Chloramphenicol ampoules. Chloramphenicol description of the trade name: instructions and analogues

Name: Chloramphenicolum

Chloramphenicolum

pharmachologic effect

The active substance is considered a synthetically obtained antibiotic, which is similar to the antibacterial substances synthesized by streptomycetes. An antibacterial effect is realized due to inhibition of peptidyl transferase after binding of the substance to the ribosomal apparatus of the cell. As a result, there is a blockage of synthetic processes for the production of protein in the cell of a sensitive microorganism.

The drug has a bacteriostatic effect. The following microorganisms are sensitive to chloramphenicol: most cocci (G +, G-), Escherichia coli, Salmonella, Haemophilus influenzae, spirochetes, Shigella, anaerobic microorganisms, rickettsia, klebsiella, serrata, proteus, yersinia.

Virulocidal result is observed in relation to the pathogen of trachoma, inguinal lymphogranulomatosis, psittacose. There is a sensitivity to chloramphenicol in penicillin-resistant strains of bacteria, streptomycin-resistant microorganisms, bacteria insensitive to sulfonamides. Weak drug activity is observed in relation to bacteria resistant to acids, in Pseudomonas aeruginosa, orders of protozoa, clostridia. Drug resistance develops slowly.

Indications for use

Parenteral and oral forms of the drug Chloramphenicol are indicated for:

• typhoid fever;
• tularemia;
• pathologies associated with Yersinia;
• paratyphoid infection;
• pathologies associated with meningococci;
• dysentery infection;
• trachoma;
• infectious lesion urinary tract;
• salmonellosis;
• lymphogranuloma in the groin area;
• wound infection with purulent discharge;
• infectious pathologies associated with rickettsia;
• abscess of cerebral tissues;
• purulent peritonitis;
• chlamydia;
• ehrlichiosis;
• infectious lesion of the organs of bile secretion;
• brucellosis.

External forms of the release of the drug Chloramphenicol are indicated for skin lesions with bacterial agents (boils, burns complicated by infection, trophic ulcers, pressure ulcers, cracks in the nipple region in nursing mothers).

Eye drops are indicated for the treatment of infections in ophthalmology.

Mode of application

Tablets, capsules are taken orally on an empty stomach (in 30 minutes). With nausea or vomiting, you can take it 60 minutes after eating. The daily dosage is 2–4 g, divided into 4 doses.

The calculation of the dose for children (single) is carried out according to the following formula: 10-15 mg per kilogram of body for patients under 3 years of age. When indicated in children 3–8 years old, it is shown to take 0.15–0.2 g per dose. For patients after 8 years, 0.6-1.2 g / day is prescribed. The course of therapy is 7-10 days. Probably lengthening the course to 14 days in the presence of correct tolerance of the therapeutic agent.

Liniment and external solution are used to treat skin surfaces 2-3 times / day. Probably the use of liniment under an occlusive dressing with dressings once every 1–4 days. Use is continued until the wound surface is fully cleansed.

Eye drops are used for instillation into the conjunctival sac. Instillation is carried out several times a day for a week.

Dosing of parenteral forms of the drug is carried out on an individual basis, depending on the type and severity of the pathological process.

Suppositories are administered intravaginally after release dosage form from the contour packaging. The introduction is carried out in the supine position. It is shown to use 2–3 suppositories / day. Probably the appointment of girls in puberty for 1-2 suppositories / day. The duration of therapy is 8-10 days.

Side effects

The use of the medication Chloramphenicol may be accompanied by:

• dyspeptic symptoms;
• psychomotor disorders;
• leukopenia;
• depressive conditions;
• urge to vomit;
• dermatitis;
• thrombocytopenia;
• bouts of nausea;
• hypoglobinemia;
• headache;
• hallucinations (visual, auditory);
• diarrhea;
• agranulocytosis;
• angioedema;
• cardiovascular collapse (in children under 12 months);
• hearing impairment;
• irritation of the oral mucosa;
• visual impairment;
• change in consciousness;
• aplastic anemia;
• delirium;
• dysbiosis;
• skin rash;
• a change in taste perception;
• hives;
• the addition of a fungal infection;
• optic neuritis;
• itchy skin;
• hyperemia of the skin.

