranfenicol is effective against a wide variety of microorganisms, but due to serious side-effects (e.g., damage to the bone marrow, including aplastic anemia) in humans, it is usually reserved for the treatment of serious and life-threatening infections (e.g., typhoid fever). Cloranfenicol is bacteriostatic but may be bactericidal in high concentrations or when used against highly susceptible organisms. Cloranfenicol stops bacterial growth by binding to the bacterial ribosome (blocking peptidyl transferase) and inhibiting protein synthesis.

Trade Name Cloranfenicol
Availability Prescription only
Generic Chloramphenicol
Chloramphenicol Other Names Chloramphénicol, Chloramphenicol, Chloramphenicolum, Chlornitromycin, Cloramfenicol, Cloranfenicol, Laevomycetinum, Levomicetina, Levomycetin
Related Drugs amoxicillin, doxycycline, ciprofloxacin, cephalexin, metronidazole, azithromycin, clindamycin, ceftriaxone, levofloxacin, triamcinolone
Type
Formula C11H12Cl2N2O5
Weight Average: 323.129
Monoisotopic: 322.012326918
Protein binding

Plasma protein binding is 50-60% in adults and 32% is premature neonates.

Groups Approved, Vet approved
Therapeutic Class Ear Anti-Infectives & Antiseptics, Eye Anti-Infectives & Antiseptics
Manufacturer
Available Country
Last Updated: September 19, 2023 at 7:00 am
Cloranfenicol
Cloranfenicol

Uses

Cloranfenicol is used for Ocular infections, Bacterial meningitis, Anaerobic bacterial infections, Anthrax, Brain abscess, Ehrlichiosis, Gas gangrene, Granuloma inguinale, Infections caused by H. influenzae, Listeriosis, Plague, Psittacosis, Q fever, Severe gastroenteritis, Severe melioidosis, Severe systemic infections with Camphylobacter fetus, Tularaemia, Whipple's disease, Otitis externa

Cloranfenicol is also used to associated treatment for these conditions: Acne, Bacterial Conjunctivitis, Bacterial Conjunctivitis caused by susceptible bacteria, Bacterial Infections, Bacterial dacryocystitis, Bacterial diarrhoea, Conjunctivitis allergic, Corneal Inflammation, Eye swelling, Keratitis bacterial, Ocular Inflammation, Trachoma, Anterior eye segment inflammation, Bacterial blepharitis, Bacterial corneal ulcers, Non-purulent ophthalmic infections caused by susceptible bacteria, Superficial ocular infections, Skin disinfection

How Cloranfenicol works

Cloranfenicol is lipid-soluble, allowing it to diffuse through the bacterial cell membrane. It then reversibly binds to the L16 protein of the 50S subunit of bacterial ribosomes, where transfer of amino acids to growing peptide chains is prevented (perhaps by suppression of peptidyl transferase activity), thus inhibiting peptide bond formation and subsequent protein synthesis.

Dosage

Cloranfenicol dosage

For Eye: Adults, children and infants (all age groups): One or two drops 4 to 6 times a day should be placed in the infected eyes. If necessary the frequency of dose can be increased. Treatment should be continued for approximately 7 days but should not be continued for more than three weeks without re-evaluation by the prescribing physician.

For Ear: 2 to 3 drops into ear canal thrice or four times daily.

Otic/Aural: Otitis externa:Instill 2-3 drops of a 5% solution into the ear bid-tid.

Oral:Bacterial meningitis, Anaerobic bacterial infections, Anthrax, Brain abscess, Ehrlichiosis, Gas gangrene, Granuloma inguinale, Infections caused by H. influenzae, Listeriosis, Plague, Psittacosis, Q fever, Severe gastroenteritis, Severe melioidosis, Severe systemic infections with Camphylobacter fetus, Tularaemia, Whipple's disease:

  • Adult:50 mg/kg/day in 4 divided doses increased to 100 mg/kg/day for meningitis or severe infections due to moderately resistant organisms. Continue treatment after the patient's temperature has normalised for a further 4 days in rickettsial disease and 8-10 days in typhoid fever.
  • Child:Premature and full-term neonates: 25 mg/kg/day in 4 divided doses. Full-term infants >2 wk: 50 mg/kg/day in 4 divided doses. Children: 50 mg/kg/day in 4 divided doses increased to 100 mg/kg/day for meningitis or severe infections.

