Last update Dec. 31, 2014

Chloramphenicol

High Risk

Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.

Stupor, flatulence or vomiting have been described. Theoretical risk though never reported of bone marrow toxicity. Use only if necessary. Avoid any use during neonatal period.

Be aware of the possibility of false negative results of bacterial cultures when the mother is on antibiotics.

Alternatives

  • Amoxicillin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Ampicilline ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Azithromycin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Cefotaxime Sodium ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Cefoxitin Sodium ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Ceftriaxone Sodium ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Clindamycin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Doxycycline (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Erythromycin (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Imipenem + Cilastatin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Meropenem ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Metronidazole ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Piperacillin Sodium + Tazobactam sodium ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Tetracycline ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Ticarcillin Sodium; Ticarcillin Disodium ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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José María Paricio, founder of e-lactancia.
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Other names

Chloramphenicol is also known as


Group

Chloramphenicol belongs to this group or family:

Tradenames

Main tradenames from several countries containing Chloramphenicol in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 80 %
Molecular weight 323 daltons
Protein Binding 53 - 60 %
VD 0.57 l/Kg
Tmax 1 - 2 hours
T½ 1.5 - 4 hours
M/P ratio 0.5 - 0.6 -
Theoretical Dose 0.3 - 0.9 mg/Kg/d
Relative Dose 0.3 -1.84 %
Ped.Relat.Dose 0.3 - 1.84 %

References

  1. Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006 Abstract
  2. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  3. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001 Feb;17(1):54-65. Abstract
  4. Zhang Y, Zhang Q, Xu Z. [Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women]. Zhonghua Fu Chan Ke Za Zhi. 1997 Abstract
  5. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5(2):57-60. Abstract
  6. Plomp TA, Thiery M, Maes RA. The passage of thiamphenicol and chloramphenicol into human milk after single and repeated oral administration. Vet Hum Toxicol. 1983 Abstract
  7. Burke JT, Wargin WA, Sherertz RJ, Sanders KL, Blum MR, Sarubbi FA. Pharmacokinetics of intravenous chloramphenicol sodium succinate in adult patients with normal renal and hepatic function. J Pharmacokinet Biopharm. 1982 Abstract
  8. Nahata MC, Powell DA. Bioavailability and clearance of chloramphenicol after intravenous chloramphenicol succinate. Clin Pharmacol Ther. 1981 Abstract
  9. Koup JR, Lau AH, Brodsky B, Slaughter RL. Chloramphenicol pharmacokinetics in hospitalized patients. Antimicrob Agents Chemother. 1979 Abstract Full text (link to original source) Full text (in our servers)
  10. Havelka J, Hejzlar M, Popov V, Viktorinová D, Procházka J. Excretion of chloramphenicol in human milk. Chemotherapy. 1968 Abstract

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