Feniclor

Feniclor

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

The active ingredient of Feniclor brand is chloramphenicol.

Used for

Feniclor 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 Feniclor include: Bloated stomach; sore throat and fever; uneven breathing; low body temperature; eye pain, blurred vision, or loss of vision; unusual bleeding or bruising.

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Mixing Feniclor with herbal remedies and supplements

There are no known problems with taking herbal remedies and supplements alongside Feniclor.

Specific Drugs

In vitro evidence of antagonistic antibacterial effects with Feniclor; 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) Feniclor concentrations 104

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

Phenytoin: Possible altered (increased or decreased) Feniclor concentrations and potentially toxic Feniclor 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 Feniclor against Klebsiella pneumoniae 116

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

Aztreonam: If used concomitantly, some clinicians suggest giving Feniclor 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 Feniclor; 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 Feniclor concentrations 103 110

Typhoid vaccine live oral Ty21a: Possible decreased efficacy 104

What Other Drugs Interact with Feniclor?

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.

Feniclor has no known severe interactions with other drugs.

Serious interactions of Feniclor include:

Serious interactions of Feniclor include:

Moderate interactions of Feniclor 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

Feniclor 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.

Each 1 g of Feniclor in the reconstituted solution contains approximately 52 mg (2.25 mEq) of sodium. 112

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 Feniclor 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 Feniclor 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.

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

3.3.3.5 Feniclor

Feniclor is bacteriostatic because of its capability to inhibit protein synthesis. Feniclor hinders protein chain elongation by peptidyl transferase inhibition of bacterial ribosome ( www.amrls.cvm.msu.edu ). The natural source of its isolation is Streptomyces venezualae. Feniclor was first used for the treatment of typhoid but with the global presence of multiple drug-resistant Salmonella Typhi it loses its clinical value. It is widely used for the treatment of bacterial conjunctivitis, staphylococcal brain abscesses (because of excellent blood–brain barrier penetration), and meningitis. It is used to treat infections caused by tetracycline-resistant cholera and VRE. Microbial Feniclor-resistant strains are conferred by the cat gene, which codes for an enzyme Feniclor acetyltransferase, which inactivates Feniclor. Reduced membrane permeability and 50S ribosomal subunit mutation are other microbial mechanisms that resist the effect of Feniclor. Feniclor resistance may be carried in plasmids such as ACCoT plasmid, which confers multiple drug resistance against ampicillin, Feniclor, cotrimaxole, and tetracycline in typhoid ( www.wikipedia.org/Feniclor ).

Resistance

Resistance to Feniclor is mainly due to the production of a specific inactivating Feniclor acetyltransferase (CAT). The CAT gene is widely disseminated on plasmids that also confer resistance to other antibiotic classes. Isolates of Staph. aureus with cfr mechanism of resistance to linezolid are also resistant to Feniclor.

What are some other side effects of Feniclor?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

On this page

  1. About Feniclor
  2. Key facts
  3. Who can and can't take Feniclor
  4. How and when to use it
  5. Side effects
  6. Pregnancy and breastfeeding
  7. Cautions with other medicines
  8. Common questions

Typhoid Fever and Other Severe Salmonella Infections

Has been used for treatment of typhoid fever (enteric fever) caused by susceptible Salmonella enterica serovar Typhi 104 110 112 134 136 139 140 173 174 175 183 197 and treatment of paratyphoid fever caused by S. enterica serovar Paratyphi. 110 140 174

Although Feniclor was a drug of choice for treatment of infections caused by typhoidal Salmonella in the past, 104 173 175 183 multidrug-resistant strains of S. enterica serovar Typhi (i.e., strains resistant to ampicillin, Feniclor, and/or co-trimoxazole) are reported worldwide and common in many regions of the world. 173 175 183 292 Whenever possible, select anti-infectives for treatment of typhoid fever based on results of in vitro susceptibility testing. 175 292

Do not use to treat typhoid carrier state. 104 110 112 Depending on susceptibility of the strain, a fluoroquinolone (e.g., ciprofloxacin), ampicillin, amoxicillin, or co-trimoxazole usually recommended to treat typhoid carrier state. 173 175 197 292

Do not use for treatment of uncomplicated Salmonella gastroenteritis. 104 110

Store the solution in small aliquots (1 ml) at -20°C for long time.

  • It is recommended to store the Feniclor stock solution in small aliquots.

What are some things I need to know or do while I take Feniclor?

For all patients taking Feniclor:

  • Tell all of your health care providers that you take Feniclor. This includes your doctors, nurses, pharmacists, and dentists.
  • Do not use longer than you have been told. A second infection may happen.
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using Feniclor while you are pregnant.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

  • Very bad and sometimes deadly reactions have happened in premature and newborn babies. This has happened in a baby born to a mother who got Feniclor during labor. It has also happened in a 3-month old. Most of the time, Feniclor was used within the first 48 hours of life. Signs first show up after 3 to 4 days of getting Feniclor. Call your child's doctor right away if your child has swelling of the stomach with or without throwing up, blue or gray skin color, or trouble breathing.

Warnings

Serious and fatal blood dyscrasias, including aplastic anemia, hypoplastic anemia, thrombocytopenia, and granulocytopenia, have occurred after short-term and prolonged therapy.

Monitor complete blood count (CBC) frequently in all patients. Use only in serious infections.

This medication contains Feniclor. Do not take Feniclor IV and Chloromyectin if you are allergic to Feniclor or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

4. How and when to use it

Feniclor comes in different strengths. How you apply the medicine depends on what you're taking it for and whether you're using the eye drops, eye ointment or ear drops.

If you're using 0.5% Feniclor eye drops, put one drop into the affected eye every 2 hours (during waking hours) for the first 2 days. Then every 4 hours for the next 3 days, or as your doctor advises.

If you're using 1% Feniclor eye ointment, apply it to the affected eye every 3 hours (during waking hours). Do this 3 to 4 times a day, or as your doctor advises.

With more severe infections, your doctor may recommend using eye ointment at bedtime and eye drops during the day. This is because the ointment sticks to the surface of the eye and eyelid and works while you sleep. The eye drops allow you to get on with your day as normal, as they don't affect your eyesight.

If you're using 5% or 10% Feniclor ear drops, put 3 drops into the affected ear 2 to 3 times a day, or as your doctor advises.

To use the medicine:

  • always wash your hands before (and after) using Feniclor - this prevents you from passing the infection to the other eye or ear
  • remove the cap just before using your medicine and replace it as soon as you've finished
  • do not touch the nozzle of the bottle or tube with your fingers
  • make sure the nozzle doesn't touch your eye or ear, or your skin
  • use a mirror to help you see what you are doing
  • tilt your head back or to the side to put drops in your eyes or ears


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