Side Effects

Oral: GI symptoms; bleeding; peripheral and optic neuritis, visual impairment, blindness; encephalopathy, confusion, delirium, mental depression, headache. Haemolysis in patients with G6PD deficiency.

ophthalmic application: Hypersensitivity reactions including rashes, fever and angioedema.

Ear drops: Ototoxicity.

Toxicity

Oral, mouse: LD50 = 1500 mg/kg; Oral, rat: LD50 = 2500 mg/kg. Toxic reactions including fatalities have occurred in the premature and newborn; the signs and symptoms associated with these reactions have been referred to as the gray syndrome. Symptoms include (in order of appearance) abdominal distension with or without emesis, progressive pallid cyanosis, vasomotor collapse frequently accompanied by irregular respiration, and death within a few hours of onset of these symptoms.

Precaution

Impaired renal or hepatic function; premature and full-term neonates. Monitor plasma concentrations to avoid toxicity.

Interaction

Decreased effects of iron and vitamin B12 in anaemic patients. Phenobarbitone and rifampin reduce efficacy of chloramphenicol. Impairs the action of oral contraceptives.

Food Interaction

  • Take on an empty stomach.

Cloranfenicol Disease Interaction

Major: colitis, bone marrow suppression, renal/liver disease

Elimination Route

Rapidly and completely absorbed from gastrointestinal tract following oral administration (bioavailability 80%). Well absorbed following intramuscular administration (bioavailability 70%). Intraocular and some systemic absorption also occurs after topical application to the eye.

Half Life

Half-life in adults with normal hepatic and renal function is 1.5 - 3.5 hours. In patients with impaired renal function half-life is 3 - 4 hours. In patients with severely impaired hepatic function half-life is 4.6 - 11.6 hours. Half-life in children 1 month to 16 years old is 3 - 6.5 hours, while half-life in infants 1 to 2 days old is 24 hours or longer and is highly variable, especially in low birth-weight infants.

Pregnancy & Breastfeeding use

Pregnancy Category C. Either studies in animals have revealed adverse effects on the fetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the fetus.

Contraindication

History of hypersensitivity or toxic reaction to the drug; pregnancy, lactation; porphyria; parenteral admin for minor infections or as prophylaxis; preexisting bone marrow depression or blood dyscrasias.

Storage Condition

Cap/susp: Store at temp not exceeding 30°C.

Ophth/otic preparation: Store between 2-8°C. Do not freeze. Protect from light.

Innovators Monograph

You find simplified version here Cloranfenicol

Cloranfenicol contains Chloramphenicol see full prescribing information from innovator Cloranfenicol Monograph, Cloranfenicol MSDS, Cloranfenicol FDA label

FAQ

What is Cloranfenicol used for?

Cloranfenicol is an antibiotic useful for the treatment of a number of bacterial infections. This includes use as an eye ointment to treat conjunctivitis. By mouth or by injection into a vein, it is used to treat meningitis, plague, cholera, and typhoid fever. It's mainly used to treat eye infections (such as conjunctivitis) and sometimes ear infections.

How safe is Cloranfenicol?

Cloranfenicol is safe for most adults and children. For most eye infections, you'll usually start to see an improvement within 2 days of using Cloranfenicol. For ear infections, you should begin to feel better after a few days.

How does Cloranfenicol work?

Cloranfenicol is a bacteriostatic by inhibiting protein synthesis. It prevents protein chain elongation by inhibiting the peptidyl transferase activity of the bacterial ribosome.

