CHLORAMPHENICOL oral

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    Prescription under medical supervision

     

     
    The use of chloramphenicol should be restricted to severe infections when other less toxic antibacterials are not effective or contra-indicated.

     

     

     

    Therapeutic action

    • Phenicol antibacterial

    Indications

    • Alternative to first-line treatments of bubonic plague
    • Typhoid fever if the strain is susceptible (recent drug susceptibility test)
    • Completion treatment following parenteral therapy with chloramphenicol

    Forms and strengths

    • 250 mg capsule

    Dosage

    • Child from 1 year to less than 13 years: 12.5 mg/kg 3 to 4 times daily; the dose should be doubled in severe infection (max. 3 g daily)
    • Child ≥ 13 years and adult: 1 g 3 to 4 times daily

     

    Age

    Weight

    250 mg capsule

    1 to < 4 years

    10 to < 17 kg

    1 cap x 3

    4 to < 9 years

    17 to < 30 kg

    2 cap x 3

    9 to < 13 years

    30 to < 45 kg

    3 cap x 3

    ≥ 13 years and adult

    ≥ 45 kg

    4 cap x 3

     

    Duration

    • Plague: 10 days
    • Typhoid fever: 7 days

    Contra-indications, adverse effects, precautions

    • Do not administer to children under 1 year.
    • Do not administer to patients with:
      • history of allergic reaction or bone marrow depression during a previous treatment with chloramphenicol;
      • G6PD deficiency.
    • May cause:
      • dose-related haematological toxicity (bone marrow depression, anaemia, leucopenia, thrombocytopenia), allergic reactions. In these events, stop treatment immediately;
      • gastrointestinal disturbances, peripheral and optic neuropathies.
    • Reduce dosage in patients with hepatic or renal impairment.
    • Avoid or monitor combination with potentially haematotoxic drugs (carbamazepine, co-trimoxazole, flucytocine, pyrimethamine, zidovudine, etc.).
    • Pregnancy: CONTRA-INDICATED, except if vital, if there is no therapeutic alternative. If used during the 3rd trimester, risk of grey syndrome in the newborn infant (vomiting, hypothermia, blue-grey skin colour and cardiovascular depression).
    • Breast-feeding: CONTRA-INDICATED

    Remarks

    • Oral treatment is more effective than parenteral treatment: blood and tissue concentrations are higher when chloramphenicol is given orally.
    • Capsules can be opened and their content mixed into a spoon with food.
    • Also comes in 150 mg/5 ml powder for oral suspension.
       

    Storage

     
    – Below 25 °C