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Floxin - medtigo

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Floxin

Brand Name :

BRAND NAME IN US Floxin , INTERNATIONAL BRAND NAME WITH COUNTRIES Akilen (ID, SG) Indonesia,singapore, Avaflox (LK);sri lanka , Biloxcin (VN);vietnam, Cinaflox (EG);egypt, Danoflox (ID);Indonesia, Evaflox (MY);Malaysia, Flobacin (IT);Italy, Flogirax (BR);Brazil, Floksan (UA);Ukraine, Flotavid (ID);Indonesia, Flovid (HK, PH, SG);Hong kong, Philippines,singapore, Floxitop (EC);Ecuador, Floxstat (BB, BM, BS, CO, EC, GY, JM, NL, PR, SR, TT, VE); Barbados, Bermuda, Bahamas, Colombia, Ecuador, Guyana, Jamaica, Netherlands, Puerto Rico, Surinam, Trinidad and Tobago, Venezuela, Fugacin (VN); Vietnam Hyflox (TH); Thailand Kinflocin (TW); Taiwan, Province of China Kinoxacin (KR); Republic of Korea Loxinter (ID); Indonesia Loxwin (VN); vietnam Medofloxine (MY); Malaysia Mefoxa (ID); Indonesia Menazin (VN); vietnam Microbac (EC); Ecuador Novecin (AE, BH, CY, EG, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE); United Arab Emirates , Bahrain, Cyprus, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Oman , Qatar, Saudi Arabia, Syria, Yemen Nufafloqo (ID); Indonesia Ofcin (MY, TH, TW); Malaysia, Thailand, Taiwan, Province of China, Ofla (TH); Thailand Oflacin (BD); Bangladesh Oflamed (HK);Hong kong Oflin (IN);India Oflobid (LK);Srilanka Oflocee (TH);Thailand Oflocet (FR, NZ, PT); France, New Zealand, Portugal Oflocin (IT); Italy Oflodal (TW); Taiwan, Province of China Oflodex (IL); Israel Oflodura (DE); Germany Oflovir (ES); Spain Ofloxin (CZ, EE, LT, RO, SK, TH, UA); Czech Republic, Estonia, Lithuania, Romania, Slovakia, Thailand, Ukraine Ofloxol (MY); Malaysia, Oltrex (GT); Guatemala, Onexacin (PH); Philippines, Orivid (TH); Thailand, Orocin (KR); Republic of Korea, Oxacid (MT); Malta , Oxacin (TW); Taiwan, Province of China, Pharflox (ID); Indonesia, Quotavil (HK);Hong Kong, Rilox (ID); Indonesia, Sinflo (TW); Taiwan, Province of China, Tabrin (GR); Greece, Tafloc (ZA); South Africa Taravid (AE, CY, EG, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE);United Arab Emirates, Cyprus, Egypt, Iraq, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, Yemen Tariflox (ID); Indonesia Tarivid (BE, BF, BJ, CH, CI, CL, EE, ET, GB, GH, GM, GN, HN, ID, IE, IN, JP, KE, KR, LR, LU, MA, ML, MR, MT, MU, MW, MY, NE, NG, NO, PK, PL, RU, SC, SD, SG, SK, SL, SN, TH, TN, TR, TW, TZ, UG, ZM); Belgium, Burkina Faso, Benin, Switzerland, Switzerland ,Côte D' Ivoire,Chile, Estonia, Ethiopia, Great Britain [UK], Ghana, Gambia, Guinea, Honduras, Indonesia, Ireland,India, Japan, Kenya, Republic of Korea, Liberia, Luxembourg, Morocco, Mali, Mauritania, Malta, Mauritius, Malawi, Malaysia, Niger, Nigeria, Norway, Pakistan, Poland, Russian Federation, Seychelles, Sudan, Singapore, Slovakia, Sierra Leone, Senegal, Thailand, Tunisia , Turkey, Taiwan, Province of China, Tanzania, Turkey, Taiwan, Province of China, Uganda, Zambia. Taroflex (SK); Slovakia Telbit (KR); Republic of Korea Uro Tarivid (AE, BH, CY, IQ, IR, JO, KW, LB, LY, OM, SA, SY, YE); United Arab Emirates, Bahrain, Cyprus, Iraq, Iran, Jordan, Kuwait, Lebanon,Libya, Oman, Saudi Arabia, Syrian Arab Republic, Yemen Vioflox (KR); Republic of Korea, Vioson (PH); Philippines, Viotisone (TH); Thailand, Zanocin (IN, LV, ZA):India, Latvia, South Africa

Synonyms :

BRN 3657947, CCRIS 5233, DL 8280, DL-8280, Floxin, Floxin in dextrose 5% , Floxin Otic , HOE 280 , HSDB 8030, NSC 727071, NSC 758178, Ocuflox, Oflocet , Ofloxacin, Ofloxacin Otic, Ofloxacina, Ofloxacina [DCIT], Ofloxacine, Ofloxacine [French], Ofloxacino, Ofloxacino [Spanish], Ofloxacinum, Ofloxacinum [Latin], ORF 18489 , Oxaldin , PT 01 Tarivid, UNII-A4P49JAZ9H, Visiren

Class :