What are the common side effects of Cloranfenicol?

Common side effects of Cloranfenicol are include:

  • not enough red blood cells produced (aplastic anemia)
  • bone marrow suppression
  • diarrhea
  • inflammation of the small intestine and the colon (enterocolitis)
  • accumulation of chloramphenicol especially in newborns (gray syndrome)
  • headache
  • nausea
  • nightmares
  • inflammation of the optic nerve
  • weakness and numbness in your hands and feet
  • rash
  • inflamed and sore mouth
  • vomiting

Is Cloranfenicol safe during pregnancy?

There is a wealth of clinical data demon-strating that  Cloranfenicol is safe to use in pregnancy if it is not circulating at the time of delivery, since the drug will cause gray syndrome in neonates. It does not seem to harm the fetus, however, which makes it safe to use during most of the pregnancy.

Is Cloranfenicol safe during breastfeeding?

If Cloranfenicol is considered the appropriate treatment it can be used as normal by breastfeeding mothers. Use of Cloranfenicol during breastfeeding is considered to be of concern by the American Academy of Pediatrics; according to some experts, this drug should be avoided.

Can I drink alcohol with Cloranfenicol?

Yes, you can drink alcohol with Cloranfenicol.

Can I drive after taking Cloranfenicol?

Cloranfenicol shouldn't affect you being able to drive or cycle. However, if you experience stinging or burning immediately after applying the eye drops, do not drive or operate machinery immediately. Wait until your eyes are comfortable again and your vision is clear.

When should be taken of Cloranfenicol?

Your doctor may recommend using eye ointment at bedtime and eye drops during the day.If you're using 1% Cloranfenicol eye ointment, apply it to the affected eye every 3 hours. Do this 3 to 4 times a day, or as your doctor advises.

Can I take Cloranfenicol on empty stomach?

Cloranfenicol is best taken with a full glass of water on an empty stomach (either 1 hour before or 2 hours after meals), unless otherwise directed by your doctor.

Who should not take Cloranfenicol?

If you have liver problems, decreased kidney function, a patient who is producing milk and breastfeeding, anemia due to depressed bone marrow you should not take Cloranfenicol.

What happen if I overdose on Cloranfenicol?

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How long does Cloranfenicol take to work?

You'll usually start to see an improvement within 2 days of using Cloranfenicol. For ear infections, you should begin to feel better after a few days. Your eyes may sting for a short time after using the eye drops or ointment.

What is the half-life of Cloranfenicol?

The apparent half-life of Cloranfenicol was extremely variable, ranging from 1.7 to 12.0 hours with a mean of 5.1 hours. Apparent half-lives were inversely correlated with age.

Can I take Cloranfenicol for a long time?

Prolonged use of Cloranfenicol eye drops should be avoided as it may increase the likelihood of sensitisation and emergence of resistant organisms. If any new infection appears during the treatment, the antibiotic should be discontinued and appropriate measures taken.

How long can I take Cloranfenicol?

Do not use them for more than 5 days, unless your doctor tells you to. This is because your eyes can become more sensitive or you could get another eye infection.

When should I stop taking Cloranfenicol?

Eye ointment use the ointment until the eye appears normal and for 2 days afterwards. Do not use it for more than a week, unless your doctor tells you to. Ear drops use the drops for up to a week. Avoid using the medicine for longer than this unless your doctor tells you to.

What happen If I missed dose of Cloranfenicol?

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

Can Cloranfenicol affect my fertility?

There's no firm evidence to suggest that taking chloramphenicol will reduce fertility in either men or women.

Can Cloranfenicol affects my kidney?

Though Cloranfenicol was found to be hepatotoxic, there is no strong evidence to suggest that Cloranfenicol is nephrotoxic according to this study, There was no noticeable pathological changes observe from renal histopathology.

*** Taking medicines without doctor's advice can cause long-term problems.
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