Moxifloxacin information from DrugsUpdate
P - Contraindicated in pregnancy
L - Contraindicated in lactation
Moxifloxacin is a third generation synthetic fluoroquinolone chemotherapeutic agent developed by Bayer AG (initially called BAY 12-8039). It is marketed worldwide (as the hydrochloride) under the brand names Avelox, Avalox and Avelon for oral treatment. In most countries the drug is also available in parenteral form for intravenous infusion. Moxifloxacin is also sold in an ophthalmic solution (eye drops) under the brand name Vigamox for the treatment of conjunctivitis (pink eye).
Pharmacodynamics
Pharmacokinetics
Moxifloxacin inhibits the topoisomerase II (DNA gyrase) and topoisomerase IV required for bacterial DNA replication, transcription, repair and recombination.
Absorption
Well absorbed from GI tract.
Distribution
Widely distributed throught the body. 30-50% protein bound.
Metabolism
Metabolised via glucuronide and sulfate conjugation.
Excretion
Excreted in urine and faeces as unchanged drug and metabolite. Elimination half life of around 12 hours.
Moxifloxacin Indications / Moxifloxacin Uses
Information Not Available
Moxifloxacin Adverse Reactions / Moxifloxacin Side Effects
GI disturbances, CNS effects, hypersensitivity-type reactions, reversible arthralgia, abnormal liver function tests, hepatitis, haematological disturbances, tachycardia, superinfection, pain and irritation at the Inj site, tendon damage, phloebitis and thrombophloebitis, peripheral neuropathy, photosensitivity, abdominal pain, headache, vaginitis.
Precautions
Warnings
Tendonitis
Moxifloxacin has been associated with an increased risk of tendonitis and tendon rupture in patients of all ages. The risk is increased in patients older than 60 yr of age, in patients taking corticosteroids, and in patients with kidney, heart, or lung transplants.
Overdosage
Stomach should be emptied and hydration maintained. Activated charcoal may be useful soon after oral overdosage. Treatment should be supportive, dialysis may be of some limited use.
Special Precautions
Maintain adequate fluid intake; exposure to strong sunlight/sunlamp. Epilepsy, history of CNS disorders, DM. Not recommended in severe hepatic impairment. May worsen myasthenia gravis. Discontinue in case of tendon pain, inflammation or rupture. High level of resistance with S. aureus infections. Increased risk of tendon inflammation/rupture especially in elderly taking corticosteroids. Caution in patients with proarrhythmic conditions e.g. clinically significant bradycardia or acute MI. Existing QT prolongation, bradycardia, heart failure with reduced left ventricular ejection fraction; uncorrected hypokalaemia. Avoid concomitant usage with drugs that are known to prolong QT interval. Prolonged use may increase risk of fungal or bacterial superinfection.
Other Drug Interactions
Moxifloxacin should be taken 4 hours before or 8 hours after admin of magnesium or aluminium containing antacids or iron and zinc containing products. Increased risk of CNS stimulation and convulsions with NSAIDs. May increase adverse effects of corticosteroids when used together. May increase anticoagulant effect of coumarin derivatives. May reduce serum levels of mycophenolate. Didanosine, sevelamer, sucralfate and quinalapril may reduce the absorption of orally-administered moxifloxacin.
Potentially Fatal: Risk of torsade de pointes with QT prolonging drugs e.g. class Ia or class III antiarrythmics, terfenadine, cisapride, astemizole.
Other Interactions
Information Not Available
Dosage
Oral
Acute bacterial sinusitis
Adult: 400 mg once daily for 10 days.
Oral
Acute bacterial exacerbation of chronic bronchitis
Adult: 400 mg once daily for 5-10 days.
Oral
Community-acquired pneumonia
Adult: 400 mg once daily for 7-14 days.
Oral
Skin and skin structure infections
Adult: Complicated: 400 mg once daily for 7-21 days; uncomplicated: 400 mg once daily for 7 days.
Intravenous
Acute bacterial sinusitis
Adult: 400 mg by IV infusion over 60 minutes every 24 hours for 10 days.
Intravenous
Acute bacterial exacerbation of chronic bronchitis
Adult: 400 mg by IV infusion over 60 minutes every 24 hours for 5-10 days.
Intravenous
Community-acquired pneumonia
Adult: 400 mg by IV infusion over 60 minutes every 24 hours for 7-14 days.
Intravenous
Skin and skin structure infections
Adult: Complicated: 400 mg once daily for 7-21 days; uncomplicated: 400 mg once daily for 7 days. Dose to be infused over 60 minutes.
Intravenous
Intra-abdominal infections
Adult: 400 mg for 5-14 days. May change to oral therapy when clinically appropriate. Dose to be infused over 60 minutes.
Ophthalmic
Bacterial conjunctivitis
Adult: As 0.5% ophthalmic solution: instil 1 drop in the affected eye tid for 7 days.
Child: >1 year as 0.5% ophthalmic solution: instil 1 drop in the affected eye tid for 7 days.
Food(before/after)
May be taken with or without food
List of Contraindications
Moxifloxacin and Pregnancy
Contraindicated in pregnancy
Moxifloxacin and Lactation
Contraindicated in lactation
Moxifloxacin and Children
PO/IV
Safety and efficacy not established.
Ophthalmic
Safety and efficacy in children younger than 1 year of age not established.
Moxifloxacin and Geriatic
Information Not Available
Moxifloxacin and Other Contraindications
Hypersensitivity; child, adolescent; pregnancy, lactation.
Storage
Intravenous
Store at 25°C.
Ophthalmic
Store at 2-25°C.
Oral
Store at 25°C.
Lab interference
Intravenous
Store at 25°C.
Ophthalmic
Store at 2-25°C.
Oral
Store at 25°C.
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