Fluoroquinolones, Antibiotic, Bioterrorism





Chlamydia trachomatis

Citrobacter spp

Enterobacter spp

E. coli

Klebsiella pneumoniae

N. gonorrhoeae

Proteus mirabilis

Pseudomonas aeruginosa

S. aureus

S. pneumoniae

DRUG INTERACTION

Floxin

&

  • psyllium
  • bifidobacterium
  • lactobacillus
  • Saccharomyces boulardii
  • lanreotide
  • cyproterone
  • ramucirumab (Rx)
  • fidaxomycin
  • tobramycin (systemic)
  • dacomitinib
  • pembrolizumab
  • amikacin (systemic)
  • panitumumab
  • blinatumomab
  • durvalumab
  • olaratumab
  • necitumumab
  • moxetumomab pasudotox
  • mogamulizumab
  • inotuzumab
  • dinutuximab
  • pentamycin
  • dibekacin
  • cemiplimab
  • gemtuzumab
  • demeclocycline
  • omadacycline
  • tobramycin (ophthalmic)
  • sarecycline
  • cefiderocol
  • valrubicin
  • plicamycin
  • denileukin diftitox
  • decitabine
  • niraparib
  • methacholine
  • carbachol
  • bethanechol
  • acetylcholine
  • atezolizumab
  • raloxifen
  • avelumab
  • leucovorin
  • cladabrine
  • Abocitinib
  • pralatrexate
  • meclofenamate
  • pemetrexed
  • ustekinumab
  • diroximel fumarate
  • daratumumab
  • coccidioidin skin test
  • candida albicans extract
  • brewer’s yeast
  • brewer’s yeast
  • poliovirus vaccine, live, trivalent
  • elotuzumab
  • trimetrexate
  • l-methyl folate
  • Methyclothiazide
  • Influenza virus vaccine
  • Acitretin
  • Tafamidis
  • Sapropterin
  • Pidotimod
  • Nitisinone
  • Mipomersen
  • Levetiracetam
  • Inebilizumab
  • Diethylamine salicylate
  • COVID-19 vaccine
  • Cephalothin
  • Alitretinoin
  • methotrexate
  • Verteporfin
  • Omacetaxine
  • methyl aminolevulinate topical
  • efgartigimod alfa
  • aminolevulinic acid
  • cetuximab
  • streptozocin
  • zoster vaccine recombinant
  • lyme disease vaccine
  • human papillomavirus vaccine
  • daclizumab
  • capecitabine  
  • lomustiine
  • amitriptyline
  • triptorelin
  • Tedizolid
  • rituximab
  • Darolutamide
  • Altretamine
  • Varicella-zoster vaccine
  • Deferiprone
  • topotecan
  • ajmaline
  • pneumococcal vaccine
  • poliovirus vaccine
  • adenovirus vaccine type 7
  • adenovirus vaccine type 4
  • brincidofovir
  • lenograstim
  • ofatumumab
  • doxorubicin
  • thioguanine
  • tetanus toxoid
  • primidone
  • lipegfilgrastim
  • pegaspargase
  • monomethyl fumarate
  • ibritumomab
  • dimethyl fumarate
  • varicella-zoster vaccine (recombinant)
  • influenza virus vaccine, h5n1, live
  • carmustine
  • influenza virus vaccine (h5n1), adjuvanted
  • influenza a (h5n1) vaccine
  • eluxadoline
  • influenza virus vaccine quadrivalent, adjuvanted
  • idecabtagene vicleucel
  • adenovirus types 4 and 7 live, oral
  • thiotepa
  • tocilizumab
  • levodopa
  • efalizumab
  • canakinumab
  • aminoglutethimide
  • ado-trastuzumab emtansine
  • adenovirus vaccine
  • zoster vaccine live
  • typhoid vaccine, live
  • influenza virus vaccine, live, trivalent
  • influenza virus vaccine, h1n1, live
  • delavirdine
  • paclitaxel
  • siltuximab
  • miconazole
  • fludarabine
  • epirubicin
  • vinblastine
  • lomustine
  • risankizumab
  • rilonacept
  • pacritinib
  • linezolid
  • griseofulvin
  • vincristine
  • rufinamide
  • phenobarbital
  • nelarabine
  • mitoxantrone
  • mitomycin
  • mitapivat
  • letermovir
  • lasmiditan
  • idarubicin
  • filgrastim
  • elagolix
  • daunorubicin
  • daclatasvir
  • carfilzomib
  • brentuximab
  • anakinra
  • alefacept
  • thalidomide
  • teriflunomide
  • rubella virus vaccine
  • ozanimod
  • mumps virus vaccine
  • measles virus vaccine
  • golimumab
  • etanercept
  • certolizumab
  • adalimumab
  • etoposide
  • mechlorethamine
  • adenovirus type 7 vaccine
  • melphalan
  • varicella virus vaccine
  • yellow fever vaccine
  • measles mumps and rubella vaccine
  • ocrelizumab
  • palifermin
  • pimecrolimus
  • ropeginterferon alfa 2b
  • tacrolimus
  • tisagenlecleucel
  • tofacitinib
  • amphotericin B cholesteryl sulfate
  • amphotericin B deoxycholate
  • amphotericin B liposomal
  • amphotericin B phospholipid complex
  • anthrax vaccine adsorbed
  • denosumab
  • diphtheria & tetanus toxoids
  • echinacea
  • haemophilus influenzae type b vaccine
  • hepatitis A vaccine inactivated
  • hepatitis a/b vaccine
  • hepatitis b vaccine
  • HIV vaccine
  • human papillomavirus vaccine, quadrivalent
  • hydroxyurea
  • influenza virus vaccine (H5N1)
  • influenza virus vaccine trivalent
  • influenza virus vaccine trivalent, adjuvanted
  • influenza virus vaccine trivalent, recombinant
  • meningococcal A C Y and W-135 diphtheria conjugate vaccine
  • meningococcal A C Y and W-135 polysaccharide vaccine combined
  • meningococcal group B vaccine
  • ofatumumab SC
  • pneumococcal vaccine 13-valent
  • pneumococcal vaccine heptavalent
  • pneumococcal vaccine polyvalent
  • poliovirus vaccine inactivated
  • rabies vaccine
  • roflumilast
  • sipuleucel-T
  • trastuzumab
  • trastuzumab deruxtecan
  • eslicarbazepine acetate
  • vitamin a
  • rifampin
  • belzutifan
  • belimumab
  • belatacept
  • armodafinil
  • amobarbital
  • alemtuzumab
  • pimecrolimus
  • ocrelizumab
  • nivolumab
  • natalizumab
  • fingolimod
  • desogestrel
  • butalbital
  • brexanolone
  • zoster vaccine
  • yellow fever vaccine
  • varicella virus vaccine
  • smallpox vaccine
  • rotavirus vaccine
  • rubella vaccine
  • measles vaccine
  • influenza virus vaccine quadrivalent
  • atracurium
  • dengue vaccine
  • tisagenlecleucel
  • palifermin
  • lisocabtagene maraleucel
  • ciltacabtagene autoleucel
  • brexucabtagene autoleucel
  • axicabtagene ciloleucel
  • chlorambucil
  • ethinyl estradiol
  • dicumarol
  • atenolol
  • anisindione
  • penicillin G benzathine
  • chloramphenicol
  • heparin
  • enoxaparin
  • dalteparin
  • bivalirudin
  • argatroban
  • willow bark
  • bazedoxifene/conjugated estrogens
  • aspirin rectal
  • aspirin/citric acid/sodium bicarbonate
  • Aspirin
  • ganaxolone
  • erythromycin stearate
  • erythromycin lactobionate
  • erythromycin ethylsuccinate
  • elbasvir/grazoprevir
  • daridorexant
  • cholera vaccine
  • lumacaftor/ivacaftor
  • dienogest/estradiol valerate
  • zafirlukast
  • urofollitropin
  • tralokinumab
  • torsemide
  • tazarotene
  • pseudoephedrine
  • propoxiphene napsylate
  • propoxiphene hydrochloride
  • oxyphencyclimine hydrochloride
  • oxymetazoline hydrochloride
  • naxitamab
  • nandrolone decanoate
  • methylphenidate
  • methocarbamol
  • idoxuridine
  • hyaluronidase
  • hyaluronic acid
  • gonadoreline hydrochloride
  • glycopyrrolate
  • ganirelix acetate
  • gallium citrate
  • gadobutarol
  • fulvestrant
  • fexofenadine hydrochloride
  • fenefluramine hydrochloride
  • febuxostat
  • famciclovir
  • ergocalciferol
  • divalproex sodium
  • diclorfenamide
  • dezocine
  • desmopressin acetate
  • demeclocycline hydrochloride
  • defibrotide sodium
  • deferiprone
  • deferasirox
  • daunorubicin hydrochloride
  • darunavir
  • darifenacin hydrobromide
  • daptomycin
  • dapsone
  • dantrolene sodium
  • danazol
  • dalafampridine
  • dalbavancin Hydrochloride
  • daclatasvir dihydrochloride
  • dactinomycin
  • dacitabine
  • cefiderocol sulfate tosylate
  • butoconazole nitrate
  • benralizumab
  • albuterol
  • acetylcysteine
  • acebutolol
  • acam2000
  • abrocitinib
  • abobotulinumtoxin A
  • abatacept
  • abametapir
  • abaloparatide
  • chloroquine
  • ferric maltol
  • lorlatinib
  • piracetam
  • timolol
  • chlorothiazide
  • ferric pyrophosphate citrate
  • lornoxicam
  • piretanide
  • tinidazole
  • chloroxylenol
  • ferric sulfate
  • lorpiprazole
  • pirfenidone
  • tiopronin
  • chlorpheniramine
  • ferrous bisglycinate
  • losartan
  • piroxicam
  • tiotropium
  • chlorpromazine
  • ferrous fumarate
  • lovastatin
  • pitavastatin
  • tipranavir
  • chlorpropamide
  • ferrous gluconate
  • loxoprofen
  • pitolisant
  • tirofiban
  • chlorprothixene
  • ferrous succinate
  • lubiprostone
  • pivampicillin
  • tisotumab vedotin
  • chlorthalidone
  • ferrous sulfate anhydrous
  • lumateperone
  • pivmecillinam
  • tixocortol
  • chlorzoxazone
  • ferumoxides
  • lumefantrine
  • plazomicin
  • tizanidine
  • abiraterone
  • cholecalciferol
  • ferumoxsil
  • lumiracoxib
  • plerixafor
  • tobramycin (oral inhalation)
  • acalabrutinib
  • choline c 11
  • ferumoxytol
  • lurasidone
  • polatuzumab vedotin
  • tocainide
  • acarbose
  • choline magnesium trisalicylate
  • fesoterodine
  • lurbinectedin
  • polythiazide
  • tocofersolan
  • aceclofenac
  • choline salicylate
  • fexinidazole
  • lynestrenol
  • pomalidomide
  • tocopherol
  • acemetacin
  • chondroitin sulfate
  • finasteride
  • macimorelin
  • ponatinib
  • tofacitinib
  • acenocoumarol
  • chromic chloride
  • finerenone
  • macitentan
  • ponesimod
  • tolazamide
  • acetaminophen
  • chromic nitrate
  • fish oil
  • magaldrate
  • posaconazole
  • tolbutamide
  • acetazolamide
  • chromium
  • flavoxate
  • magnesium
  • potassium
  • tolcapone
  • acetohexamide
  • chromium gluconate
  • flecainide
  • magnesium carbonate
  • potassium acetate
  • tolfenamic acid
  • acetylsalicylic acid
  • chromium nicotinate
  • flibanserin
  • magnesium chloride
  • potassium bicarbonate
  • tolmetin
  • acipimox
  • chromous sulfate
  • floctafenine
  • magnesium citrate
  • potassium cation
  • tolterodine
  • aclidinium
  • ciclesonide
  • florbetaben (18f)
  • magnesium gluconate
  • potassium chloride
  • tolvaptan
  • acrivastine
  • cidofovir
  • florbetapir (18f)
  • magnesium hydroxide
  • potassium citrate
  • topiramate
  • acyclovir
  • cilazapril
  • floxuridine
  • magnesium oxide
  • potassium nitrate
  • adefovir dipivoxil
  • cilostazol
  • flucloxacillin
  • magnesium silicate
  • potassium perchlorate
  • torasemide
  • adenosine
  • cimetidine
  • fluconazole
  • magnesium sulfate
  • potassium sulfate
  • toremifene
  • agomelatine
  • cinacalcet
  • flucytosine
  • magnesium trisilicate
  • tositumomab
  • albendazole
  • cinnarizine
  • fludeoxyglucose (18f)
  • mangafodipir
  • pralidoxime
  • trabectedin
  • albiglutide
  • cinoxacin
  • fludrocortisone
  • manidipine
  • pralsetinib
  • tramadol
  • albutrepenonacog alfa
  • ciprofibrate
  • fluindione
  • mannitol
  • pramipexole
  • trametinib
  • alclofenac
  • cisapride
  • flumazenil
