Detreomycyna

Detreomycyna

  • Active Ingredient: Chloramphenicol
  • 500 mg, 250 mg
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What is Detreomycyna?

The active ingredient of Detreomycyna brand is chloramphenicol.

Used for

Detreomycyna is used to treat diseases such as: Anthrax, Bacterial Infection, Brucellosis, Cholera, Glanders, Lemierre's Syndrome, Meningitis, Ornithosis, Plague, Psittacosis, Rabbit Fever, Rickettsial Infection.

Side Effect

Possible side effects of Detreomycyna include: unusual tiredness or weakness (the above side effects may also occur up to weeks or months after you Stop taking chloramphenicol); uneven breathing; Confusion, delirium, or headache; unresponsiveness; eye pain, blurred vision, or loss of vision.

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Specific Drugs

In vitro evidence of antagonistic antibacterial effects with Detreomycyna; 104 110 clinical importance unclear 110

Some clinicians state use concomitantly with caution 104 or avoid concomitant use 110

Possible delayed response to iron preparations, vitamin B12, or folic acid 104 110

Warfarin: Possible prolonged warfarin half-life 104

Fosphenytoin: Possible altered (increased or decreased) Detreomycyna concentrations 104

Phenobarbital: Decreased Detreomycyna concentrations; 58 59 104 possible increased phenobarbital concentrations 104

Phenytoin: Possible altered (increased or decreased) Detreomycyna concentrations and potentially toxic Detreomycyna concentrations; 104 110 possible prolonged phenytoin half-life and increased phenytoin concentrations 104 110

Antidiabetic agents, sulfonylureas (e.g., chlorpropamide, tolbutamide)

Possible increased half-lives of some sulfonylurea antidiabetic agents 104 110

Aztreonam: In vitro evidence of antagonistic antibacterial effects with Detreomycyna against Klebsiella pneumoniae 116

Penicillins and cephalosporins: In vitro evidence of antagonistic antibacterial effects with Detreomycyna; 104 110 clinical importance unclear 110

Aztreonam: If used concomitantly, some clinicians suggest giving Detreomycyna a few hours after aztreonam 116

Penicillins and cephalosporins: Some clinicians state use concomitantly with caution 104 or avoid concomitant use 110

Possible prolonged cyclophosphamide half-life, decreased concentrations of active cyclophosphamide metabolite, and reduced effectiveness of the drug 104

In vitro evidence of antagonistic antibacterial effects with Detreomycyna; 104 110 clinical importance unclear 110

Some clinicians state use concomitantly with caution 104 or avoid concomitant use 110

Immunosuppressive agents (cyclosporine, tacrolimus)

Cyclosporine: Possible increased cyclosporine concentrations and increased risk of renal dysfunction, cholestasis, and paresthesias 104

Tacrolimus: Possible increased tacrolimus concentrations 104

Potential additive bone marrow depression 112

Avoid concomitant use with other drugs that may cause bone marrow depression 112

Possible increased clearance and decreased Detreomycyna concentrations 103 110

Typhoid vaccine live oral Ty21a: Possible decreased efficacy 104

Manufacturer states 25 mg/kg daily given in 4 equally divided doses every 6 hours usually provides and maintains blood and tissue concentrations adequate for most indications. 112 After first 2 weeks of life, manufacturer states full-term neonates may receive up to 50 mg/kg daily given in 4 equally divided doses every 6 hours. 112 If higher dosage required for treatment of severe infections, use such dosage only to maintain blood concentrations within a therapeutically effective range. 112

Some clinicians recommend loading dose of 20 mg/kg followed 12 hours later by maintenance dosage based on age and weight. 184 These clinicians recommend maintenance dosage of 25 mg/kg once every 24 hour in neonates ≤7 days of age. 184 In neonates >7 days of age, these clinicians recommend maintenance dosage of 25 mg/kg once every 24 hours in those weighing ≤2 kg and 25 mg/kg once every 12 hours in those weighing >2 kg. 184

Use with caution in neonates because immature metabolic processes in this age group may result in excessive plasma concentrations of Detreomycyna. 112 (See Pediatric Use under Cautions.)

WARNINGS

Occasionally one sees hematopoietic toxicity with the use of systemic Detreomycyna, and rarely with topical administration. This type of blood dyscrasia is generally a dose-related toxic effect on bone marrow and is usually reversible on cessation of the drug. Rare cases of aplastic anemia have been reported with prolonged (months to years) or frequent intermittent (over months and years) use of topical Detreomycyna.