Contraindications

Chloramphenicol is not prescribed for:

• hypersensitivity to chloramphenicol;
• psoriasis;
• acute intermittent porphyria;
• eczema;
• hypersensitivity to additive components of the prescribed dosage form;
• skin pathologies associated with fungal infection;
• pathologies of the kidneys with severe impairment of their functions;
• pathologies of the hematopoietic organs;
• indications in the neonatal period;
• severe liver pathologies;
• testimony in early childhood;
• deficiency of G6FDH;
• lactation (for oral, parenteral forms of the drug).

Caution is needed when prescribing Chloramphenicol for:

• pathologies of the cardiovascular system;
• a tendency to develop allergic reactions.

Pregnancy

The use of Chloramphenicol in pregnant patients is likely in the absence of a safer alternative and there is a potentially measurable benefit of the drug that exceeds possible risk for the developing fetus.

Interaction with other medicinal products

Overdose

When using external forms of the drug, eye drops the risk of overdose is minimal. When exceeding therapeutic doses chloramphenicol develops cardiovascular syndrome. It is especially common in patients in the neonatal and early childhood period.

Large doses of chloramphenicol provoke a negative effect on the myocardium with the appearance of a gray skin tone, hypothermia, respiratory failure, and myocardial insufficiency. Mortality with the development of this syndrome reaches 40%. It is shown carrying out hemosorption measures, prescribing therapy corresponding to the symptoms.

Release form

Chloramphenicol is available in the form of eye drops, suppositories, alcohol solution, tablets, capsules, liniment. The packaging of the medicine is as follows:

- 10 tablets / paper packaging;

- 5 ml drops / glass bottle + dropper cap / packaging;

- 10 ml drops / glass bottle + dropper cap / packaging;

- 20 tablets / cardboard packing;

- 20 caps / cardboard packaging;

- 25 ml solution / glass bottle;

- 0.5 g powder / glass bottle / packaging;

- 1 g powder / glass bottle / packaging;

- 25 g liniment / tube / package;

- 10 suppositories / pack.

Storage conditions

Storage temperature of tablets - up to 25 degrees Celsius. The shelf life of the tablet form is 3 years. The alcohol solution should be stored at a temperature of 8-15 degrees Celsius for no more than 1 year.

Chloramphenicol eye drops are suitable for use for 2 years if stored at a temperature of 8-15 degrees Celsius. The powder in vials should be stored at a temperature of 15-25 degrees Celsius for no more than 4 years.

Chloramphenicol capsules are suitable for use for 5 years at storage temperatures up to 25 degrees Celsius. Liniment should be stored at a temperature of 15-25 degrees for no more than 2 years.

Synonyms

Levomycetin-LekT, Berlitsetin, Levomycetin, Levomycetin-BHFZ, Levomycetin-Darnitsa, Levomycetin succinate, Sintomycin, Chloramphenicol Levo, Chlorsin, Levomycetin-Ferein, Levomycetin-AKOS, Levomycetin-Uphysiomytin-I Acri, Levovinisol, Levomycetin Aktitab, Amphoben, Levamycin, Euchlor, Chlorocid-G.

Composition

1 suppository Chloramphenicol contains 250 mg chloramphenicol. Additive component: witepsol.

1 ml of Chloramphenicol eye drops contains 25 mg of Chloramphenicol. Additive components: boric acid, prepared water.

1 g of liniment Chloramphenicol 5% contains chloramphenicol 0.05 g. Additive components: emulsifier, castor oil, sodium carmellose, sorbic acid, treated water.

1 g of liniment Chloramphenicol 10% contains chloramphenicol 0.1 g. Additive components: emulsifier, castor oil, sodium carmellose, sorbic acid, prepared water.