  • maprotiline
  • pramlintide
  • trandolapril
  • aldesleukin
  • cisplatin
  • flumethasone
  • maraviroc
  • prasugrel
  • trastuzumab emtansine
  • alectinib
  • citalopram
  • flunarizine
  • maribavir
  • pravastatin
  • trazodone
  • alendronic acid
  • cladribine
  • flunisolide
  • mebeverine
  • prazepam
  • treprostinil
  • alfentanil
  • clarithromycin
  • flunitrazepam
  • mecamylamine
  • praziquantel
  • tretinoin
  • alfuzosin
  • clemastine
  • fluocinolone acetonide
  • mecasermin
  • prednisolone
  • triamcinolone
  • alimemazine
  • clevidipine
  • fluocinonide
  • meclofenamic acid
  • prednisolone acetate
  • triamterene
  • aliskiren
  • clindamycin
  • fluocortolone
  • medrogestone
  • prednisolone phosphate
  • triazolam
  • allopurinol
  • clobazam
  • fluorouracil
  • medroxyprogesterone acetate
  • prednisone
  • trichlormethiazide
  • almasilate
  • clobetasol propionate
  • fluoxetine
  • mefenamic acid
  • prednisone acetate
  • triclabendazole
  • almotriptan
  • clofarabine
  • flupentixol
  • mefloquine
  • pregabalin
  • triethylenetetramine
  • alogliptin
  • clofazimine
  • fluprednisolone
  • megestrol acetate
  • pregnenolone
  • trifluoperazine
  • alosetron
  • clofibrate
  • flurazepam
  • melatonin
  • prenylamine
  • trifluridine
  • alpelisib
  • clomipramine
  • flurbiprofen
  • meloxicam
  • pretomanid
  • trilaciclib
  • alprazolam
  • clonazepam
  • fluspirilene
  • memantine
  • primaquine
  • trilostane
  • aluminium
  • clonidine
  • flutamide
  • menthyl salicylate
  • probenecid
  • trimebutine
  • aluminium phosphate
  • clopidogrel
  • fluticasone
  • meperidine
  • probucol
  • trimethadione
  • aluminum hydroxide
  • clorazepic acid
  • fluticasone furoate
  • mephenytoin
  • procainamide
  • trimethoprim
  • amantadine
  • clotiazepam
  • fluticasone propionate
  • mepivacaine
  • procaine benzylpenicillin
  • ambrisentan
  • clove oil
  • fluvastatin
  • meprednisone
  • procarbazine
  • trimipramine
  • ambroxol
  • cloxacillin
  • fluvoxamine
  • mepyramine
  • prochlorperazine
  • triprolidine
  • amifampridine
  • clofazimine
  • folic acid
  • mercaptopurine
  • progesterone
  • amikacin (oral inhalation)
  • clofibrate
  • fomepizole
  • meropenem
  • promazine
  • troglitazone
  • amiloride
  • clomipramine
  • fondaparinux
  • mesalazine
  • promethazine
  • troleandomycin
  • aminophenazone
  • clonazepam
  • formestane
  • mesoridazine
  • propafenone
  • tropisetron
  • aminophylline
  • clonidine
  • formoterol
  • mestranol
  • propantheline
  • trovafloxacin
  • amiodarone
  • fosamprenavir
  • metamfetamine
  • propiverine
  • tucatinib
  • amisulpride
  • fosaprepitant
  • metamizole
  • propofol
  • typhoid vaccine
  • amitriptyline
  • foscarnet
  • metaxalone
  • propranolol
  • ubidecarenone
  • amlodipine
  • fosfomycin
  • metformin
  • propylthiouracil
  • ubrogepant
  • ammonium chloride
  • fosinopril
  • methadone
  • protriptyline
  • udenafil
  • amodiaquine
  • clozapine
  • fosnetupitant
  • methazolamide
  • prucalopride
  • ulipristal
  • amoxapine
  • cobicistat
  • fosphenytoin
  • methimazole
  • prussian blue
  • upadacitinib
  • amoxicillin
  • cobimetinib
  • fostamatinib
  • pyrantel
  • vaborbactam
  • amphetamine
  • cocaine
  • fostemsavir
  • methotrimeprazine
  • pyrazinamide
  • valaciclovir
  • amphotericin b
  • codeine
  • framycetin
  • methoxsalen
  • pyridoxine
  • valbenazine
  • ampicillin
  • colchicine
  • frovatriptan
  • methsuximide
  • pyrimethamine
  • valdecoxib
  • amprenavir
  • colistimethate
  • furosemide
  • methyldopa
  • pyrithione
  • valganciclovir
  • amrinone
  • colistin
  • fusidic acid
  • methylene blue
  • quazepam
  • valproic acid
  • anagrelide
  • conivaptan
  • gabapentin enacarbil
  • methylergometrine
  • quetiapine
  • valsartan
  • ancestim
  • conjugated estrogens
  • gadobenic acid
  • methylnaltrexone
  • quinapril
  • vancomycin
  • antazoline
  • copanlisib
  • gadodiamide
  • methylprednisolone
  • quinapril
  • vandetanib
  • antihemophilic factor (recombinant), pegylated
  • corifollitropin alfa
  • gadofosveset trisodium
  • methylprednisolone aceponate
  • quinethazone
  • vardenafil
  • antipyrine
  • corticotropin
  • gadopentetic acid
  • methylprednisolone hemisuccinate
  • quinidine
  • varenicline
  • antithrombin iii human
  • cortisone acetate
  • gadoteric acid
  • methylprednisone
  • quinine
  • velpatasvir
  • antrafenine
  • crizotinib
  • gadoteridol
  • methyltestosterone
  • rabeprazole
  • vemurafenib
  • apalutamide
  • cyanocobalamin
  • galantamine
  • methysergide
  • raltegravir
  • venetoclax
  • apixaban
  • cyclacillin
  • ganciclovir
  • meticillin
  • ramelteon
  • venlafaxine
  • apomorphine
  • cyclandelate
  • gatifloxacin
  • meticrane
  • ramipril
  • verapamil
  • apremilast
  • cyclizine
  • gefitinib
  • metoclopramide
  • ranitidine
  • vernakalant
  • aprepitant
  • cyclobenzaprine
  • gemcitabine
  • metolazone
  • ranolazine
  • vibrio cholerae cvd 103-hgr strain live antigen
  • arformoterol
  • cyclopenthiazide
  • gemfibrozil
  • metoprolol
  • rasagiline
  • vilanterol
  • aripiprazole
  • cyclophosphamide
  • gemifloxacin
  • metronidazole
  • reboxetine
  • vilazodone
  • aripiprazole lauroxil
  • cyclosporine
  • gentamicin
  • metyrapone
  • regorafenib
  • vildagliptin
  • arsenic trioxide
  • cyclothiazide
  • gestrinone
  • mexiletine
  • relebactam
  • viloxazine
  • artemether
  • cyproheptadine
  • gilteritinib
  • mezlocillin
  • relugolix
  • asciminib
  • cyproterone acetate
  • gimeracil
  • mianserin
  • remdesivir
  • asenapine
  • cytarabine
  • givosiran
  • midazolam
  • repaglinide
  • vindesine
  • astemizole
  • dabrafenib
  • glasdegib
  • midostaurin
  • rescinnamine
  • vinflunine
  • asunaprevir
  • dacarbazine
  • gliclazide
  • mifepristone
  • reserpine
  • vinorelbine
  • atazanavir
  • dapagliflozin
  • glimepiride
  • migalastat
  • resorcinol
  • vismodegib
  • atogepant
  • dasatinib
  • glipizide
  • miglitol
  • retapamulin
  • vitamin d
  • atomoxetine
  • deflazacort
  • gliquidone
  • milnacipran
  • ribavirin
  • vitamin e
  • atorvastatin
  • degarelix
  • glyburide
  • milrinone
  • ribociclib
  • voclosporin
  • atovaquone
  • delafloxacin
  • glycerol phenylbutyrate
  • minocycline
  • ribostamycin
  • vorapaxar
  • auranofin
  • delamanid
  • glycol salicylate
  • mirabegron
  • rifabutin
  • voriconazole
  • aurothioglucose
  • desflurane
  • glymidine
  • mirtazapine
  • rifamycin
  • vorinostat
  • avacopan
  • desipramine
  • golodirsen
  • modafinil
  • rifapentine
  • vortioxetine
  • avanafil
  • desloratadine
  • goserelin
  • mobocertinib
  • rilpivirine
  • voxelotor
  • avapritinib
  • desoximetasone
  • granisetron
  • modafinil
  • riluzole
  • voxilaprevir
  • axitinib
  • deutetrabenazine
  • grazoprevir
  • moexipril
  • rimegepant
  • warfarin
  • azacitidine
  • dexamethasone
  • grepafloxacin
  • mometasone furoate
  • rimonabant
  • yohimbine
  • azatadine
  • dexamethasone acetate
  • guanabenz
  • montelukast
  • riociguat
  • zaleplon
  • azathioprine
  • dexbrompheniramine
  • guanethidine
  • moricizine
  • ripretinib
  • zanamivir
  • azelaic acid
  • dexchlorpheniramine maleate
  • guanfacine
  • morphine
  • risdiplam
  • zanubrutinib
  • azelastine
  • dexfenfluramine
  • guanidine
  • moxifloxacin
  • risedronic acid
  • zidovudine
  • azilsartan medoxomil
  • dexibuprofen
  • halofantrine
  • moxisylyte
  • risperidone
  • zileuton
  • azithromycin
  • dexketoprofen
  • haloperidol
  • muzolimine
  • ritonavir
  • zinc
  • azlocillin
  • dexlansoprazole
  • hetacillin
  • mycophenolate mofetil
  • rivaroxaban
  • zinc acetate
  • aztreonam
  • dexmedetomidine
  • histrelin
  • mycophenolic acid
  • rizatriptan
  • zinc ascorbate
  • bacampicillin
  • dexpanthenol
  • hydralazine
  • n-acetyltyrosine
  • rofecoxib
  • zinc chloride
  • bacitracin
  • dexrazoxane
  • hydrochlorothiazide
  • nabumetone
  • roflumilast
  • zinc gluconate
  • baclofen
  • dextran
  • hydrocodone
  • nadolol
  • rolapitant
  • zinc oxide
  • balsalazide
  • dextromethorphan
  • hydrocortisone
  • nafarelin
  • romidepsin
  • zinc sulfate
  • baricitinib
  • dextropropoxyphene
  • hydrocortisone acetate
  • nafcillin
  • ropinirole
  • zinc sulfate, unspecified form
  • bcg vaccine
  • diatrizoate
  • hydrocortisone butyrate
  • naldemedine
  • ropivacaine
  • ziprasidone
  • beclomethasone dipropionate
  • diazepam
  • hydrocortisone cypionate
  • nalidixic acid
  • rosiglitazone
  • zofenopril
  • bedaquiline
  • dichlorobenzyl alcohol
  • hydrocortisone phosphate
  • nalmefene
  • rosoxacin
  • zolmitriptan
  • belumosudil
  • diclofenac
  • hydrocortisone succinate
  • naloxegol
  • rosuvastatin
  • zolpidem
  • benazepril
  • diclofenamide
  • hydroflumethiazide
  • naloxone
  • rotigotine
  • zonisamide
  • bendamustine
  • dicloxacillin
  • hydromorphone
  • naltrexone
  • roxithromycin
  • zopiclone
  • bendroflumethiazide
  • dicoumarol
  • hydrotalcite
  • naproxen
  • rucaparib
  • zotepine
  • benorilate
  • dicyclomine
  • hydroxocobalamin
  • nateglinide
  • rupatadine
  • zuclopenthixol
  • benoxaprofen
  • didanosine
  • hydroxychloroquine
  • nebivolol
  • ruxolitinib
  • abacavir
  • benserazide
  • dienogest
  • hydroxyethyl starch
  • nedaplatin
  • sacubitril
  • abemaciclib
  • benzatropine
  • diethylstilbestrol
  • hydroxyprogesterone caproate
  • nedocromil
  • safinamide
  • benznidazole
  • diflunisal
  • hydroxyzine
  • nefazodone
  • salbutamol
  • benzocaine
  • difluocortolone
  • hyoscyamine
  • nelfinavir
  • salicylamide
  • benzphetamine
  • digitoxin
  • ibandronate
  • neomycin
  • salicylic acid
  • benzthiazide
  • digoxin
  • ibrexafungerp
  • neratinib
  • salmeterol
  • benzydamine
  • dihydralazine
  • ibrutinib
  • netilmicin
  • salmon calcitonin
  • benzyl alcohol
  • ibuprofen
  • netupitant
  • salsalate
  • benzylpenicillin
  • dihydro-alpha-ergocryptine
  • ibutilide
  • nevirapine
  • samidorphan
  • benzylpenicilloyl polylysine
  • dihydrocodeine
  • icatibant
  • niacin
  • saquinavir
  • bepotastine
  • dihydroergocornine
  • icosapent
  • nicardipine
  • saxagliptin
  • bepridil
  • dihydroergocristine
  • idarucizumab
  • nicorandil
  • scopolamine
