WARNING

Chloromycetin Injection (chloramphenicol) is an antibiotic used to treat serious bacterial infections. However, it carries several risks and potential side effects:

• Bone marrow suppression: Chloramphenicol can suppress bone marrow function, leading to decreased production of blood cells (aplastic anemia, thrombocytopenia, leukopenia). This can result in increased susceptibility to infections, easy bruising or bleeding, and fatigue.
• Gray syndrome: Particularly in newborns and infants, chloramphenicol can lead to “gray syndrome,” a serious condition characterized by abdominal distention, vomiting, cyanosis (blue discoloration), and cardiovascular collapse.
• Hypersensitivity reactions: Allergic reactions to chloramphenicol can range from mild skin rashes to severe reactions like anaphylaxis, which is a life-threatening emergency.
• Liver toxicity: Elevated liver enzymes and liver damage can occur with chloramphenicol use, especially with prolonged therapy.
• Optic neuritis: Rarely, chloramphenicol can cause inflammation of the optic nerve (optic neuritis), leading to visual disturbances.
• Gastrointestinal disturbances: Nausea, vomiting, and diarrhea are common side effects of chloramphenicol.

Due to these risks, chloramphenicol is generally reserved for serious infections where other antibiotics are not effective or feasible. It is important to use chloramphenicol under close medical supervision and to monitor for any signs of adverse effects during treatment.

Why is this medication prescribed?

Chloromycetin Injection (chloramphenicol) is prescribed for the treatment of serious bacterial infections caused by susceptible organisms. It is particularly used when other antibiotics are not effective or when the infection is severe and requires intravenous administration.

• Serious bacterial infections: Chloramphenicol is effective against a wide range of bacteria, including gram-positive and gram-negative organisms. It may be used for infections such as meningitis, septicemia (bloodstream infections), and certain types of pneumonia.

How should this medicine be used?

Here’s how it is generally used:

• Dosage: The dosage of Chloromycetin Injection depends on the severity of the infection, the patient’s weight, and kidney function. It is typically given intravenously (IV) or intramuscularly (IM).
• Frequency: The frequency of administration and duration of treatment will be determined by the prescribing healthcare provider based on the specific infection being treated.
• Monitoring: During treatment with Chloromycetin Injection, regular monitoring of blood counts (particularly hematologic parameters) and liver function tests is crucial due to the risk of bone marrow suppression and liver toxicity.
• Special populations: In neonates and infants, chloramphenicol dosing requires careful consideration due to the risk of gray syndrome. It should be used cautiously in patients with impaired liver function.
• Avoidance of alcohol: Patients should avoid consuming alcohol while on chloramphenicol therapy due to potential interactions that can exacerbate liver toxicity.

Chloromycetin Injection should only be used under the supervision of a healthcare provider experienced in the use of antibiotics and with awareness of the potential risks associated with its use. It is important to follow the prescribed dosage and duration of treatment to ensure effectiveness and minimize the risk of adverse effects.

Other uses for this medicine

• Typhoid fever: Chloramphenicol can be used for treating typhoid fever caused by Salmonella typhi, particularly in cases where the organism is resistant to other antibiotics.
• Brain abscesses: It may be used as part of combination therapy to treat brain abscesses caused by susceptible organisms.
• Rickettsial infections: Chloramphenicol is sometimes used in the treatment of rickettsial infections, such as scrub typhus.
• Anaerobic infections: In some cases, chloramphenicol can be effective against anaerobic bacteria, though it is not commonly used as first-line therapy.

What special precautions should I follow?

When using Chloromycetin Injection, it’s important to adhere to specific precautions to ensure safety and effectiveness:

• Monitoring: Regular monitoring of blood counts (particularly hematologic parameters like white blood cells, platelets, and hemoglobin) is essential due to the risk of bone marrow suppression. This monitoring should continue throughout the course of treatment.
• Liver function: Liver function tests should be performed periodically as chloramphenicol can cause liver toxicity. It should be used cautiously in patients with pre-existing liver disease.
• Renal function: Adjustments to the dosage may be necessary in patients with impaired renal function to avoid potential accumulation of the drug.
• Neonates and infants: Use of chloramphenicol in neonates and infants requires careful consideration due to the risk of gray syndrome, a potentially fatal condition characterized by cardiovascular collapse, cyanosis, and abdominal distention.
• Allergy and cross-reactivity: Patients with a history of hypersensitivity reactions to chloramphenicol or other medications should be monitored closely for allergic reactions. Cross-reactivity with other antibiotics should also be considered.
• Alcohol consumption: Patients should avoid consuming alcohol during chloramphenicol therapy as it can increase the risk of liver toxicity.
• Drug interactions: Chloramphenicol can interact with other medications, so it’s important to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.
• Pregnancy and breastfeeding: Chloramphenicol should be used with caution during pregnancy and breastfeeding, weighing the potential benefits against the risks to the fetus or infant.

