Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For chloramphenicol, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to chloramphenicol. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Chloramphenicol has not been shown to cause birth defects in humans. However, use is not recommended within a week or two of your delivery date. Chloramphenicol may cause gray skin color, low body temperature, bloated stomach, uneven breathing, drowsiness, pale skin, sore throat and fever, unusual bleeding or bruising, unusual tiredness or weakness, or other problems in the infant.

Breast-feeding—Chloramphenicol passes into the breast milk and has been shown to cause unwanted effects, such as pale skin, sore throat and fever, unusual bleeding or bruising, unusual tiredness or weakness, or other problems in nursing babies. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children—Newborn infants are especially sensitive to the side effects of chloramphenicol because they cannot remove the medicine from their body as well as older children and adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of chloramphenicol in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking chloramphenicol, it is especially important that your health care professional know if you are taking any of the following:

• Alfentanil or
• Antidiabetics, oral (diabetes medicine you take by mouth) or
• Phenobarbital or
• Warfarin (e.g., Coumadin)—Use of chloramphenicol with these medicines may increase the chance of side effects of these medicines

• Amphotericin B by injection (e.g., Fungizone) or
• Antineoplastics (cancer medicine) or
• Antithyroid agents (medicine for overactive thyroid) or
• Azathioprine (e.g., Imuran) or
• Colchicine or
• Cyclophosphamide (e.g., Cytoxan) or
• Ethotoin (e.g., Peganone) or
• Flucytosine (e.g., Ancobon) or
• Ganciclovir (e.g., Cytovene) or
• Interferon (e.g., Intron A, Roferon-A) or
• Mephenytoin (e.g., Mesantoin) or
• Mercaptopurine (e.g., Purinethol) or
• Methotrexate (e.g., Mexate) or
• Phenytoin (e.g., Dilantin) or
• Plicamycin (e.g., Mithracin) or
• Zidovudine (e.g., AZT, Retrovir) or
• X-ray treatment—Use of chloramphenicol with any of these medicines or with x-ray treatment may increase the risk of blood problems

• Clindamycin (e.g., Cleocin) or
• Erythromycins (medicine for infection) or
• Lincomycin (e.g., Lincocin)—Use of chloramphenicol with any of these medicines may decrease the effectiveness of these medicines

• Phenytoin (e.g., Dilantin)—Use of chloramphenicol with phenytoin may increase the chance of blood problems or increase the side effects of phenytoin

Other medical problems—The presence of other medical problems may affect the use of chloramphenicol. Make sure you tell your doctor if you have any other medical problems, especially:

• Anemia, bleeding, or other blood problems—Chloramphenicol may cause blood problems

• Liver disease—Patients with liver disease may have an increased risk of side effects