Chloramphenicol Sod Succinate (chloramphenicol sod succinate)

Dosage of chloramphenicol sodium succinate is expressed in terms of chloramphenicol.

Because the difference between therapeutic and toxic plasma concentrations of chloramphenicol is narrow (i.e., a narrow therapeutic index) and because of interindividual differences in chloramphenicol metabolism and elimination, most clinicians recommend that plasma concentrations of chloramphenicol be monitored in all patients receiving the drug and dosage adjusted accordingly. Blood samples to measure peak plasma concentrations of chloramphenicol usually are obtained 0.5-1.5 hours after an IV dose.

Chloramphenicol dosage generally should be adjusted to maintain plasma concentrations of 5-20 mcg/mL (usually 10-20 mcg/mL). When used in pediatric patients beyond the neonatal period, the American Academy of Pediatrics (AAP) suggests that chloramphenicol dosage be adjusted to maintain target plasma concentrations of 15-25 mcg/mL. Some clinicians suggest that dosage in pediatric patients be adjusted to maintain peak plasma concentrations of 15-25 mcg/mL for the treatment of meningitis or 10-20 mcg/mL for the treatment of other infections. Chloramphenicol plasma concentrations greater than 25 mcg/mL have been associated with toxicity.

Chloramphenicol should be used no longer than is necessary to eradicate the infection with little or no risk of relapse. IV chloramphenicol should be switched to an appropriate oral anti-infective as soon as feasible.

Repeated courses of chloramphenicol should be avoided if possible.

Because patients with renal and/or hepatic impairment may have reduced ability to metabolize and eliminate chloramphenicol, dosage should be based on plasma chloramphenicol concentrations and adjusted accordingly.

Clinicians should consider that pediatric patients with impaired renal or hepatic function may retain excessive amounts of the drug. (See General Dosage for Pediatric Patients with Immature Metabolic Processes under Dosage: Pediatric Dosage, in Dosage and Administration.)

No dosing information is available for this tab.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

There are no adequate and well-controlled studies evaluating use of chloramphenicol in pregnant women. Animal reproduction studies have not been conducted using the drug.

Studies using oral chloramphenicol (no longer commercially available in the US) indicate that the drug crosses the placenta.

Use of chloramphenicol during late pregnancy and during labor has been associated with the gray syndrome and other adverse effects in the fetus or infant. (See Cautions: Gray Syndrome.)

Because of potential toxic effects on the fetus, the manufacturer states that chloramphenicol should be used during pregnancy only if potential benefits justify potentials risks to the fetus.

Studies using oral chloramphenicol (no longer commercially available in the US) indicate that the drug is distributed into human milk.

Because chloramphenicol potentially could cause serious adverse effects in breast-fed infants (see Cautions: Gray Syndrome), the manufacturer states that a decision should be made whether to discontinue nursing or chloramphenicol, taking into account the importance of the drug to the woman.

No enhanced messaging available.