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Brand Name :
Chloromycetin Succinate
(Canada) [Available]Synonyms :
chloramphenicol
Class :
Antibiotics
Brand Name :
Chloromycetin Succinate
(Canada) [Available]Synonyms :
chloramphenicol
Class :
Antibiotics
Dosage Forms & StrengthsÂ
Injectable solutionÂ
1000mg/vialÂ
Infections Caused by Susceptible Strains
:
Administer 50 mg/kg/day divided every 6 hours intravenously; in extreme circumstances, patients with severe infections or organisms with a moderate level of resistance may need to take up to 100 mg/kg/day.
Dosage Forms & StrengthsÂ
Injectable solutionÂ
1000mg/vialÂ
Children and infants: As in adults, administer up to 100 mg/kg/day to achieve appropriate cerebrospinal fluid concentrations; however, the dose should be lowered as soon as feasible to 50 mg/kg/day.
Infants and children suspected of having underdeveloped metabolic functions: Administer 25 mg/kg/day divided into six hours will result in blood levels of the medication that are therapeutic.
Neonates (<28 days):
Loading dose-Administer 20 mg/kg intravenously and the maintenance dosage 12 hours apart.
Maintenance dose:
Infants under 7 days old: Administer 25 mg/kg intravenously once a day
Infants older than 7 days and weighing less than 2000 g: Administer 25 mg/kg intravenously once a day.
Over 2,000 g and older infants: Administer 50 mg/kg/day intravenously twice a day
Refer adult dosingÂ
when both drugs are combined, there may be an increased effect of nilotinib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
may increase the CNS depressant effect of CNS depressants
may enhance the risk of adverse effect of clobetasol propionate
It may enhance the effect when combined with irinotecan liposomal by affecting CYP3A4 metabolism
It may enhance the effect when combined with sufentanil by affecting CYP3A4 metabolism
may enhance myelosuppressive toxicity of pemetrexed
may enhance myelosuppressive toxicity of pralatrexate
when both drugs are combined, there may be an increased effect of cabozantinib by affecting hepatic or intestinal enzyme cyp3a4 metabolism  
when both drugs are combined, there may be an increased effect of abemaciclib by affecting hepatic or intestinal enzyme CYP3A4 metabolism  
when both drugs are combined, there may be a reduced metabolism of erlotinib  
the effect of chloramphenicol is increased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism. the effect of carbamazepine is decreased by lorlatinib, by altering intestinal or hepatic CYP3A4 enzyme metabolism
may increase the serum levels and effects of docetaxel
chloramphenicol increases the effect of lapatinib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
when both drugs are combined, there may be an increase in the QTC interval
it will increase the impact or level of regorafenib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
it increases the effect or level of ruxolitinib by altering the intestinal or hepatic CYP3A4 enzyme metabolism
may increase the level by affecting the hepatic enzyme CYP3A4 metabolism
may have an increased adverse effect when comb
may have an increased adverse effect when comb
may have an increased adverse effect when comb
may have an increased adverse effect when comb
may have an increased adverse effect when comb
chloramphenicol: they may decrease the therapeutic effect of Vitamin B12
It may enhance the levels when combined with tamsulosin by affecting CYP3A4 metabolism
it may diminish the metabolism when combined with formoterol
chloramphenicol: they may increase the toxic effect of myelosuppressive agents
It may enhance the risk of adverse reactions when combined with Ethylenimine
It may enhance the risk of adverse reactions when combined with Ethylenimine
When alprazolam and chloramphenicol is used together, this leads to reduction in the alprazolam’s metabolism
When dexrabeprazole and chloramphenicol is used together, this leads to reduction in the dexrabeprazole’s metabolism
When acetohexamide is used together with chloramphenicol, this lead to reduction in acetohexamide’s metabolism
When mometasone furoate is used together with chloramphenicol, this leads to enhanced risk or seriousness of adverse outcomes
When chloramphenicol is used together with andrographolide, this leads to enhanced risk or seriousness of bleeding
dried ferrous sulfate/folic acidÂ
may increase serum iron levels
dried ferrous sulfate / sodium ascorbateÂ
may increase serum iron levels
piperacillin decreases the effectiveness of chloramphenicol by altering intestinal flora.