  • berotralstat
  • dihydroergotamine
  • idebenone
  • nifedipine
  • secobarbital
  • betamethasone
  • dihydrostreptomycin
  • idelalisib
  • nilotinib
  • selegiline
  • betamethasone phosphate
  • diltiazem
  • ifosfamide
  • nilutamide
  • selenious acid
  • betaxolol
  • dimenhydrinate
  • iloperidone
  • nilvadipine
  • selenium
  • bexarotene
  • dimercaprol
  • iloprost
  • nimesulide
  • selexipag
  • bezafibrate
  • dimethyl sulfoxide
  • imatinib
  • nimodipine
  • selinexor
  • bicalutamide
  • diphenhydramine
  • imipramine
  • nintedanib
  • selpercatinib
  • bicisate
  • disopyramide
  • indacaterol
  • nirmatrelvir
  • selumetinib
  • bictegravir
  • disulfiram
  • indapamide
  • nisoldipine
  • semaglutide
  • bilastine
  • dl-methylephedrine
  • indigotindisulfonic acid
  • nitrazepam
  • sertindole
  • binimetinib
  • dobutamine
  • indinavir
  • nitrendipine
  • sertraline
  • bismuth subgallate
  • docetaxel
  • indomethacin
  • nitric oxide
  • sevelamer
  • bismuth subnitrate
  • dofetilide
  • infigratinib
  • nitrofurantoin
  • sevoflurane
  • bisoprolol
  • dolasetron
  • infliximab
  • nitroprusside
  • sibutramine
  • bisoxatin
  • domperidone
  • inosine pranobex
  • nizatidine
  • sildenafil
  • bleomycin
  • donepezil
  • inositol
  • nomegestrol
  • silodosin
  • boceprevir
  • dopamine
  • inotersen
  • nomegestrol acetate
  • simeprevir
  • bortezomib
  • doravirine
  • insulin aspart
  • norelgestromin
  • simvastatin
  • bosentan
  • doripenem
  • insulin beef
  • norethisterone
  • siponimod
  • bosutinib
  • dosulepin
  • insulin degludec
  • norethynodrel
  • sirolimus
  • brentuximab vedotin
  • doxacurium
  • insulin detemir
  • norfloxacin
  • sitagliptin
  • bretylium
  • doxazosin
  • insulin glargine
  • norgestimate
  • sodium acetate
  • brexpiprazole
  • doxepin
  • insulin glulisine
  • norgestrel
  • sodium aurothiomalate
  • brigatinib
  • insulin human
  • nortriptyline
  • sodium bicarbonate
  • brivaracetam
  • doxycycline
  • insulin lispro
  • nylidrin
  • sodium feredetate
  • bromazepam
  • doxylamine
  • insulin pork
  • octinoxate
  • sodium ferric gluconate complex
  • bromocriptine
  • dronabinol
  • iobenguane sulfate i-123
  • octreotide
  • sodium fluoride
  • bromotheophylline
  • dronedarone
  • iodixanol
  • ofloxacin
  • sodium sulfate
  • brompheniramine
  • droperidol
  • ioflupane i-123
  • olanzapine
  • sofosbuvir
  • buclizine
  • drospirenone
  • iopromide
  • olaparib
  • solifenacin
  • budesonide
  • droxidopa
  • iothalamic acid
  • oliceridine
  • solriamfetol
  • bumadizone
  • dulaglutide
  • ioversol
  • olmesartan
  • somatotropin
  • bumetanide
  • duloxetine
  • ioxilan
  • olodaterol
  • sonidegib
  • bupivacaine
  • dutasteride
  • ipecac
  • olsalazine
  • sorafenib
  • bupropion
  • duvelisib
  • ipilimumab
  • omeprazole
  • sorbitol
  • buprenorphine
  • dydrogesterone
  • irbesartan
  • ondansetron
  • sotagliflozin
  • bupropion
  • dyphylline
  • irinotecan
  • opium
  • sotalol
  • buserelin
  • ebastine
  • iron
  • orphenadrine
  • sparfloxacin
  • buspirone
  • edoxaban
  • iron dextran
  • oseltamivir
  • spirapril
  • busulfan
  • edrophonium
  • iron isomaltoside 1000
  • osilodrostat
  • spironolactone
  • butabarbital
  • efavirenz
  • iron sucrose
  • osimertinib
  • stavudine
  • butriptyline
  • elbasvir
  • isavuconazole
  • ospemifene
  • stiripentol
  • cabazitaxel
  • eletriptan
  • isavuconazonium
  • oxacillin
  • streptomycin
  • cabergoline
  • eliglustat
  • isoflurane
  • oxaliplatin
  • strontium chloride
  • cabozantinib
  • eltrombopag
  • isoniazid
  • oxaprozin
  • stavudine
  • caffeine
  • elvitegravir
  • isosorbide
  • oxatomide
  • stiripentol
  • calcitriol
  • emedastine
  • isosorbide mononitrate
  • oxazepam
  • streptomycin
  • calcium acetate
  • empagliflozin
  • isosulfan blue
  • oxtriphylline
  • strontium chloride
  • calcium carbonate
  • emtricitabine
  • isotretinoin
  • oxybenzone
  • strontium ranelate
  • calcium chloride
  • enalapril
  • isoxicam
  • oxybutynin
  • sucralfate
  • calcium citrate
  • enalaprilat
  • isradipine
  • oxycodone
  • sufentanil
  • calcium glucoheptonate
  • enasidenib
  • istradefylline
  • oxymorphone
  • sulbactam
  • calcium gluconate
  • encainide
  • itraconazole
  • oxyphenbutazone
  • sulfadiazine
  • calcium lactate
  • encorafenib
  • ivabradine
  • oxyquinoline
  • sulfamethoxazole
  • calcium phosphate
  • enfortumab vedotin
  • ivacaftor
  • oxytocin
  • sulfasalazine
  • calcium polycarbophil
  • enoxacin
  • ivermectin
  • sulfinpyrazone
  • canagliflozin
  • entecavir
  • ivosidenib
  • palbociclib
  • sulfisoxazole
  • candesartan cilexetil
  • entrectinib
  • ixabepilone
  • paliperidone
  • sulindac
  • cannabidiol
  • enzalutamide
  • ixazomib
  • palonosetron
  • sulpiride
  • canrenoic acid
  • epinastine
  • kanamycin
  • palovarotene
  • sultamicillin
  • capecitabine
  • eplerenone
  • ketamine
  • pamidronic acid
  • sultopride
  • capmatinib
  • epoprostenol
  • ketazolam
  • panobinostat
  • sumatriptan
  • capreomycin
  • eprosartan
  • ketoconazole
  • pantoprazole
  • sunitinib
  • capsaicin
  • eravacycline
  • ketoprofen
  • papaverine
  • suvorexant
  • captopril
  • erdafitinib
  • ketorolac
  • paramethadione
  • synthetic conjugated estrogens, a
  • carbamazepine
  • ergoloid mesylate
  • labetalol
  • parecoxib
  • synthetic conjugated estrogens, b
  • carbenicillin
  • ergometrine
  • lacidipine
  • paricalcitol
  • tacrine
  • carbidopa
  • ergotamine
  • lacosamide
  • paritaprevir
  • tacrolimus
  • carbimazole
  • eribulin
  • lactulose
  • paromomycin
  • tadalafil
  • carbinoxamine
  • erlotinib
  • lamivudine
  • paroxetine
  • tafenoquine
  • carboplatin
  • ertapenem
  • lamotrigine
  • pasireotide
  • talc
  • carindacillin
  • ertugliflozin
  • lansoprazole
  • patent blue
  • tamoxifen
  • cariprazine
  • erythromycin
  • lanthanum carbonate
  • patiromer
  • tamsulosin
  • escitalopram
  • lapatinib
  • pazopanib
  • tasimelteon
  • carprofen
  • esketamine
  • larotrectinib
  • pefloxacin
  • tazemetostat
  • carvedilol
  • esmolol
  • latamoxef
  • pegaptanib
  • technetium tc-99m exametazime
  • cefaclor
  • esomeprazole
  • ledipasvir
  • peginesatide
  • technetium tc-99m mebrofenin
  • cefadroxil
  • estazolam
  • lefamulin
  • technetium tc-99m oxidronate
  • cefalotin
  • esterified estrogens
  • leflunomide
  • pemigatinib
  • teduglutide
  • cefamandole
  • estetrol
  • lemborexant
  • penbutolol
  • tegafur
  • cefapirin
  • estradiol
  • lenalidomide
  • penciclovir
  • telaprevir
  • cefazolin
  • estradiol acetate
  • lenvatinib
  • penicillamine
  • telavancin
  • cefdinir
  • estradiol benzoate
  • lercanidipine
  • pentaerythritol tetranitrate
  • telithromycin
  • cefditoren
  • estradiol cypionate
  • lesinurad
  • pentamidine
  • telmisartan
  • cefepime
  • estradiol dienanthate
  • letrozole
  • pentastarch
  • temazepam
  • cefmenoxime
  • estradiol valerate
  • leuprolide
  • pentetic acid
  • temocillin
  • cefmetazole
  • estramustine
  • levacetylmethadol
  • pentobarbital
  • temozolomide
  • cefonicid
  • estrone sulfate
  • levamlodipine
  • pentostatin
  • temsirolimus
  • cefoperazone
  • eszopiclone
  • levobupivacaine
  • pentoxifylline
  • teniposide
  • ceforanide
  • etacrynic acid
  • levocabastine
  • perampanel
  • tenofovir alafenamide
  • ceforanide
  • etafedrine
  • levocarnitine
  • perflubutane
  • tenofovir disoproxil
  • cefotaxime
  • ethambutol
  • levocetirizine
  • perflutren
  • tenoxicam
  • cefotetan
  • ethanol
  • levofloxacin
  • perhexiline
  • tepotinib
  • cefotiam
  • ethinylestradiol
  • levoketoconazole
  • perindopril
  • terbinafine
  • cefoxitin
  • ethosuximide
  • levomenthol
  • permethrin
  • terbutaline
  • cefpiramide
  • ethynodiol diacetate
  • levomilnacipran
  • perphenazine
  • terfenadine
  • cefpirome
  • etodolac
  • levonorgestrel
  • pexidartinib
  • terlipressin
  • cefpodoxime
  • etomidate
  • levosalbutamol
  • phenazopyridine
  • testolactone
  • cefprozil
  • etonogestrel
  • levosimendan
  • phenelzine
  • testosterone
  • cefradine
  • levothyroxine
  • pheneticillin
  • testosterone cypionate
  • ceftaroline fosamil
  • etoricoxib
  • lidocaine
  • phenformin
  • testosterone enanthate
  • ceftazidime
  • etravirine
  • lidoflazine
  • phenindione
  • testosterone propionate
  • ceftibuten
  • eucalyptus oil
  • linagliptin
  • pheniramine
  • testosterone undecanoate
  • ceftizoxime
  • everolimus
  • liothyronine
  • penicillin v
  • tetrabenazine
  • ceftobiprole
  • exemestane
  • liotrix
  • phenprocoumon
  • tetracycline
  • ceftolozane
  • exenatide
  • liraglutide
  • phentermine
  • tetradecyl hydrogen sulfate (ester)
  • ceftriaxone
  • ezogabine
  • lisinopril
  • phentolamine
  • tetraferric tricitrate decahydrate
  • cefuroxime
  • famotidine
  • lisuride
  • phenylbutazone
  • tezacaftor
  • celecoxib
  • fedratinib
  • lithium carbonate
  • phenytoin
  • theophylline
  • celiprolol
  • felbamate
  • lithium citrate
  • pholcodine
  • thiabendazole
  • cenobamate
  • felodipine
  • lixisenatide
  • phosphoric acid
  • thiamylal
  • cephalexin
  • fenbufen
  • lofexidine
  • phylloquinone
  • thiethylperazine
  • cephaloglycin
  • fenfluramine
  • lomefloxacin
  • picosulfuric acid
  • thioridazine
  • ceritinib
  • fenofibrate
  • lomitapide
  • pimavanserin
  • cerivastatin
  • fenofibric acid
  • lonafarnib
  • pimozide
  • thiothixene
  • certolizumab pegol
  • fenoldopam
  • loperamide
  • pinacidil
  • tiagabine
  • cetirizine
  • fenoprofen
  • lopinavir
  • pinaverium
  • tiaprofenic acid
  • cevimeline
  • fentanyl
  • loracarbef
  • pindolol
  • ticagrelor
  • chenodeoxycholic acid
  • ferric ammonium citrate
  • loratadine
  • piperacillin
  • ticarcillin
  • chloral hydrate
  • ferric carboxymaltose
  • lorazepam
  • piperaquine
  • ticlopidine
  • chlorcyclizine
  • ferric cation
  • lorcaserin
  • pipotiazine
  • tiludronic acid
  • acebutolol
  • albuterol
  • bcg vaccine live
  • aminolevulinic acid topical
  • aminolevulinic acid oral
  • ProQuin XR
  • ofloxacin
  • Moxifloxacin Systemic
  • moxifloxacin
  • Floxin
  • Cipro
  • Cipro XR
  • delafloxacin
  • Avelox
  • ciprofloxacin
Floxin + 