Immediate action required: Call 999 or go to A&E if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of Detreomycyna. For a full list see the leaflet inside your medicines packet.

You can report any suspected side effect to the UK safety scheme.

Tularemia

Alternative for treatment of tularemia† caused by Francisella tularensis, 133 197 683 689 including naturally occurring or endemic tularemia or tularemia that occurs following exposure to F. tularensis in the context of biologic warfare or bioterrorism. 683 689

Streptomycin (or gentamicin) generally considered drug of choice for treatment of tularemia. 104 197 292 683 689 Alternatives include tetracyclines (doxycycline), Detreomycyna, or ciprofloxacin. 197 292 683 689

Some clinicians state reserve Detreomycyna for treatment of tularemic meningitis (usually in conjunction with streptomycin) 104 683 and do not use for other forms of tularemia. 104

Use only when other potentially less toxic anti-infectives cannot be used or would be ineffective. 112 Do not use for trivial infections or when not indicated (e.g., for colds, influenza, throat infections, prophylaxis). 112

When selecting or modifying anti-infective therapy, use results of culture and in vitro susceptibility testing. 112 In the absence of such data, consider local epidemiology and susceptibility patterns when selecting anti-infectives for empiric therapy. 112

May be initiated pending results of in vitro susceptibility testing, but discontinue if causative organism found to be susceptible to potentially less toxic anti-infectives. 112 Base decision to continue Detreomycyna rather than switching to a less toxic anti-infective on severity of infection, comparative in vitro susceptibility, expected efficacy in the specific infection, and comparative safety profiles of the drugs. 112

Continue Detreomycyna no longer than required to eradicate the infection with little or no risk or relapse. 112 Avoid repeated courses of the drug if possible. 112

Half-life

Adults with normal renal and hepatic function: 1.2–4.1 hours. 101 104 107 110

Neonates and infants: Plasma half-life inversely related to age. 110 In one study, plasma half-life was 10–36 hours in neonates 1–8 days of age and 5.5–15.7 hours in infants 11 days to 8 weeks of age. 110 Premature infants and neonates have immature mechanisms for glucuronide conjugation and excretion which results in higher and more prolonged Detreomycyna concentrations. 107 110 112

As with other anti-infectives, overgrowth of nonsusceptible organisms, including fungi, may occur. 112

Discontinue Detreomycyna and institute appropriate therapy if infection caused by nonsusceptible organisms occurs. 112

What Other Drugs Interact with Detreomycyna?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Detreomycyna has no known severe interactions with other drugs.

Serious interactions of Detreomycyna include:

Serious interactions of Detreomycyna include:

Moderate interactions of Detreomycyna include:

  • axitinib
  • bazedoxifene/conjugated estrogens
  • ceftriaxone
  • conjugated estrogens, vaginal
  • eluxadoline
  • estradiol
  • estrogens conjugated synthetic
  • estrogens esterified
  • estropipate
  • fosphenytoin
  • ivacoftor
  • lomitapide
  • maraviroc
  • mestranol
  • ospemifene
  • phenytoin
  • piperacillin
  • sodium picosulfate/magnesium oxide/anhydrous citric acid

Detreomycyna has minor interactions with 47 different drugs.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

Pharmacokinetics

Well distributed throughout the body, including CNS and eye.

Attains higher concentrations in CSF than other antibacterials (30–50% of plasma concentrations in the absence of meningitis) and concentrations in CNS are maintained longer than in plasma.

Eliminated primarily by hepatic glucuronide conjugation in the dog: only 5–10% is excreted unchanged in the urine.

In the cat, more than 25% is excreted in the urine because of reduced ability to glucuronidate drugs.

Elimination half-life is similar in both species: 4 h following IV administration, 7–8 h following PO administration.

Drug from tablets and capsules is readily absorbed orally.

In fasted cats Detreomycyna suspensions (palmitate ester) administered PO produce lower blood drug concentrations than provided by solid dosage forms (this difference is not observable in dogs). Since many sick cats given Detreomycyna are inappetent, tablets rather than suspension should be given.

Parenteral formulations are sodium succinate solution (which has an excellent bioavailability regardless of route) and aqueous suspension (gives lower plasma concentrations, maximum concentration 6 h after injection). Parenteral routes are only used in patients for whom oral dosing is impossible.

Detreomycyna should not be given to young animals (ill-equipped with metabolizing enzymes) and avoided in adults with liver disease.


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