1 bottle of Chloramphenicol powder 1 g contains chloramphenicol sodium salt (sterilized) 1000 mg (in terms of chloramphenicol).

1 bottle of Chloramphenicol 500 mg powder contains chloramphenicol sodium salt (sterilized) 500 mg (in terms of chloramphenicol).

1 tablet of Chloramphenicol 250 mg contains chloramphenicol 0.25 g. Additive components: calcium stearate, starch.

1 tablet of Chloramphenicol 0.5 g contains Chloramphenicol 250 mg. Additive components: stearic acid, starch.

1 capsule of Chloramphenicol contains chloramphenicol 0.25 g.

Nosological classification (ICD-10)

Typhoid fever (A01.0)

Other salmonella infections (A02)

Extraintestinal yersiniosis (A28.2)

Tularemia (A21)

Chlamydial lymphogranuloma venereal (A55)

Paratyphoid fever, unspecified (A01.4)

Other sexually transmitted chlamydial diseases (A56)

Q fever (A78)

Diarrhea and gastroenteritis of suspected infectious origin (A09)

Brucellosis, unspecified (A23.9)

Rickettsia rickettsii spotted fever (A77.0)

Other diseases caused by chlamydia (A74)

Trachoma (A71)

Intracranial and intravertebral abscess and granuloma (G06)

Typhus (A75)

Keratoconjunctivitis (H16.2)

Sclerite (H15.0)

Conjunctivitis (H10)

Decubital ulcer (L89)

Skin abscess, furuncle and carbuncle (L02)

Episclerite (H15.1)

Meningococcal disease (A39)

Cholangitis (K83.0)

Keratitis (H16)

Blepharitis (H01.0)

No localized urinary tract infection (N39.0)

Local infection of skin and subcutaneous tissue, unspecified (L08.9)

Other rickettsioses (A79)

Inflammatory diseases of women pelvic organscaused by chlamydia A56.1 (N74.4 *)

Peritonitis (K65)

Nipple fissure and fistula (N64.0)

Thermal and chemical burns, unspecified (T30)

Trophic skin ulcer (L98.4.2 *)

Post-traumatic wound infection, not elsewhere classified (T79.3)

ATX

Additionally

When treating with parenteral, oral forms of the drug for long periods, it is necessary to prescribe tests to monitor the state of the blood.

The drug in the form of liniment can be used by nursing mothers to treat cracks in the nipple region. It is not required to stop lactation.

Due to the risk of developing severe toxic reactions, the use of the drug Chloramphenicol is carried out only in infectious pathologies as an alternative agent in the presence of resistance to other antibacterial agents.

Chloramphenicol easily penetrates into breast milk... This substance can provoke the development of serious adverse symptoms in infants on breastfeeding... Together with the doctor, you need to make a decision on the temporary suspension of lactation.

What is a chemical compound like chloramphenicol? Instructions for the use of drugs based on this substance will be presented below. We will also tell you about what properties this remedy has, what trade name it has, what it is prescribed for, etc.

General information

What properties are inherent in such chemical substancehow is chloramphenicol? Instructions for use informs that this is a bright representative of amphenicol. Its levorotatory isomer possesses the greatest antibacterial properties.

The mentioned compound is odorless and colorless crystals. It is poorly soluble in water, but readily soluble in propylene glycol, pyridine, ethylene glycol, and ethanol. This substance is used as an antibiotic not only in medicine, but also in animal husbandry.

Under what name can chloramphenicol be purchased at the pharmacy? The trade name of this drug sounds like "Levomycetin".

The component in question was first synthesized back in 1940 from Streptomyces venezuelae. Today this antibiotic is obtained from styrene through a 10-step synthesis.

The drug in question is quite effective. However, it is very toxic and often causes the appearance adverse reactions.

Medicines containing chloramphenicol (the trade name was presented above) are available in the form of an ointment, drops, solution for intramuscular and intravenous administrationas well as tablets and capsules.