Doses Form and Uses

CNS

Headache(4%),dizziness (3%),insomnia(2%)

Endocrine & Metabolic:Decrease serum glucose(>2%),hyperchloremia(>2%),increase serum albumin(>2%),hypokalemia(1%)

GIT

Nausea(7%),diarrhea(6%),decreased amylase(>2%),constipation(2%),vomiting(2%),abdominal pain(1-2%),dyspepsia(1%).

Hematologic and oncologic

Decreased basophils(>2%),Decreased RBC (>2%),eosinopenia(>2%),increase MCH(>2%),increase neutrophils(>2%),leukocytosis(>2%),prolonged prothrombin time (>2%),anemia(1%)

Hepatic

decrease serum bilirubin(>2%),increase serum bilirubin (>2%),increase alanine aminotransferase(1%).

Immunologic

Increased serum globulins(>2%)

Renal

Increase serum calcium(>2%)

Respiratory

Hypoxia(>2%)

Miscellaneous

Fever

Less than 1% postmarketing or case reports related with following adverse effect

Agitation,abdominal distention,abdominal distress,abnormal gait,abnormal liver function test,agranulocytosis,allergic dermatitis,anaphylaxis,anaphylactic shock,

angina pectoris,angioedema,anorexiaaplastic,anemia,anxiety,asthma,ataxiaatrial fibrillation,auditory impairment,back pain,blurred vision,bronchospasm,candidiasis,cardiac puncture ,chest pain,chills,cholestatic hepatitis,CDAD,confusion,deafness,decrease appetite,dehydration,delirium,depression,disorientation,disturbance in attention,drowsiness,dysesthesia,dysgeusia,dyspnea,dysuria,edema,facial pain,fatigue,flatulence,fungal infection,gastritis,gastroenteritis ,hallucination,GIT reflux disease ,hemolytic anemia,hepatic failure,hepatic necrosis,hepatitis,hepatotoxicity (idiosyncratic),hyperglycemia,hyperhidrosis,hyperlipidemia,hypersensitivity pneumonitis,hypersensitivity reaction,hypertension,hypoesthesia,intracranial hypertension,increase amylase,increase blood urea nitrogen,increased gamma glutamyl transferase,, increase intracranial pressure,increase lactate dehydrogenase,increase serum creatinine,increased  alkaline phosphatase,serum aspartate aminotransferase, increased serum lipase,increased serum triglycerides,increased in uric acid,interstitial nephritis, jaundice,laryngeal edema,ethargy,leukopenia,limb pain,loss of consciousness,malaise,memory impairment,muscle spasm,musculoskeletal pain,myalgia,myasthenia,nervousness,neutropenia,nightmares,night sweats,pain,palpitations,pancytopenia,paranoid ideation,paresthesia,peripheral neuropathy,pharyngeal edema,phlebitis,phototoxicity,polyneuropathy,prolonged partial thromboplastine timeprolonged QT interval,renal failure syndrome, renal insufficiency,restlessness,rupture of tendon,seizure,serum sickness,skin photosensitivity,skin rash,Stevens johnson syndrome,suicidal thoughts,suicidal tendencies,syncope,tachycardia,tendinopathy,thrombocythemia,thrombocytopenia,

thrombotic thrombocytopenic purpura,tingling sensation,tinnitus,torsades de pointes,toxic epidermal necrolysis,toxic psychosis,tremor ,urticaria,vaginal infection,vasculitis,ventricular tachyarrhythmia,vertigo,vision loss,vulvovaginal pruritus,wheezing,xerostomia.

 

 

 

 

IRREVERSIBLE ADVERSE EFFECTS  

Fluoroquinolones have been associated with disabling and potentially irreversible severe adverse reactions that have occurred together with tendinitis and tendon rupture, peripheral neuropathy, and CNS effects. 

Tendinitis/tendon rupture may occur during treatment or months after treatment is discontinued and risk all ages. 

Risk increased in older patients aged more than 60 years. 

Strictly Avoided inpatient on Corticosteroids and Kidney/Heart/Lung transplant patients.

Avoid in Myasthenia Gravis patients leads to exacerbating muscle weakness.

 

RESERVE USE FOR PATIENTS WITH NO ALTERNATIVE OPTIONS

 

ACUTE BACTERIAL SINUSITIS

ACUTE BACTERIAL EXACERBATION OF CHRONIC BRONCHITIS

UNCOMPLICATED UTI

 

 

Hypersensitivity to ofloxacin or other members of the quinolones of antibiotic class. Fluoroquinolones show a permanent adverse severe reaction from different body systems in the patient. Discontinue the treatment immediately at the first sign or symptoms of following such as tendinitis, tendon rupture, arthralgia, myalgia, peripheral neuropathy, hallucination, anxiety, depression, insomnia, severe headache confusion. 

Fluoroquinolones associated with an increase in the risk of tendinitis and tendon rupture in all ages include Achilles tendon, rotator cuff the shoulder, the hand, biceps, thumb. 

Prolonged or repeated use of antibiotics leads to periodic evaluation of renal, hepatic, hematopoietic system function.

Avoid excessive sunlight, which leads to a phototoxicity reaction. 

Peripheral neuropathy resulting in hypothesis, dysesthesias paresthesias, weakness reported with initial drug and potentially permanent. 

Hypoglycemia reported in patients without any clinical survey (Shows with gatifloxacin)Monitor glucose levels in patients with diabetes; discontinue therapy and use an alternative therapy. 

One of the side effects is QT interval prolongation which increases the risk of ventricular arrhythmias, torsade the pointes, acute myocardial ischemia, patients with hypomagnesemia or hypokalemia. 

Without infection of organism suspected; avoid using any antibiotic that produces resistance in the patients. 

IF clostridium difficile associated diarrhea is reported, an ongoing antibiotic, which is not directed for CDAD, stop the treatment. This condition requires the correct antibiotic treatment, fluid & electrolyte management, protein supplement, and surgical evaluation. 

Discontinue the treatment with the first sign of skin rash, hypersensitivity, and jaundice.   

EFFECT ON CNS 

FQ shows an increased risk of CNS effects like intracranial pressure increase, convulsion, toxic. Psychosis, nervousness, insomnia, agitation, dizziness, confusion, tremors, hallucination, depression, suicidal ideation/thoughts, and self-injurious behavior such as attempted or completed suicide. If any of these reactions occur, discontinue treatment and consult your physician.FQ increase seizure or lower the seizure threshold. 

According to FDA safety alert issued in 12.20.2018

After two months of use of fluoroquinolones in elderly patients with fluoroquinolones for systemic use IV OR oral, increase the rate of aortic aneurysm include peripheral atherosclerotic vascular disease, hypertension, some genetic disorder Marfan syndrome, Ehlers-Danlos. The patient immediately seeks medical help if any symptoms occur. Discontinue the treatment immediately .reserve the use of fluoroquinolones when no alternative drug is available. 

According to FDA safety alert issued in 07.10.2018

The FDA warns prescribing FQ to the clinician, decreasing blood glucose and particularly adverse mental health. In elderly patients, hypoglycemia results in oral antidiabetic drugs or insulin coma. Instruct the elderly patients if symptoms of hypoglycemia occur. Safety alert affects systemic formulations like early signs, confusion, dizziness, unusual hunger, headache, irritability, pale skin, pounding heart or high-speed pulse, sweating, trembling, weakness or unusual anxiety, feeling shaky. This also included mental health issues like disturbances in attention, disorientation, agitation, nervousness, memory impairment, delirium. Immediately discontinue the treatment if any CNS-related adverse effects increase blood glucose level or potential risk of adverse psychiatric reactions after the initial dose. Consult your doctor for other antibiotic therapy.

 

Pregnancy Warning  

Ofloxacin crosses the placenta and increases the concentration in the amniotic fluid. The serum concentration of ofloxacin is lower during pregnancy than in nonpregnant women. Based on available data, the teratogenic effect has not been observed using during pregnancy. 

Breastfeeding Warnings

Ofloxacin is present in breast milk. Therapy on breastfeeding patients should consider the risk of infant exposure.No available data for the use of ofloxacin in breastfeeding mothers either continue or discontinue therapy.

 

Mechanism Of Action.            

Fluoroquinolones inhibit the enzyme bacterial DNA gyrase ( Primarily active in gram-negative bacteria), which nicks double-stranded DNA, introduces negative supercoils, and then reseals the neaked ends, needed to prevent supercoiling of strands. At the same time, they separate to permit replication or transcription. The DNA gyrase consists of Two A and Two B subunits: The A subunits carry nicking DNA, the B subunit introduces negative supercoils & then the A subunit reseals the strands. Fluoroquinolones bind to A subunits with high affinity and interfere with its strand cutting and resealing function.

In gram-positive bacteria, the primary target of   Fluoroquinolones action is a similar enzyme topoisomerase IV which nicks and DNA replicates & separates daughter DNA strands from it. Higher the topoisomerase IV affinity confer higher potency against gram-positive bacteria. The bactericidal action probably results from the digestion of DNA by exonucleases whose production issignaled by the damaged DNA. 

Absorption

Well absorbed; absorption is not affected by high-fat meal or yogurt

Bioavailability: 98% in oral forms. 

Distribution

Distribution :2.4 To 3.5 L/kg

Protein bound:32 % primarily albumin 

Metabolism

Metabolized in liver CYP450

Elimination

Half-life: 9 hr ( biphasic 4 to 5hr [6.4 to 7.4 hr in elderly patients]

Excretion

Feces (4 to 8%), urine (65% to 80% as unchanged drug) less than <10% metabolized

And 20 hr to 25 hr for <5% prolonged with renal impairment.

Feces (48%), urine (50% as unchanged d

Oral Administration 

ADULT 

Take with or without food. Administer at least 2 hrs before or 6 hrs after antacid containing magnesium or aluminum, sucralfate, metal cations(Iron), multivitamins containing zinc, iron, or didanosine buffered tablets for oral suspension, or pediatric powder for oral solution.

PEDIATRIC 

Take with or without food.

Generic Name: ofloxacin ( Oral) 

Pronounced: oh-FLOX-uh-sin 

Why do we use ofloxacin?