When penicillin G benzathine combines with chloramphenicol, the action and effectiveness of penicillin G benzathine decreases.
may enhance the adverse effects of bone marrow suppression
when both drugs are combined, there may be a high metabolism of vincristine  
when both drugs are combined, there may be a decreased metabolism of paclitaxel 
when both drugs are combined, there may be an increased risk or severity of adverse effects  
when both drugs are combined, there may be an increased risk or severity of adverse effects   
may enhance the adverse myelosuppressive effects of chloramphenicol
may enhance the adverse myelosuppressive effects of chloramphenicol
when both drugs are combined, there may be an increased risk or severity of adverse effects   
may enhance adverse toxic effects of myelosuppressive agents
may enhance bone marrow suppression
may increase myelosuppressive effects
When both drugs are combined, there may be an increased risk of adverse effects  
when both drugs are combined, there may be a reduced effect of ceftriaxone by pharmacodynamic antagonism   ceftri
when both drugs are combined, there may be an increase in adverse/toxic effects of bone marrow suppression
it may increase the adverse effects such as bone marrow suppression activity floxu
it enhances the toxic effect of myelosuppressive agents
when both drugs are combined, there may be an increase in the adverse or toxic effects of myelosuppressive agents
it may increase the toxic or adverse effect of myelosuppressive agents
it increases the toxic/adverse effect of myelosuppressive drugs
may enhance bone marrow suppression
it increases by affecting the hepatic enzyme CYP3A4 metabolism
may increase the toxic effect of myelosuppressive agents
may increase the toxic effect of myelosuppressive agents
may increase the adverse effect of Myelosuppressive Agents
may increase the adverse effect of Myelosuppressive Agents
choline magnesium trisalicylate
It may enhance the risk of adverse reactions when combined with Salicylates
sodium ferric gluconate complexÂ
By affecting bone marrow activity, chloramphenicol may counteract the effects of the sodium ferric gluconate complex in the treatment of anemia.
chloramphenicol may alter the effects of hydroxocobalamin in the treatment of anemia by altering the function of bone marrow.
may have a decrease in excretion when combined with chloramphenicol
When chloramphenicol is used together with lomitapide, this leads to enhanced concentration serum of lomitapide
when both drugs are combined, there may be an increased risk of adverse effects  
the interaction reduces the effects of cefprozil
the interaction reduces the effects of cefaclor
when both drugs are combined, there may be an increased risk of adverse effects  
the interaction reduces the effects of cefepime
the interaction reduces the effects of cefuroxime
lansoprazole amoxicillin and clarithromycin
when amoxicillin combines with chloramphenicol it decreases the effects of the action of drug by antagonism effect
amoxicillin and clavulanate potassium
when amoxicillin combines with chloramphenicol it decreases the effects of the action of drug by antagonism effect
omeprazole amoxicillin and clarithromycin
when amoxicillin combines with chloramphenicol, it decreases the effects of the action of the drug by antagonism effect
when amoxicillin combines with chloramphenicol, it decreases the effects of the action of the drug by antagonism effect
Actions and Spectrum:Â
chloramphenicol is a broad-spectrum antibiotic that inhibits bacterial protein synthesis. Its mechanism of action involves interference with the bacterial ribosome, specifically the 50S subunit. Â
Spectrum of Activity:Â
chloramphenicol exhibits a broad spectrum of activity against both Gram-positive and Gram-negative bacteria. It is effective against a wide range of bacterial species, including those causing respiratory, urinary tract, skin, and gastrointestinal infections.Â
Frequency not definedÂ
NauseaÂ
Inflammation of the optic nerveÂ
RashÂ
HeadacheÂ
NightmaresÂ
Weakness in hands and feetÂ
Inflamed and sore mouthÂ
Black box warning:Â
NoneÂ
Contraindications/caution:Â
Pregnancy consideration: chloramphenicol crosses the placenta, so its use during pregnancy is discouragedÂ
Lactation: chloramphenicol is excreted in breast milk due to concerns about potential adverse effects on fetal and neonatal development. Â
Pregnancy category:Â
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.Â
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence, these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this categoryÂ
Pharmacology:Â
Spectrum of Activity:Â
Pharmacokinetics:Â
AbsorptionÂ
chloramphenicol can be administered through various routes, including oral, intravenous (IV), and topical.Â
chloramphenicol is well-absorbed from the gastrointestinal tract when taken orally, but oral absorption can be variable. When applied topically, chloramphenicol can be absorbed through the skin, and the extent of absorption depends on the formulation.Â
DistributionÂ
chloramphenicol is distributed widely in various tissues, including the liver, kidneys, lungs, and central nervous system (CNS). It can penetrate tissues well, including the blood-brain barrier, making it effective in treating some central nervous system infections. A significant portion of chloramphenicol is bound to plasma proteins, primarily albumin.Â
MetabolismÂ
chloramphenicol is primarily metabolized in the liver through glucuronidation, forming inactive metabolites. The primary metabolic pathway involves the conjugation of chloramphenicol with glucuronic acid, leading to the formation of chloramphenicol glucuronide.Â
Elimination and ExcretionÂ
The elimination half-life of chloramphenicol is relatively long, and it can vary among individuals. Both the active drug and its metabolites are excreted in the urine. A significant portion of chloramphenicol is eliminated unchanged in the urine.Â
Administration:Â
Intravenous administrationÂ
Patient information leafletÂ
Generic Name: chloramphenicolÂ
Why do we use chloramphenicol?Â
chloramphenicol is an antibiotic that has historically been used for the treatment of various bacterial infections. Here are some of the historical uses of chloramphenicol:Â
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