Pharmacodynamics

How does chloramphenicol work? The instructions for use inform that this agent is capable of disrupting the processes of bacterial protein synthesis by inhibiting an enzyme such as dioxo-peptidyl transferase. It should also be said that chloramphenicol has a pronounced bacteriostatic effect. It is active against streptococci, large viruses, gram-negative bacteria and staphylococci. Characteristic feature this antibiotic is also the fact that it has a detrimental effect on strains that are resistant to sulfonamide, penicillin and streptomycin. As for tolerance, it develops very slowly to the drug in question.

Pharmacokinetics

Is chloramphenicol absorbed? The instructions for use inform that when the drug is taken orally, this substance is rapidly absorbed from the gastrointestinal tract. The maximum concentration of chloramphenicol is reached after three hours, and its bioavailability is 90%.

About half medicinal substance binds to plasma proteins.

Chloramphenicol is metabolized in the liver and excreted within three hours by the kidneys, as well as along with bile and feces. It should also be noted that this compound undergoes hydrolysis in the intestine, resulting in the formation of inactive metabolites.

When topical application the drug or its entry into the conjunctival sac, it has a slight degree of systemic absorption. But at the same time, the antibiotic creates a sufficient concentration on the surface of the skin or in the moisture of the eye to promote bacteriostatic action.

Indications for use

What is the purpose of prescribing Levomycetin capsules or tablets? Chloramphenicol for oral administration is used in the treatment of typhoid fever, paratyphoid fever, salmonellosis in generalized form, various rickettsioses, brucellosis, tularemia, dysentery, brain abscesses and

Also, this remedy is often prescribed to patients with chlamydia, trachoma, purulent wound infections, peritonitis, ehrlichiosis, inguinal lymphogranuloma, various infections of the bile and urinary tract, yersiniosis.

What external diseases does chloramphenicol treat? Ointment is prescribed for wounds infectious diseases skin, furuncles, burns, trophic ulcers and bedsores. It is also used for cracked nipples in nursing mothers.

Drops of "Chloramphenicol" are instilled in for the treatment of keratitis, bacterial infections eyes, blepharitis, conjunctivitis, scleritis, keratoconjunctivitis and episcleritis.

Contraindications of the drug

Medicines containing chloramphenicol are not recommended to be prescribed:

• in childhood (up to one month);
• with blood diseases;
• with fungal infections on the skin, psoriasis and eczema;
• people with glucose-6-phosphate dehydrogenase deficiency and liver disease;
• nursing mothers and pregnant women;
• if you are allergic to the specified substance or other antibiotic agents belonging to this group.

Extreme caution must be observed in case of vascular and heart diseases, as well as with a tendency to allergic reactions.

"Chloramphenicol": instructions for the use of drugs

As mentioned above, funds based on this substance are used intramuscularly, intravenously, topically, orally and conjunctivally.

The scheme of therapy and its duration depend on the dosage form of the drug and the disease. They are determined by the attending physician on an individual basis.

Levomycetin tablets should be taken 30 minutes before meals or an hour after.

With intravenous or intramuscular injection, as well as oral administration, adult patients are prescribed 2 g of the active element per day (divided into 4 parts).

The maximum dosage of this medication per day is 4 g. With this amount of medication, it is imperative to monitor kidney function and blood counts.

For children, this drug is prescribed depending on body weight:

• up to 3 years - 10-15 mg per kg;
• 3-8 years - 15-20 mg per kg;
• over 8 years old - 20-30 mg per kg.

The frequency of application of the solution or tablets in children is the same as in adults.

The duration of treatment with this antibiotic is 7-11 days. The maximum duration of therapy is 2 weeks.

When applied externally, the drug is applied to the affected areas several times a day using gauze wipes. If necessary, the product can be applied together with. In this case, dressings are done every 3 days, until the wound is cleansed and healed.

As for the drops, they are used in the form of a 0.25 and 1% solution in combination with others medicines.