Moxifloxacin is used in bacterial infectionspneumonia, skin infection, and abdominal infections. ofloxacin treat and prevent plague, bronchitis, or sinus infection 

Warning  

Ofloxacin may cause a severe permanent effect on tendon-like tendon rupture, tendonitis, nerve problem in the leg & arm ( peripheral neuropathy), and nervous system problem like depression seizures. Contact your physician if you are on Ciprofloxacin and observe the following symptoms: Pain/numbness/burning/tingling/weakness in arms/hands/legs/feet, changes in senses touch, pain, temperature, vibration, body position, severe or lasting headache, vision changes, shaking ( tremors), mental/mood changes like agitation, anxiety, confusion, hallucination, depression, rare thoughts of suicide. If you observe any sign like pain or swelling in joints/muscles, stop exercising, take a rest and seek medical help. Avoid patients with age more than 60yr and patients taking prednisolone ( Corticosteroids), patients with transplant (kidney, heart, lung), which leads to increased tendon problems. Ciprofloxacin worsens Myasthenia gravis condition. Consult your doctor if you have new or worsening muscle weakness such as drooping eyelids, unsteady walk, or trouble breathing. Talk to the doctor before using this medicine. 

HOW TO USE 

Ofloxacin took with or without food once a day for 5 to 21 days. Duration of treatment depends upon the type and severity of infection decided by the physician/Doctor. Take medicine at the same time. If you don’t understand any part of moxifloxacin use, please consult a doctor/Pharmacist. Follow doctor instructions taking medication. Call your doctor if you should begin to feel better during the first few days of treatment with moxifloxacin or symptoms do not improve. Do not stop medication even you feel better. It’s always better to complete a course of antibiotics to avoid resistance to antibiotics. 

Other uses for this medicine

Ofloxacin is used to treat T.B., sexually transmitted diseases, endocarditis, and anthrax with no alternative medicine. This drug is also used for salmonella infection, which causes diarrhea, shigella infection, which causes severe diarrhea in HIV patients. Tell your doctor about the risk condition for using this medicine. If you need information about the drug, ask your doctor/Pharmacist. 

SIDE EFFECT

Avoid ofloxacin in children younger than 18 years old, which leads to problems in bones, joints, and tissues around joints in children. If you find other side effects that are not mentioned, contact your doctor/pharmacist or directly report the side effects to the manufacturing company or FDA official website. 

Severe diarrhea watery or blood in stools occur with or without fever and stomach cramps occur up to 2 months or more after treatment, rash, itching, peeling or blistering of the skin, fever, hives, swelling of the eyes, face, mouth, lips, tongue, throat, hands, feet ankles, hoarseness or sore throat, difficulty breathing or swallowing, yellow skin or eyes, pale skin, dark urine or light color stool, powerful thrust or hunger, fast or fluttering heartbeat, frequent urination, trembling, blurred vision, loss of consciousness unusual anxiety, fainting, decreased urination, unusual bruising or bleeding, sudden pain in the chest, stomach or back, nausea, vomiting, stomach pain, diarrhea. If you observe this symptom, immediately stop the drug and call your doctor.  

PRECAUTIONS 

Tell your doctor/Pharmacist to show allergic reaction to moxifloxacin or other quinolones other fluoroquinolones like Cipro, delafloxacin, Gemifloxacin, levofloxacin, ofloxacin, nutritional, vitamins, other supplements, the herbal product you are taking or plan to take. Glipizide, glyburide, tolazamide, and tolbutamide, for irregular heartbeat including amiodarone such as Nexterone, Pacerone disopyramide like Norpace, procainamide, quinidine, and sotalol such as Betapace, Betapace AF, Sorine, Sotylize in this condition your doctor need to change doses of medication, monitor, carefully. If your taking an antacid like aluminum or magnesium or didanosine, sucralfate, administer moxifloxacin at least 4 hrs before or 8hrs after this medication 

IMPORTANT WARNING  

Anticoagulants such as warfarin, Coumadin, Jantoven, Antidepressants, antipsychotics, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen as Advil, Motrin, others and naproxen as Aleve, Naprosyn, others; cisapride as Propulsid, diuretics, erythromycin, insulin or other medicine to treat diabetes such as chlorpropamide, glimepiride glipizide, glyburide, tolazamide, and tolbutamide; certain medications for irregular heartbeat including amiodarone Nexterone, Pacerone, disopyramide, procainamide, quinidine, and sotalol. Consult your doctor immediately for changing doses of your medicine and monitor to prevent side effects.

Tell your doctor if you or your family history of prolonged QTc interval means any heart-related diseases or rare heart problem or sudden death, irregular heartbeat, aortic aneurysm, B.P., peripheral vascular disease, Marfan syndrome, Ehlers-Danlos syndrome, low potassium or magnesium level, diabetes or low sugar level, liver condition. 

Before administration of ofloxacin, tell your doctor if you are pregnant or nursing an infant or toddler to avoid risk in infants or infants.

Avoid driving, machine operator, or any other activity that needs alertness or coordination until you know how moxifloxacin affects you. Also, unnecessary exposure to sunlight or U.V. light, wear protective clothes, sunglasses, sunscreen because moxifloxacin shows phototoxicity as a side effect.  

DRUG-DRUG INTERACTION  

Drug-drug interaction may change how your medications work, increase your risk for a severe side effect, or require patient monitoring. This document does not claim all possible drug-drug interactions. Before visiting the doctor, keep a list of all products you use, including prescribed drugs, OTC, and herbal products; share this with your doctor or Pharmacist. Without your doctor’s approval, don’t stop, change, or start the medicine. Some products like acenocoumarol, warfarin, strontium may interact with Ciprofloxacin.Many drugs like amiodarone,dofetilide,quinidine,procainamidesotalol prolonged QTc interval besides ciprofloxacin . Drugs like duloxetine, flibanserin, lomitapide, pirfenidone, tasimelteon, tizanidine removal of this drug slow down by Ciprofloxacin. Avoid caffeine intake, OTC product that contains caffeine; this medicine increases the effect of caffeine. 

OVERDOSE

The patient overdosed and has severe symptoms of passing out or breathing; in the U.S., call 911 and call a poison control center immediately. Other countries call an ambulance and are admitted to the hospital.  

NOTES 

Do not share your medicine with others. Medicine selection depends upon types of microorganism, site of infection,severity of infection decision, lab test , CBC,cultures, kidney function taken by doctors only. This medicine is prescribed only for the present condition, so do not administer it for future use, producing resistance against microorganisms. This should be monitored closely for progress or to check the side effects. Consult your doctor for more details about the medication. Don’t change the brand of medicine without consulting the doctor; not all brands have the same effects. 

OTHER INFORMATION  

Visit a doctor and the laboratory regularly. Sometimes the doctor may order another test to see how your body reacts to moxifloxacin. If you have diabetes and taking the antidiabetic drug or insulin, talk to your doctor about that and constantly monitor sugar levels in the body when on moxifloxacin. 

Do not share your medicine with others. Your dose is not refillable. If there is no improvement in the symptoms, immediately talk to your doctor. 

Always keep a list of prescribed, nonprescribed OTC drugs supplement or plan to be on treatment when you visit a clinic or at the time of hospital admit. This will be helpful for a doctor in an emergency condition. 

MISSED DOSE 

If you miss a dose, If it’s less than 6 hours before the next dose, skip the missed dose. Do not double the dose to level up the missed dose. Take the next dose at the regular time. 

STORAGE

Keep the medicine in the air-tight container at room temperature and out of reach of children and pets. Avoid storing at the place of excess heat or moisture. Before discarding, consult the doctor/physician if you have any doubts or queries.

 

 

 

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Floxin

Brand Name :

BRAND NAME IN US Floxin , INTERNATIONAL BRAND NAME WITH COUNTRIES Akilen (ID, SG) Indonesia,singapore, Avaflox (LK);sri lanka , Biloxcin (VN);vietnam, Cinaflox (EG);egypt, Danoflox (ID);Indonesia, Evaflox (MY);Malaysia, Flobacin (IT);Italy, Flogirax (BR);Brazil, Floksan (UA);Ukraine, Flotavid (ID);Indonesia, Flovid (HK, PH, SG);Hong kong, Philippines,singapore, Floxitop (EC);Ecuador, Floxstat (BB, BM, BS, CO, EC, GY, JM, NL, PR, SR, TT, VE); Barbados, Bermuda, Bahamas, Colombia, Ecuador, Guyana, Jamaica, Netherlands, Puerto Rico, Surinam, Trinidad and Tobago, Venezuela, Fugacin (VN); Vietnam Hyflox (TH); Thailand Kinflocin (TW); Taiwan, Province of China Kinoxacin (KR); Republic of Korea Loxinter (ID); Indonesia Loxwin (VN); vietnam Medofloxine (MY); Malaysia Mefoxa (ID); Indonesia Menazin (VN); vietnam Microbac (EC); Ecuador Novecin (AE, BH, CY, EG, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE); United Arab Emirates , Bahrain, Cyprus, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Oman , Qatar, Saudi Arabia, Syria, Yemen Nufafloqo (ID); Indonesia Ofcin (MY, TH, TW); Malaysia, Thailand, Taiwan, Province of China, Ofla (TH); Thailand Oflacin (BD); Bangladesh Oflamed (HK);Hong kong Oflin (IN);India Oflobid (LK);Srilanka Oflocee (TH);Thailand Oflocet (FR, NZ, PT); France, New Zealand, Portugal Oflocin (IT); Italy Oflodal (TW); Taiwan, Province of China Oflodex (IL); Israel Oflodura (DE); Germany Oflovir (ES); Spain Ofloxin (CZ, EE, LT, RO, SK, TH, UA); Czech Republic, Estonia, Lithuania, Romania, Slovakia, Thailand, Ukraine Ofloxol (MY); Malaysia, Oltrex (GT); Guatemala, Onexacin (PH); Philippines, Orivid (TH); Thailand, Orocin (KR); Republic of Korea, Oxacid (MT); Malta , Oxacin (TW); Taiwan, Province of China, Pharflox (ID); Indonesia, Quotavil (HK);Hong Kong, Rilox (ID); Indonesia, Sinflo (TW); Taiwan, Province of China, Tabrin (GR); Greece, Tafloc (ZA); South Africa Taravid (AE, CY, EG, IQ, IR, JO, KW, LB, LY, OM, QA, SA, SY, YE);United Arab Emirates, Cyprus, Egypt, Iraq, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, Yemen Tariflox (ID); Indonesia Tarivid (BE, BF, BJ, CH, CI, CL, EE, ET, GB, GH, GM, GN, HN, ID, IE, IN, JP, KE, KR, LR, LU, MA, ML, MR, MT, MU, MW, MY, NE, NG, NO, PK, PL, RU, SC, SD, SG, SK, SL, SN, TH, TN, TR, TW, TZ, UG, ZM); Belgium, Burkina Faso, Benin, Switzerland, Switzerland ,Côte D' Ivoire,Chile, Estonia, Ethiopia, Great Britain [UK], Ghana, Gambia, Guinea, Honduras, Indonesia, Ireland,India, Japan, Kenya, Republic of Korea, Liberia, Luxembourg, Morocco, Mali, Mauritania, Malta, Mauritius, Malawi, Malaysia, Niger, Nigeria, Norway, Pakistan, Poland, Russian Federation, Seychelles, Sudan, Singapore, Slovakia, Sierra Leone, Senegal, Thailand, Tunisia , Turkey, Taiwan, Province of China, Tanzania, Turkey, Taiwan, Province of China, Uganda, Zambia. Taroflex (SK); Slovakia Telbit (KR); Republic of Korea Uro Tarivid (AE, BH, CY, IQ, IR, JO, KW, LB, LY, OM, SA, SY, YE); United Arab Emirates, Bahrain, Cyprus, Iraq, Iran, Jordan, Kuwait, Lebanon,Libya, Oman, Saudi Arabia, Syrian Arab Republic, Yemen Vioflox (KR); Republic of Korea, Vioson (PH); Philippines, Viotisone (TH); Thailand, Zanocin (IN, LV, ZA):India, Latvia, South Africa

Synonyms :

BRN 3657947, CCRIS 5233, DL 8280, DL-8280, Floxin, Floxin in dextrose 5% , Floxin Otic , HOE 280 , HSDB 8030, NSC 727071, NSC 758178, Ocuflox, Oflocet , Ofloxacin, Ofloxacin Otic, Ofloxacina, Ofloxacina [DCIT], Ofloxacine, Ofloxacine [French], Ofloxacino, Ofloxacino [Spanish], Ofloxacinum, Ofloxacinum [Latin], ORF 18489 , Oxaldin , PT 01 Tarivid, UNII-A4P49JAZ9H, Visiren

Class :

Fluoroquinolones, Antibiotic, Bioterrorism




Chlamydia trachomatis

Citrobacter spp

Enterobacter spp

E. coli

Klebsiella pneumoniae

N. gonorrhoeae

Proteus mirabilis

Pseudomonas aeruginosa

S. aureus

S. pneumoniae

ADULT DOSING 

Tablet

200 mg

300mg

400 mg

Epididymitis, acute ( off label use) 

Enteric organism

Dose 

Oral:200 mg twice daily for 14 days. 

