Moxifloxacin is a quinolone antibacterial of the class fluoroquinolone. It is a part of the fourth generation of quinolone antibiotics
USES OF MOXIFLOXACIN
- Primarily used for the treatment of eye infections & conjunctivitis
- Treatment of lung infection
- Second line treatment for Tuberculosis
- Nosocomial pneumonia
- Sinus infection (sinusitis)
- Skin infections
- Bite wounds
- Bone & joint infection
- Diabetic foot
- Meningitis
- Nocardiosis
- Urethritis
- Cervicitis
- Mastitis (infection of the breast)
- Surgical prophylaxis
- Inhalational anthrax
- Treatment of bacterial plague.
DOSAGE
Types of dosage forms
- Tablets: 400 mg
- Injection: 400 mg/250 ml
- Eye drops/solution: 0.5%
- Eye ointment: 0.5%
- Dry syrup: 250 mg
Dosage guide
- Adult dose for pneumonia: 400 mg orally or IV every 24 hours for 7 to 14 days.
- Adult dose for sinusitis: 400 mg orally or IV every 24 hours for 10 days.
- Dose for conjunctivitis and eye infections:
a) Administration of drops every 4 hours for 5 days.
b) Application of eye ointment, in and around the eye, twice a day for 5 days.
Missed dose: If a dose is missed & it is way past the time to take the particular dose, skip the dose & do not take it close to or along with the following dose.
Overdose:
a) Treatment is followed by removal of drug by inducing vomiting or administering a gastric lavage.
b) Maintaining appropriate hydration & nutrition.
SIDE EFFECTS
- Nausea
- Vomiting
- Change in taste
- Diarrhea or constipation
- Headache
- Hives/rash
- Difficulty sleeping
- Abdominal pain
- Flatulence
- Allergic reaction
ADVERSE EFFECTS ARISING FROM MOXIFLOXACIN
- Death of peripheral nerve cells
- Low blood sugar
- Tendinitis
- Hypoxia
- Abnormal heart beat
- Fluctuation in serum bilirubin
- Decreased RBC level
- CNS issues like seizures, delusion, hallucinations, etc.
- Inflammation of the colon
- Exacerbation of myasthenia gravis
- Syncope/fainting
- QT prolongation
- Low blood pressure
- Shock
- Kidney failure
PRECAUTIONS & CONTRAINDICATIONS
Moxifloxacin is contraindicated in patients & precaution is advised, with following conditions or disorders:
- Muscle or nerve disorder like myasthenia gravis
- Kidney disease
- In patients over 60 taking corticosteroids
- Brain tumor
- People with CNS diseases or disorders when given Moxifloxacin can develop rare & severe convulsions.
- Autoimmune disorders
- Genetic/Hereditary disorders
- Low levels of serum/blood potassium or magnesium
- Diabetes
- Problems in blood flow
- Cardiovascular disorders
- Aneurysm/blood clots
- Hypertension
- Bone or tendon problems.
INTERACTIONS OF MOXIFLOXACIN
Drugs whose blood level is increased/or effectiveness is increased (unwanted) when given in presence of moxifloxacin:
- Vitamin K
- QT prolonging agents
- Warfarin – blood thinning drug
- Glyburide – leads to very low blood sugar
- Nadifloxacin
- Sucralfate
- Heroin
Drugs that reduce the effectiveness of moxifloxacin when given in combination:
- Iron salts
- Antacids
- Calcium containing salts, these drugs can bind with moxifloxacin and reduce its absorption.
- Sucralfate
- Levofloxacin when taking along with NSAIDs can increase CNS stimulation and cause varying symptoms.
Drug-Food interaction
- Milk and other dairy products reduce the effectiveness of the drug.
- When oral solution is given with enteric tube feedings, the action of the drug is reduced.
- Multivitamins can interfere with the absorption of the drug.
- Alcohol not to be taken along with the drug.
IN PREGNANCY, BREASTFEEDING & CHILDREN
- Pregnancy: Moxifloxacin is categorized as a category C drug, which includes drugs that have no adequate information or controlled studies on it.
- Breastfeeding: Fluoroquinolones are present in the breast milk of the mother, and therefore can pass on to infants causing serious adverse effects, although less concentration of moxifloxacin is present in the breast milk, & therefore can be prescribed when properly monitored.
- Children: Moxifloxacin is not recommended in children except in life threatening infections. For eg: Eye drops & IV drug are approved for children in two indications: Anthrax & conjunctivitis