Chloromycetin

Chloromycetin is one of the most recent antibiotics to have been synthesised, and its application leads to an extremely rapid disappearance of the symptoms of typhoid fever. This drug is effective for other conditions, in particular typho-exanthematic fevers, such as historical typhus, whose name is universally known, but less graphic than those of its exotic sisters: the purple fever of the Rocky Mountains, the river fever of Japan, the typhus of the Indian Jungle, the scrub fever of the Malayan countryside.

This medicine is an antibiotic belonging to the macrolide family.

250 mg tablets are used in adults for:

• the treatment of various infections of the sinuses, bronchi, lungs, throat, skin, gums and teeth;
• the treatment of certain opportunistic infections in HIV-infected individuals.

500 mg tablets are used in adults for:

• the treatment of various infections of the sinuses, bronchi and lungs;
• the treatment of certain opportunistic infections in HIV-infected individuals;
• the eradication of Helicobacter pylori (responsible for recurrent peptic ulcers) in combination with other medicines.

How To Take

This medicine is best taken with meals.

Usual dose:

Adults: 250 mg to 500 mg, morning and evening.

This dosage may be increased in the treatment of AIDS-related infections.

In the treatment of Helicobacter pylori eradication: 500 mg, morning and evening, in combination with another antibiotic and an anti-ulcer agent.

Side Effects

Most common: nausea, vomiting, diarrhoea, abdominal pain, taste disorders.

Common (1-10% of patients): insomnia, headache, sweating.

Uncommon (less than 1% of patients): stomach pain, constipation, flatulence, mouth inflammation, dry mouth, loss of appetite, itching, urticaria, anxiety, nervousness, dizziness, drowsiness, tremor, dizziness, hearing impairment, ringing in the ears, palpitations, muscle pain, cramps, candidiasis, abnormal blood count, increased transaminases, allergic reaction.

Undetermined frequency: confusion, depression, disorientation, hallucinations, abnormal dreams, change or loss of sense of smell, discolouration of tongue or teeth, convulsions, severe bullous skin reaction, heart rhythm disturbances, hepatitis (see Warning), renal failure.

Precautions

Macrolide antibiotics carry a risk of torsades de pointes. Caution should be exercised in certain situations: association with other medicines likely to cause torsades de pointes, slow (bradycardia) or irregular heart rhythm (cardiac arrhythmia), severe heart failure, angina pectoris, magnesium deficiency.

Do not continue to take this medicine without consulting your doctor if you experience:

• redness of the skin with pustules and fever;
• signs of liver damage, such as loss of appetite, jaundice, abnormally dark urine, itching.

Precautions should be taken in cases of severe liver or kidney failure.

Many antibiotics can cause watery stools or diarrhoea, which is generally harmless. However, your doctor should be informed of any significant diarrhoea that occurs during or in the days following antibiotic treatment.

A reduction in fever or the disappearance of symptoms are not synonymous with a cure: it is essential that the duration of treatment is respected to avoid relapses or the emergence of resistance to the antibiotic.

Dizziness, dizziness, confusion or disorientation may occur. Make sure you tolerate this medicine well before driving or operating dangerous machinery.

When should Chloromycetin not be used?

This medicinal product must not be used in the following cases:

• allergy to macrolides;
• hypokalaemia;
• electrocardiogram (ECG) abnormality known as QT interval prolongation;
• history of cardiac rhythm disorders, particularly torsades de pointes;
• renal insufficiency associated with severe hepatic insufficiency;
• in association with ergot derivatives (ergotamine, dihydroergotamine, etc.) and medicines containing colchicine, mizolastine, pimozide, simvastatin, alfuzosin, dapoxetine, avanafil, ivabradine, eplerenone, dronedarone, quetiapine or ticagrelor.

Interactions

This medicinal product must not be combined with medicinal products containing:

• ergotamine, dihydroergotamine, methylergometrine: risk of ergotism;
• cisapride, bepridil, mizolastine or pimozide: risk of torsades de pointes;
• colchicine, alfuzosin, avanafil, dapoxetine, eplerenone, ivabradine, ibuprofen, ibuprofen, ibuprofen and ibuprofen, ivabradine, dronedarone, simvastatin, quetiapine or ticagrelor: increased risk of adverse effects from these drugs.

It is not recommended in combination with certain immunosuppressants (ciclosporin, everolimus, sirolimus, tacrolimus) and medicines containing the following substances: bromocriptine, cabergoline, pergolide, lisuride, bosutinib, disopyramide, ebastine, halofantrine, irinotecan, oxycodone, quinidine, rivaroxaban, simeprevir, tamsulosin, tolterodine.

It may also interact with many other medicines. Tell your doctor or pharmacist about any other treatment you are taking.

Pregnancy and Breastfeeding

The effect of this medicine during pregnancy is not well known: only your doctor can assess the possible risk of its use in your case.

This medicine may pass into breast milk. It may be used during breast-feeding, but the doctor should be informed promptly of any digestive problems in the infant.

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