Sexually transmitted chlamydia and gonorrhea and enteric organism ( patient who practice insertive oral sex )

Dose 

Oral:200 mg twice daily for 10 days. Combination with ceftriaxone

Pneumonia, Community-acquired 

Dose 

Oral:400 mg every 12 hours for 5 days.

Note: Before discontinuation treatment patient should be clinically stable with normal vital signs.

Prostatitis

Oral

Dose

300 mg every 12 hrs for 6 weeks.

Sexually transmitted infections

Chlamydia trachomatis Cervicitis/urethritis :

Dose 

Oral:300 mg every 12 hrs for 7 days 

Pelvic inflammatory disease for outpatient 

Oral

Dose:400 mg every 12 hrs for 10 to 14 days. with metronidazole( recommended use ) 

Skin and Skin Structure Infection 

Dose 

Oral:400 mg every 12 hr for 5 to 14 days. I depend on severity and clinical response.

Traveler’s diarrhea (uncomplicated off label use )

Does Oral

400mg once daily as a single or for 3 days therapy course.

Note: 3 day course of therapy recommended in patients with fever or dysentery except Shigella dysenteriae  Super dose for 5 days or super dose 3-day regimens.FQs resistance is increased azithromycin preferred Southeast Asia or India with a high prevalence of campylobacter organism.

UTI 

Cystitis acute and uncomplicated

Dose; Oral

200mg every 12 hr for 3 days for female

200mg every 12 hr for 5 days for male

Note: ( Infection limited to the bladder without sign/symptoms of upper tract, prostate, or systemic infection)

Complicated (pyelonephritis)

Dose; Oral

200mg every 12 hr for 5-7 days 

DOSING IN HEPATIC IMPAIRMENT

No dose adjustment is required. Use caution.

DOSING IN RENAL IMPAIRMENT

Oral

CrCl>50mL/min: No dosage adjustment required 

CrCl 20 to 50 mL/min : every 24 hrs.

CrCl <20 mL/min: every 24 hrs 

Intermittent hemodialysis (IHD): 100mg to 200mg after dialysis

Peritoneal dialysis: 200mg every 24 hrs

CRRT: 300mg every 24 hr

PEDIATRIC DOSING

Susceptible Infection

Children: oral : 15 mg/kg/day divided every 12 hrs

Adult: 200 to 400mg every 12 hrs

Epididymitis (E.Coli)

Children weighining≥ 45 kg and adolescent: Oral: 300mg every 12 hrs for 10 days with ceftriaxone

Pelvic inflammatory disease

Children weighining≥ 45 kg and adolescent: Oral:400mg every 12 hrs for 10 -14 days with metronidazole

DOSING IN HEPATIC IMPAIRMENT

No dose recommended 

DOSING IN RENAL IMPAIRMENT

No dose recommended 

 

CNS

Headache(4%),dizziness (3%),insomnia(2%)

Endocrine & Metabolic:Decrease serum glucose(>2%),hyperchloremia(>2%),increase serum albumin(>2%),hypokalemia(1%)

GIT

Nausea(7%),diarrhea(6%),decreased amylase(>2%),constipation(2%),vomiting(2%),abdominal pain(1-2%),dyspepsia(1%).

Hematologic and oncologic

Decreased basophils(>2%),Decreased RBC (>2%),eosinopenia(>2%),increase MCH(>2%),increase neutrophils(>2%),leukocytosis(>2%),prolonged prothrombin time (>2%),anemia(1%)

Hepatic

decrease serum bilirubin(>2%),increase serum bilirubin (>2%),increase alanine aminotransferase(1%).

Immunologic

Increased serum globulins(>2%)

Renal

Increase serum calcium(>2%)

Respiratory

Hypoxia(>2%)

Miscellaneous

Fever

Less than 1% postmarketing or case reports related with following adverse effect

Agitation,abdominal distention,abdominal distress,abnormal gait,abnormal liver function test,agranulocytosis,allergic dermatitis,anaphylaxis,anaphylactic shock,

angina pectoris,angioedema,anorexiaaplastic,anemia,anxiety,asthma,ataxiaatrial fibrillation,auditory impairment,back pain,blurred vision,bronchospasm,candidiasis,cardiac puncture ,chest pain,chills,cholestatic hepatitis,CDAD,confusion,deafness,decrease appetite,dehydration,delirium,depression,disorientation,disturbance in attention,drowsiness,dysesthesia,dysgeusia,dyspnea,dysuria,edema,facial pain,fatigue,flatulence,fungal infection,gastritis,gastroenteritis ,hallucination,GIT reflux disease ,hemolytic anemia,hepatic failure,hepatic necrosis,hepatitis,hepatotoxicity (idiosyncratic),hyperglycemia,hyperhidrosis,hyperlipidemia,hypersensitivity pneumonitis,hypersensitivity reaction,hypertension,hypoesthesia,intracranial hypertension,increase amylase,increase blood urea nitrogen,increased gamma glutamyl transferase,, increase intracranial pressure,increase lactate dehydrogenase,increase serum creatinine,increased  alkaline phosphatase,serum aspartate aminotransferase, increased serum lipase,increased serum triglycerides,increased in uric acid,interstitial nephritis, jaundice,laryngeal edema,ethargy,leukopenia,limb pain,loss of consciousness,malaise,memory impairment,muscle spasm,musculoskeletal pain,myalgia,myasthenia,nervousness,neutropenia,nightmares,night sweats,pain,palpitations,pancytopenia,paranoid ideation,paresthesia,peripheral neuropathy,pharyngeal edema,phlebitis,phototoxicity,polyneuropathy,prolonged partial thromboplastine timeprolonged QT interval,renal failure syndrome, renal insufficiency,restlessness,rupture of tendon,seizure,serum sickness,skin photosensitivity,skin rash,Stevens johnson syndrome,suicidal thoughts,suicidal tendencies,syncope,tachycardia,tendinopathy,thrombocythemia,thrombocytopenia,

thrombotic thrombocytopenic purpura,tingling sensation,tinnitus,torsades de pointes,toxic epidermal necrolysis,toxic psychosis,tremor ,urticaria,vaginal infection,vasculitis,ventricular tachyarrhythmia,vertigo,vision loss,vulvovaginal pruritus,wheezing,xerostomia.

 

 

 

 

IRREVERSIBLE ADVERSE EFFECTS  

Fluoroquinolones have been associated with disabling and potentially irreversible severe adverse reactions that have occurred together with tendinitis and tendon rupture, peripheral neuropathy, and CNS effects. 

Tendinitis/tendon rupture may occur during treatment or months after treatment is discontinued and risk all ages. 

Risk increased in older patients aged more than 60 years. 

Strictly Avoided inpatient on Corticosteroids and Kidney/Heart/Lung transplant patients.

Avoid in Myasthenia Gravis patients leads to exacerbating muscle weakness.

 

RESERVE USE FOR PATIENTS WITH NO ALTERNATIVE OPTIONS

 

ACUTE BACTERIAL SINUSITIS

ACUTE BACTERIAL EXACERBATION OF CHRONIC BRONCHITIS

UNCOMPLICATED UTI

 

 

Hypersensitivity to ofloxacin or other members of the quinolones of antibiotic class. Fluoroquinolones show a permanent adverse severe reaction from different body systems in the patient. Discontinue the treatment immediately at the first sign or symptoms of following such as tendinitis, tendon rupture, arthralgia, myalgia, peripheral neuropathy, hallucination, anxiety, depression, insomnia, severe headache confusion. 

Fluoroquinolones associated with an increase in the risk of tendinitis and tendon rupture in all ages include Achilles tendon, rotator cuff the shoulder, the hand, biceps, thumb. 

Prolonged or repeated use of antibiotics leads to periodic evaluation of renal, hepatic, hematopoietic system function.

Avoid excessive sunlight, which leads to a phototoxicity reaction. 

Peripheral neuropathy resulting in hypothesis, dysesthesias paresthesias, weakness reported with initial drug and potentially permanent. 

Hypoglycemia reported in patients without any clinical survey (Shows with gatifloxacin)Monitor glucose levels in patients with diabetes; discontinue therapy and use an alternative therapy. 

One of the side effects is QT interval prolongation which increases the risk of ventricular arrhythmias, torsade the pointes, acute myocardial ischemia, patients with hypomagnesemia or hypokalemia. 

Without infection of organism suspected; avoid using any antibiotic that produces resistance in the patients. 

IF clostridium difficile associated diarrhea is reported, an ongoing antibiotic, which is not directed for CDAD, stop the treatment. This condition requires the correct antibiotic treatment, fluid & electrolyte management, protein supplement, and surgical evaluation. 

Discontinue the treatment with the first sign of skin rash, hypersensitivity, and jaundice.   

EFFECT ON CNS 

FQ shows an increased risk of CNS effects like intracranial pressure increase, convulsion, toxic. Psychosis, nervousness, insomnia, agitation, dizziness, confusion, tremors, hallucination, depression, suicidal ideation/thoughts, and self-injurious behavior such as attempted or completed suicide. If any of these reactions occur, discontinue treatment and consult your physician.FQ increase seizure or lower the seizure threshold. 

According to FDA safety alert issued in 12.20.2018

After two months of use of fluoroquinolones in elderly patients with fluoroquinolones for systemic use IV OR oral, increase the rate of aortic aneurysm include peripheral atherosclerotic vascular disease, hypertension, some genetic disorder Marfan syndrome, Ehlers-Danlos. The patient immediately seeks medical help if any symptoms occur. Discontinue the treatment immediately .reserve the use of fluoroquinolones when no alternative drug is available. 