Side effects

The use of the drug in question can cause:

• itching and irritation (when applied topically);
• agranulocytosis, thrombocytopenia, aplastic anemia, leukopenia;
• dysbiosis;
• delirium, neuritis, various hallucinations, headacheconfusion, depression;
• hypoglobinemia, reticulocytopenia;
• quincke's edema, urticaria, skin rashes;
• nausea increased gassing, diarrhea, irritation of the oral mucosa, vomiting, indigestion;
• fungal infections, dermatitis;
• decreased hearing and visual acuity, impaired taste perception.

Children under 12 months of age may develop cardiovascular collapse.

Price, synonyms and analogues

Synonyms of the agent under consideration are: "Levovinisol", "Sintomycin", "Levomycetin", "Levomycetin Aktitab", levomycetin sodium succinate, "Levomycetin-LekT", alcohol solution "Levomycetin", sterile chloramphenicol sodium succinate, "Levomycetin-AKOS".

It should also be noted that analogs of this drug can be found in pharmacies: Levomethyl, Levomekol (chloramphenicol + dioxomethyltetrahydropyrimidine), Levosin (sulfadimethoxin + dioxomethyltetrahydropyrimidine + chloramphenicol + trimecaine).

As for the price, it is not very high for the antibiotic in question. Any form of the drug can be purchased for 40-90 rubles.

| Chloramphenicolum

Analogs (generics, synonyms)

Berlitsetin, Levomycetin, Levomycetin succinate, Sintomycin, Chloramphenicol Levo, Chlorsin, Detreomycin, Levomycetin-UBF, Levovinisol, Levomycetin Actitab, Amphoben, Levamycin, Euchlor, Chlorocid-G.

Recipe (international)

Rp .: Tab. Chloramphenicoli 0.25 N10
D. S. take orally 30 minutes before meals (in case of nausea and vomiting - 1 hour after eating) ½ table. 4 times a day.

pharmachologic effect

The active substance is a synthetically obtained antibiotic that is similar to the antibacterial substances synthesized by streptomycetes. The antibacterial effect is realized due to the inhibition of peptidyl transferase after binding of the substance to the ribosomal apparatus of the cell. As a result, there is a blockage of synthetic processes for the production of protein in the cell of a sensitive microorganism.

The drug has a bacteriostatic effect. The following microorganisms are sensitive to chloramphenicol: most cocci (G +, G-), Escherichia coli, Salmonella, Haemophilus influenzae, Spirochetes, Shigella, anaerobic microorganisms, Rickettsia, Klebsiella, Serrata, Proteus, Yersinia.

The virulocidal effect is observed against the causative agent of trachoma, inguinal lymphogranulomatosis, psittacosis. There is sensitivity to chloramphenicol in penicillin-resistant strains of bacteria, streptomycin-resistant microorganisms, bacteria insensitive to sulfonamides. Weak activity of the drug is observed in relation to bacteria resistant to acids, in Pseudomonas aeruginosa, orders of protozoa, clostridia. Drug resistance develops slowly.

Mode of application

For adults: Tablets, capsules are taken orally before meals (30 minutes). With nausea or vomiting, you can take it 60 minutes after eating. The daily dosage is 2–4 g with dividing the dosage into 4 doses.

The calculation of the dosage for children (single) is carried out according to the following formula: 10-15 mg per kilogram of body for patients under 3 years of age. When indicated in children 3–8 years old, it is shown to take 0.15–0.2 g per dose. For patients after 8 years, 0.6-1.2 g / day is prescribed.
The course of therapy is 7-10 days. It is possible to lengthen the course up to 14 days in the presence of normal tolerance of the therapeutic agent.

Liniment and external solution are used to treat skin surfaces 2-3 times / day. It is possible to apply liniment under an occlusive dressing with dressings once every 1–4 days.
The application is continued until the wound surface is thoroughly cleansed.

Eye drops are used for instillation into the conjunctival sac. Instillation is carried out several times a day for a week.

Dosing of parenteral forms of the drug is carried out on an individual basis, depending on the type and severity of the pathological process.

