Informational only — Not medical advice. Always consult a licensed healthcare provider.

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Indications

Ramicol is an antibiotic that has a specific, limited role: it's meant for serious infections caused by organisms that respond to it, and only when safer treatment options either won't work or can't be used. That said, a doctor may still start Ramicol based on a clinical suspicion that one of the conditions below is present, before this is confirmed. Lab sensitivity testing should be done alongside treatment, so the drug can be stopped promptly if a safer alternative turns out to be effective. If both Ramicol and another antibiotic appear effective against a particular organism in lab testing, the choice to continue with Ramicol rather than switch should weigh how severe the infection is, how susceptible the organism is to each drug, and how well each drug actually works against that infection.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

In vitro, chloramphenicol works mainly as a bacteriostatic agent against many Gram-negative and Gram positive bacteria. It is also active against rickettsiae, the lymphogranuloma-psittacosis group and Vibrio cholerae, and it is particularly active against Salmonella typhi and Haemophilus influenzae. The drug acts by interfering with or inhibiting protein synthesis, both in intact cells and in cell-free systems. Antagonism has been shown in vitro between chloramphenicol, erythromycin, clindamycin and lincomycin.

Chloramphenicol is absorbed rapidly from the GI tract. Chloramphenicol palmitate is hydrolyzed in the GI tract and absorbed as free chloramphenicol. Following a single oral dose of one gram of chloramphenicol base in healthy adults, average peak plasma concentrations were about 11 mcg/ml, reached within 1 to 3 hours. With repeated dosing, the peak rose to 18 mcg/ml after the fifth one gram dose, given every 6 hours. Mean serum levels stayed between 8 and 14 mcg/ml over a 48 hour period.

Most of the drug leaves the body in the urine. Only 8% to 12% of the antibiotic is excreted as free chloramphenicol, but even so the concentration of free drug in the urine is relatively high. The rest is excreted as inert metabolites, mainly glucuronate. Small amounts of active drug appear in bile and feces.

Chloramphenicol diffuses rapidly, though not evenly through the body. The highest concentrations are found in the liver and kidney, and the lowest in the brain and cerebrospinal fluid (CSF). The drug enters the CSF even when the meninges are not inflamed, reaching concentrations about half of those in the blood.

Pregnancy & Breastfeeding

Safety during pregnancy and breastfeeding hasn't been firmly established, so this medicine should be used only when a physician judges it truly necessary.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: Chloramphenicol, like other potent medicines, should be given at the doses known to work effectively. Most sensitive organisms are inhibited at blood concentrations of 5 to 20 mcg/ml, and the aim is to keep the drug within this range for most of the treatment period. A dose of 50 mg/kg/day, divided into 4 doses given 6 hours apart, will usually reach and maintain levels in this range. Except in certain situations, such as premature infants, newborns, and people with liver or kidney impairment, lower doses may fail to reach these concentrations. Patients should be observed closely, and if any adverse reactions occur, the dose should be reduced or the drug stopped, provided the rest of the clinical picture allows this. Adults should receive 50 mg/kg/day in divided doses, roughly one 250 mg capsule for every 4.5 kg (10 lbs) of body weight, or one 500 mg capsule for every 9 kg (20 lbs) of body weight, split into doses given 6 hours apart. In exceptional cases, patients with infections caused by moderately resistant organisms may need a higher dose, up to 100 mg/kg/day, to reach blood levels that inhibit the organism, but such high doses should be lowered again as soon as possible. Adults with impaired liver or kidney function, or both, may be less able to metabolize and clear the drug, so doses should be adjusted accordingly in these cases. Pediatric patients: A dose of 50 mg/kg/day, divided into doses given 6 hours apart, is effective against most susceptible organisms. Severe infections, such as bloodstream infections or meningitis, particularly when adequate concentrations in the cerebrospinal fluid are needed, may require up to 100 mg/kg/day; however, the dose should be brought back down to 50 mg/kg/day as soon as possible. Children with impaired liver or kidney function may retain excessive amounts of the drug. Newborn infants: A total of 25 mg/kg/day, given in 4 equal doses 6 hours apart, usually produces and maintains concentrations in the blood and tissues adequate to control most infections for which the drug is used.

Side Effects & Interactions

Side Effects

No side-effect data recorded yet.