Last update Nov. 3, 2023

Chloramphenicol (systemic use)

Limited compatibility

Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.

Chloramphenicol is a broad-spectrum antibiotic whose use is limited due to its high risk of bone marrow toxicity. Oral or intravenous administration in 3 to 4 daily doses.

It is excreted in breast milk in very small amounts (Matsuda 1984, Plomp 1983, Havelka 1968), much lower than those used in pediatrics and neonatology.

Feeding refusal, drowsiness, vomiting and abdominal distension due to gas have been reported in infants under 15 days of age whose mothers took oral chloramphenicol. (Havelka 1972)

Although a case of aplastic anemia induced by chloramphenicol taken through breast milk has never been reported (WHO 2002), this serious complication of chloramphenicol is independent of the dose administered. 

To be used during lactation only in absolutely necessary cases, avoiding it during the neonatal period and in case of prematurity. (Nahum 2006, WHO 2002)

Alternatives

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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Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

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Chloramphenicol (systemic use) in other languages or writings:

Group

Chloramphenicol (systemic use) belongs to this group or family:

Tradenames

Main tradenames from several countries containing Chloramphenicol (systemic use) in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 80 %
Molecular weight 323 daltons
Protein Binding 53 - 60 %
VD 0.57 l/Kg
pKa 8.69 -
Tmax 1 - 2 hours
1.5 - 3.5 hours
M/P ratio 0.5 - 0.6 -
Theoretical Dose 0.26 - 0.91 mg/Kg/d
Relative Dose 1.0 - 8.1 %
Ped.Relat.Dose 0.26 - 1.82 %

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 Abstract Full text (link to original source) Full text (in our servers)
  3. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5(2):57-60. Abstract
  4. 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
  5. 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
  6. Nahata MC, Powell DA. Bioavailability and clearance of chloramphenicol after intravenous chloramphenicol succinate. Clin Pharmacol Ther. 1981 Abstract
  7. 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)
  8. Havelka J, Franková A. [Adverse effects of chloramphenicol in newborn infants]. Cesk Pediatr. 1972 Jan;27(1):31-3. Czech. No abstract available. Abstract
  9. Havelka J, Hejzlar M, Popov V, Viktorinová D, Procházka J. Excretion of chloramphenicol in human milk. Chemotherapy. 1968 Abstract

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