Suppositories are administered intravaginally after the dosage form is released from the contour package. The introduction is carried out in the supine position. It is shown to use 2-3 suppositories / day. Perhaps the appointment of girls in puberty for 1-2 suppositories / day. The duration of therapy is 8-10 days.

Indications

Parenteral and oral forms of the drug Chloramphenicol are indicated for:

typhoid fever;

tularemia;

pathologies associated with Yersinia;

paratyphoid infection;

pathologies associated with meningococci;

dysentery infection;

trachoma;

infectious lesion of the urinary tract;

salmonellosis;

lymphogranuloma in the groin area;

wound infection with purulent discharge;

infectious pathologies associated with
rickettsia;

abscess of cerebral tissues;

purulent peritonitis;

chlamydia;

ehrlichiosis;

infectious lesion of the organs of bile secretion;
brucellosis.

External forms of release of the drug Chloramphenicol are indicated for skin lesions with bacterial agents (boils, burns complicated by infection, trophic ulcers, pressure ulcers, cracks in the nipple region in nursing mothers).

Eye drops are indicated for the treatment of infections in ophthalmology.

Contraindications

Individual intolerance;
Some skin diseases (fungal infections, psoriasis, eczema);
Inhibition of the function of hematopoiesis.
According to the instructions, Chloramphenicol is contraindicated in pregnant women, nursing mothers.

Do not use this medication in newborn babies. in them, it can cause the development of the "gray syndrome", manifested by nausea, flatulence, hypothermia, gray-blue skin color due to progressive cyanosis, respiratory disorders and symptoms of cardiovascular insufficiency.

Side effects

The use of Chloramphenicol can lead to the development of various side effects:

Reticulocytopenia;

Leukopenia;

Thrombocytopenia;

Anemia;

Allergic reactions;

Decreased visual acuity and hearing;

Confusion of consciousness;

Psychomotor agitation;

Visual and auditory hallucinations;

Dyspeptic symptoms. The appearance of adverse reactions requires discontinuation of the drug.

Release form

Chloramphenicol is available in the form of eye drops, suppositories, alcohol solution, tablets, capsules, liniment.

The packaging of the drug is as follows:

- 10 tablets / paper packaging;

- 5 ml drops / glass bottle + dropper cap / packaging;

- 10 ml drops / glass bottle + dropper cap / packaging;

- 20 tablets / cardboard packing;

- 20 caps / cardboard packaging;

- 25 ml solution / glass bottle;

- 0.5 g powder / glass bottle / packaging;

- 1 g powder / glass bottle / packaging;

- 25 g liniment / tube / package;

- 10 suppositories / pack.

ATTENTION!

The information on the page you are viewing was created for informational purposes only and does not in any way promote self-medication. The resource is intended to familiarize healthcare professionals with additional information about certain medicines, thereby increasing the level of their professionalism. The use of the drug "" without fail provides for a consultation with a specialist, as well as his recommendations on the method of application and dosage of your chosen medicine.

Tradename
Monopreparations: Levomycetin (Slavic pharmacy, Tatkhimfarmpreparaty, Lecco), Levomycetin-AKOS (Synthesis), Levomycetin-DIA (Diafarm), Levomycetin-Ferrein (Bryntsalov-A). Combined drugs: Colbiocin (Zambon).

Chemical name: (-) - Chloramphenicol
Molecular Formula: C 11 H 12 Cl 2 N 2 O 5
Molar mass : 323.129
CAS number: 56-75-7
Solubility: Soluble in ethanol, butanol, acetone and ethyl acetate. Poorly soluble in water.

Release form, composition
Levomycetin (Slavic pharmacy, Lecco, Diafarm) - eye drops, 2.5 mg of chloramphenicol in dropper bottles of 5.0 and 10.0 ml.

Levomycetin (Tatkhimfarmpreparaty) - eye drops, 2.5 mg chloramphenicol in a bottle with a dropper of 5.0 ml.