Always follow the guidance of your healthcare provider regarding the use of Chloromycetin Injection, and report any unusual symptoms or side effects promptly.

What special dietary instructions should I follow?

There are no specific dietary restrictions for chloramphenicol. However, maintaining a balanced diet and adequate hydration can support recovery from infections and promote overall health. Avoiding excessive alcohol consumption is particularly important while taking chloramphenicol to reduce the risk of liver toxicity.

What should I do if I forget a dose?

If you miss a dose of Chloromycetin Injection, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses to make up for a missed one.

What side effects can this medication cause?

Chloromycetin Injection (chloramphenicol) can cause several side effects, some of which can be serious. It’s important to be aware of these potential side effects and to seek medical attention if you experience any of them:

• Bone marrow suppression: This is one of the most serious side effects of chloramphenicol. It can lead to decreased production of blood cells (aplastic anemia, thrombocytopenia, leukopenia), resulting in symptoms such as easy bruising or bleeding, fatigue, and increased susceptibility to infections.
• Gray syndrome: Particularly in newborns and infants, chloramphenicol can cause “gray syndrome,” which is characterized by abdominal distention, vomiting, cyanosis (bluish discoloration of the skin), and cardiovascular collapse.
• Allergic reactions: These can range from mild skin rashes to severe reactions like anaphylaxis, which is a life-threatening emergency.
• Optic neuritis: Rarely, chloramphenicol can cause inflammation of the optic nerve, leading to visual disturbances.
• Liver toxicity: Elevated liver enzymes and liver damage can occur with chloramphenicol use, especially with prolonged therapy.
• Gastrointestinal disturbances: Nausea, vomiting, and diarrhea are common side effects.
• Peripheral neuropathy: Prolonged use of chloramphenicol may rarely lead to peripheral neuropathy, which is characterized by numbness, tingling, or weakness in the limbs.
• Fever and chills: These symptoms may occur as a reaction to the medication.
• Local reactions: Pain, swelling, or irritation at the injection site can occur with intramuscular or intravenous administration.

It’s essential to report any unusual symptoms or side effects to your healthcare provider promptly. Due to the serious nature of some of these side effects, chloramphenicol is generally reserved for use in serious infections where other antibiotics are not effective or feasible, and it should be used under close medical supervision.

What should I know about storage and disposal of this medication?

Storage and Disposal:

• Storage: Chloromycetin Injection should be stored at room temperature, between 20°C to 25°C (68°F to 77°F). Protect from light and moisture. It should not be frozen.
• Handling: Follow all instructions provided by your healthcare provider or pharmacist for the proper handling and administration of Chloromycetin Injection.
• Disposal: Dispose of any unused medication properly as per local regulations or guidelines. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Consult your pharmacist or local waste disposal company for proper disposal instructions.

In case of emergency/overdose

• Seek medical attention immediately: if you suspect an overdose of Chloromycetin Injection. Overdose symptoms may include symptoms of bone marrow suppression (such as easy bruising or bleeding, persistent sore throat, fever), severe allergic reactions, or other serious side effects.
• Poison Control: Contact your local poison control center (in the US, call 1-800-222-1222) for guidance on managing the overdose.

What other information should I know?

• Follow-up: Attend all scheduled appointments with your healthcare provider while using Chloromycetin Injection. Regular monitoring of blood counts and liver function tests may be necessary to detect any potential adverse effects early.
• Avoid Alcohol: Avoid consuming alcohol while on Chloromycetin therapy as it can increase the risk of liver toxicity.
• Inform Healthcare Providers: Inform all healthcare providers involved in your care (including dentists and pharmacists) about your use of Chloromycetin Injection. This includes mentioning any allergies, medications (prescription and over-the-counter), and supplements you are taking.
• Pregnancy and Breastfeeding: Discuss the risks and benefits of using Chloromycetin Injection if you are pregnant or breastfeeding. Use during pregnancy and lactation should be carefully considered based on the potential risks to the fetus or infant.
• Storage of Supplies: If you are administering the injection at home, store supplies securely and out of reach of children or pets.
• Patient Information Leaflet: Read the patient information leaflet provided by your pharmacist before starting Chloromycetin Injection. It contains important information about the medication, its uses, side effects, and precautions.

Always follow your healthcare provider’s instructions carefully regarding the use of Chloromycetin Injection to ensure safe and effective treatment. If you have any questions or concerns about the medication, do not hesitate to discuss them with your healthcare provider or pharmacist.