Chloramphenicol

Chloramphenicol is not suitable for some people. For example, check with a doctor or pharmacist if you've ever had an allergic reaction to a medicine.

Chloramphenicol comes as eye drops, eye ointment or ear drops for use several times a day. Follow the instructions that come with your medicine.

Side effects of chloramphenicol include stinging or burning in the eye, or itching in the ear. More serious side effects can happen in rare cases.

Most adults and children aged 2 years or over can use chloramphenicol.

Children under 2 years can sometimes use it, but only if it’s prescribed for them.

Chloramphenicol is not suitable for some people. To make sure it's safe for you, tell your doctor or pharmacist if:

• you have ever had an allergic reaction to chloramphenicol or any other medicine
• you or anyone in your family has ever had any problems with their blood, such as aplastic anaemia – this is a rare condition when your bone marrow does not produce blood cells

Who may not be able to use eye drops or ointment

Before using chloramphenicol for eye infections, tell you pharmacist or doctor if you're using any other eye drops or ointment, or if you normally wear contact lenses.

It's also important to speak to your pharmacist or doctor if you have:

• any problems with your eyesight, or severe eye pain
• swollen eyes, and a rash on your face or head
• a cloudy eye
• unusual looking pupils – irregular size, bigger than normal (dilated), or not reacting to light
• had a recent eye injury, or something in your eye
• recently had conjunctivitis
• dry eyes – when your eyes do not produce enough tears
• glaucoma
• eyes that are sensitive to light
• recurring eye infections
• had eye surgery or laser treatment in the last 6 months

Who may not be able to use ear drops

Before using chloramphenicol ear drops, tell your doctor if you:

• currently have a perforated (burst) eardrum
• are allergic to polyethylene glycol – an ingredient used in some medicines and cosmetics, and found in some foods

Chloramphenicol comes in different strengths. How much you use depends on what it's for and whether you're using the eye drops, eye ointment or ear drops.

How to use it

To use all types of chloramphenicol:

• always wash your hands before and after using it – 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 dropper or tube with your fingers
• make sure the nozzle does not touch your eye or ear, or your skin
• use a mirror to help you see what you're doing
• tilt your head back to put drops in your eyes, or to the side to put drops in your ears

Use chloramphenicol before the expiry date and within 4 weeks of opening.

When you've finished your treatment, take any leftover medicine back to the pharmacy so they can dispose of it safely.

If you usually wear contact lenses, do not wear them while you're using chloramphenicol eye drops or ointment.

If you use soft contact lenses, wait for 24 hours after your last dose of eye drops or ointment before using your contact lenses again.

There are things you can do to help cope with these side effects of chloramphenicol.

This can happen straight after using the eye drops or ointment and only lasts for a short time.

Do not rub your eye as this can make things worse.

Wet a clean flannel with cool water and hold it over your eye for a few minutes to ease the symptoms. Make sure you do not share the flannel with others, and wash it after you've used it.

Always wash your hands after touching your eyes to stop the infection spreading.

Do not drive, cycle or use machinery or tools until your eyes feel comfortable again and your vision is clear.

This can happen because of the preservative in some eye drops.

If the skin around your ear becomes red and irritated, tell your doctor. This is a sign of dermatitis and your doctor may recommend some different antibiotic ear drops for you.

Chloramphenicol eye treatments and ear drops can be used in pregnancy.

Only tiny amounts are absorbed into the bloodstream and it's not thought that these can harm your baby.

Talk to your doctor or pharmacist about the best treatment for you. This will depend on how bad the infection is and whether there are other medicines that might be more suitable.

If your baby is healthy, it's OK to use chloramphenicol eye treatment and ear drops while breastfeeding, but other medicines might be better. Talk to your doctor or pharmacist first. It's better to only use chloramphenicol treatments for a short while.

If there's a family history of any sort of blood disorder, including aplastic anaemia, you may be advised not to use chloramphenicol.

It's not yet known how much chloramphenicol passes into breast milk for treatments used for the eyes and ears, but it's likely to be very low levels. These levels are thought to be too low to cause side effects in your baby.

Wash your hands thoroughly after using these treatments and before picking up your baby.

It's important to keep monitoring your baby if you're taking any medicine while breastfeeding.

Contact your healthcare professional or call 111 as soon as possible if you notice that your baby:

• is not feeding as well as usual
• has diarrhoea or is being sick (vomiting)
• has a rash, or seems to bruise easily
• seems unusually pale or tired

If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.

There are some medicines that do not mix well with chloramphenicol.

Check with a pharmacist or your doctor if you're taking (or have recently taken) any other medicines, including:

• medicines for cancer such as cyclophosphamide
• medicines for problems with the immune system such as azathioprine or methotrexate

These are not all the medicines that may cause problems if you take them with chloramphenicol. For a full list, see the leaflet inside your medicine packet.