Levomycetin (Synthesis) - eye drops, 2.5 mg of chloramphenicol in a bottle with a dropper or a dropper bottle of 5.0 ml. Transparent slightly yellowish solution.

Levomycetin (Bryntsalov-A) - eye drops, 2.5 mg chloramphenicol in vials of 5.0 and 10.0 ml.

Colbiocin (see tetracycline).

Excipients
Levomycetin (Lecco), Levomycetin-AKOS - boric acid, purified water. Levomycetin-DIA - boric acid. Colbiocin (see tetracycline).

pharmachologic effect
Antibiotic wide range action, which primarily has a bacteriostatic effect. Able to have a bactericidal effect against Staphylococcus aureus, Moraxella species, Salmonella spp, Shigella spp, Bacteroides fragilis, Clostridia spp (some), Rickettsia spp, Chlamydia trachomatis, Mycoplasma spp, Enterobacteriaceae, Haemophilse influenza vire ).

The drug penetrates the bacterial cell wall and, by binding to the 50S ribosome subunits, inhibits protein synthesis.

Chloramphenicol resistance usually develops slowly.

Pharmacokinetics
There are no data on the pharmacokinetics of the drug when administered locally. When used orally, it is rapidly absorbed from the gastrointestinal tract (bioavailability 80%). In adults, 50-60% of the drug binds to plasma proteins. It is metabolized in the liver, where 90% is conjugated to inactive glucuronide. The half-life is normally 1.5-3.5 hours. With renal and liver failure these indicators can increase significantly. In children of the first days of life, it is 24 or more hours (especially with low body weight), at the age from 1 month to 16 years - 3-6.5 hours. It is excreted mainly by the kidneys.

Dosage regimen
1-2 drops in the affected eye up to 6 times a day. In severe cases, it can be applied every 15-20 minutes with a gradual decrease in the frequency of instillations as the infectious process subsides.

Indications for use
Treatment of bacterial conjunctivitis, keratitis, blepharitis.

Contraindications
Hypersensitivity to drug components.

Precautions and Warnings
Despite the low likelihood of developing aplastic anemia with topical application of chloramphenicol, this must be taken into account when prescribing it. The drug should not be administered to patients in whom it has previously caused bone marrow failure.

Must refrain from wearing contact lenses when using the drug.

Long-term use of chloramphenicol should be avoided, as this increases the risk of developing sensitization and resistance of microorganisms to it. It is not recommended to use it for more than 5 days. In the event that no improvement is observed within 2 days or the progression of symptoms is noted, it is advisable to replace chloramphenicol with another antibacterial drug.

The FDA pregnancy risk category is C. The safety of chloramphenicol during pregnancy and lactation has not been studied. The drug can be absorbed into the systemic circulation and penetrate the placenta into breast milk. For these reasons, its use is not recommended during pregnancy and lactation.

In experiments on mice oral intake chloramphenicol caused toxic reactions, including death of premature infants and newborns, as well as "gray" syndrome (bloating with and without vomiting, progressive "pale" cyanosis, vascular collapse, often accompanied by respiratory failure, death within a few hours after the onset of symptoms) ...

The drug can cause temporary blurred vision, eye irritation after instillation. Must refrain from managing vehicle before full recovery visual functions.

Side effects
Transient burning sensation, irritation, redness, lacrimation, dermatitis after instillation into the eye are possible.

After local use of chloramphenicol, cases of bone marrow suppression have been described, including fatal irreversible aplastic anemia.

Drug interactions
The combined use of chloramphenicol with oral antihyperglycemic drugs may enhance their hypoglycemic effect.

Simultaneous administration with drugs that inhibit bone marrow hematopoiesis (for example, sulfonamides) enhances this effect.

Prescribing a drug with erythromycin, clindamycin, lincomycin, rifampicin can weaken the effect of both drugs.

Due to the inhibitory effect of chloramphenicol on the cytochrome P450 enzyme system, combined use with phenobarbital, phenytoin, warfarin leads to a slowdown in metabolism, excretion, and an increase in plasma concentration of these drugs.