According to FDA safety alert issued in 07.10.2018

The FDA warns prescribing FQ to the clinician, decreasing blood glucose and particularly adverse mental health. In elderly patients, hypoglycemia results in oral antidiabetic drugs or insulin coma. Instruct the elderly patients if symptoms of hypoglycemia occur. Safety alert affects systemic formulations like early signs, confusion, dizziness, unusual hunger, headache, irritability, pale skin, pounding heart or high-speed pulse, sweating, trembling, weakness or unusual anxiety, feeling shaky. This also included mental health issues like disturbances in attention, disorientation, agitation, nervousness, memory impairment, delirium. Immediately discontinue the treatment if any CNS-related adverse effects increase blood glucose level or potential risk of adverse psychiatric reactions after the initial dose. Consult your doctor for other antibiotic therapy.

 

Pregnancy Warning  

Ofloxacin crosses the placenta and increases the concentration in the amniotic fluid. The serum concentration of ofloxacin is lower during pregnancy than in nonpregnant women. Based on available data, the teratogenic effect has not been observed using during pregnancy. 

Breastfeeding Warnings

Ofloxacin is present in breast milk. Therapy on breastfeeding patients should consider the risk of infant exposure.No available data for the use of ofloxacin in breastfeeding mothers either continue or discontinue therapy.

 

Mechanism Of Action.            

Fluoroquinolones inhibit the enzyme bacterial DNA gyrase ( Primarily active in gram-negative bacteria), which nicks double-stranded DNA, introduces negative supercoils, and then reseals the neaked ends, needed to prevent supercoiling of strands. At the same time, they separate to permit replication or transcription. The DNA gyrase consists of Two A and Two B subunits: The A subunits carry nicking DNA, the B subunit introduces negative supercoils & then the A subunit reseals the strands. Fluoroquinolones bind to A subunits with high affinity and interfere with its strand cutting and resealing function.

In gram-positive bacteria, the primary target of   Fluoroquinolones action is a similar enzyme topoisomerase IV which nicks and DNA replicates & separates daughter DNA strands from it. Higher the topoisomerase IV affinity confer higher potency against gram-positive bacteria. The bactericidal action probably results from the digestion of DNA by exonucleases whose production issignaled by the damaged DNA. 

Absorption

Well absorbed; absorption is not affected by high-fat meal or yogurt

Bioavailability: 98% in oral forms. 

Distribution

Distribution :2.4 To 3.5 L/kg

Protein bound:32 % primarily albumin 

Metabolism

Metabolized in liver CYP450

Elimination

Half-life: 9 hr ( biphasic 4 to 5hr [6.4 to 7.4 hr in elderly patients]

Excretion

Feces (4 to 8%), urine (65% to 80% as unchanged drug) less than <10% metabolized

And 20 hr to 25 hr for <5% prolonged with renal impairment.

Feces (48%), urine (50% as unchanged d

Oral Administration 

ADULT 

Take with or without food. Administer at least 2 hrs before or 6 hrs after antacid containing magnesium or aluminum, sucralfate, metal cations(Iron), multivitamins containing zinc, iron, or didanosine buffered tablets for oral suspension, or pediatric powder for oral solution.

PEDIATRIC 

Take with or without food.

Generic Name: ofloxacin ( Oral) 

Pronounced: oh-FLOX-uh-sin 

Why do we use ofloxacin?

Moxifloxacin is used in bacterial infectionspneumonia, skin infection, and abdominal infections. ofloxacin treat and prevent plague, bronchitis, or sinus infection 

Warning  

Ofloxacin may cause a severe permanent effect on tendon-like tendon rupture, tendonitis, nerve problem in the leg & arm ( peripheral neuropathy), and nervous system problem like depression seizures. Contact your physician if you are on Ciprofloxacin and observe the following symptoms: Pain/numbness/burning/tingling/weakness in arms/hands/legs/feet, changes in senses touch, pain, temperature, vibration, body position, severe or lasting headache, vision changes, shaking ( tremors), mental/mood changes like agitation, anxiety, confusion, hallucination, depression, rare thoughts of suicide. If you observe any sign like pain or swelling in joints/muscles, stop exercising, take a rest and seek medical help. Avoid patients with age more than 60yr and patients taking prednisolone ( Corticosteroids), patients with transplant (kidney, heart, lung), which leads to increased tendon problems. Ciprofloxacin worsens Myasthenia gravis condition. Consult your doctor if you have new or worsening muscle weakness such as drooping eyelids, unsteady walk, or trouble breathing. Talk to the doctor before using this medicine. 

HOW TO USE 

Ofloxacin took with or without food once a day for 5 to 21 days. Duration of treatment depends upon the type and severity of infection decided by the physician/Doctor. Take medicine at the same time. If you don’t understand any part of moxifloxacin use, please consult a doctor/Pharmacist. Follow doctor instructions taking medication. Call your doctor if you should begin to feel better during the first few days of treatment with moxifloxacin or symptoms do not improve. Do not stop medication even you feel better. It’s always better to complete a course of antibiotics to avoid resistance to antibiotics. 

Other uses for this medicine

Ofloxacin is used to treat T.B., sexually transmitted diseases, endocarditis, and anthrax with no alternative medicine. This drug is also used for salmonella infection, which causes diarrhea, shigella infection, which causes severe diarrhea in HIV patients. Tell your doctor about the risk condition for using this medicine. If you need information about the drug, ask your doctor/Pharmacist. 

SIDE EFFECT

Avoid ofloxacin in children younger than 18 years old, which leads to problems in bones, joints, and tissues around joints in children. If you find other side effects that are not mentioned, contact your doctor/pharmacist or directly report the side effects to the manufacturing company or FDA official website. 

Severe diarrhea watery or blood in stools occur with or without fever and stomach cramps occur up to 2 months or more after treatment, rash, itching, peeling or blistering of the skin, fever, hives, swelling of the eyes, face, mouth, lips, tongue, throat, hands, feet ankles, hoarseness or sore throat, difficulty breathing or swallowing, yellow skin or eyes, pale skin, dark urine or light color stool, powerful thrust or hunger, fast or fluttering heartbeat, frequent urination, trembling, blurred vision, loss of consciousness unusual anxiety, fainting, decreased urination, unusual bruising or bleeding, sudden pain in the chest, stomach or back, nausea, vomiting, stomach pain, diarrhea. If you observe this symptom, immediately stop the drug and call your doctor.  

PRECAUTIONS 

Tell your doctor/Pharmacist to show allergic reaction to moxifloxacin or other quinolones other fluoroquinolones like Cipro, delafloxacin, Gemifloxacin, levofloxacin, ofloxacin, nutritional, vitamins, other supplements, the herbal product you are taking or plan to take. Glipizide, glyburide, tolazamide, and tolbutamide, for irregular heartbeat including amiodarone such as Nexterone, Pacerone disopyramide like Norpace, procainamide, quinidine, and sotalol such as Betapace, Betapace AF, Sorine, Sotylize in this condition your doctor need to change doses of medication, monitor, carefully. If your taking an antacid like aluminum or magnesium or didanosine, sucralfate, administer moxifloxacin at least 4 hrs before or 8hrs after this medication 

IMPORTANT WARNING  

Anticoagulants such as warfarin, Coumadin, Jantoven, Antidepressants, antipsychotics, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen as Advil, Motrin, others and naproxen as Aleve, Naprosyn, others; cisapride as Propulsid, diuretics, erythromycin, insulin or other medicine to treat diabetes such as chlorpropamide, glimepiride glipizide, glyburide, tolazamide, and tolbutamide; certain medications for irregular heartbeat including amiodarone Nexterone, Pacerone, disopyramide, procainamide, quinidine, and sotalol. Consult your doctor immediately for changing doses of your medicine and monitor to prevent side effects.

Tell your doctor if you or your family history of prolonged QTc interval means any heart-related diseases or rare heart problem or sudden death, irregular heartbeat, aortic aneurysm, B.P., peripheral vascular disease, Marfan syndrome, Ehlers-Danlos syndrome, low potassium or magnesium level, diabetes or low sugar level, liver condition. 

Before administration of ofloxacin, tell your doctor if you are pregnant or nursing an infant or toddler to avoid risk in infants or infants.

Avoid driving, machine operator, or any other activity that needs alertness or coordination until you know how moxifloxacin affects you. Also, unnecessary exposure to sunlight or U.V. light, wear protective clothes, sunglasses, sunscreen because moxifloxacin shows phototoxicity as a side effect.  

DRUG-DRUG INTERACTION  

Drug-drug interaction may change how your medications work, increase your risk for a severe side effect, or require patient monitoring. This document does not claim all possible drug-drug interactions. Before visiting the doctor, keep a list of all products you use, including prescribed drugs, OTC, and herbal products; share this with your doctor or Pharmacist. Without your doctor’s approval, don’t stop, change, or start the medicine. Some products like acenocoumarol, warfarin, strontium may interact with Ciprofloxacin.Many drugs like amiodarone,dofetilide,quinidine,procainamidesotalol prolonged QTc interval besides ciprofloxacin . Drugs like duloxetine, flibanserin, lomitapide, pirfenidone, tasimelteon, tizanidine removal of this drug slow down by Ciprofloxacin. Avoid caffeine intake, OTC product that contains caffeine; this medicine increases the effect of caffeine. 

OVERDOSE

The patient overdosed and has severe symptoms of passing out or breathing; in the U.S., call 911 and call a poison control center immediately. Other countries call an ambulance and are admitted to the hospital.  

NOTES 

Do not share your medicine with others. Medicine selection depends upon types of microorganism, site of infection,severity of infection decision, lab test , CBC,cultures, kidney function taken by doctors only. This medicine is prescribed only for the present condition, so do not administer it for future use, producing resistance against microorganisms. This should be monitored closely for progress or to check the side effects. Consult your doctor for more details about the medication. Don’t change the brand of medicine without consulting the doctor; not all brands have the same effects. 

OTHER INFORMATION  

Visit a doctor and the laboratory regularly. Sometimes the doctor may order another test to see how your body reacts to moxifloxacin. If you have diabetes and taking the antidiabetic drug or insulin, talk to your doctor about that and constantly monitor sugar levels in the body when on moxifloxacin. 

Do not share your medicine with others. Your dose is not refillable. If there is no improvement in the symptoms, immediately talk to your doctor. 

Always keep a list of prescribed, nonprescribed OTC drugs supplement or plan to be on treatment when you visit a clinic or at the time of hospital admit. This will be helpful for a doctor in an emergency condition. 

MISSED DOSE 

If you miss a dose, If it’s less than 6 hours before the next dose, skip the missed dose. Do not double the dose to level up the missed dose. Take the next dose at the regular time. 

STORAGE

Keep the medicine in the air-tight container at room temperature and out of reach of children and pets. Avoid storing at the place of excess heat or moisture. Before discarding, consult the doctor/physician if you have any doubts or queries.

 

 

 

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