moxifloxacin (Avelox, Vigamox)
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Indications
- bacterial infections due to susceptible organisms
* on list on medications to avoid[10]
- hepatoxicity & heart disease cited
Contraindications
- NOT for use in urinary tract infections does not reach adequate concentrations in urine
- widened QRS complex may increase risk of QT prolongation
Dosage
- 400 mg QD
- no dosage adjustment needed for elderly
Tablets: 400 mg
Injection: 400 mg in 250 mL of normal saline (yellow)
Ophthalmic: (Vigamox)[4]
Dosage adjustment in renal failure
- no dosage adjustment is necessary in patients with renal impairment, including patients on hemodialysis
Pharmacokinetics
- well absorbed from the gastrointestinal tract
- absolute bioavailability ~90% with a high-fat meal
- 30-50% bound to serum proteins
- 5% metabolized via glucuronide & sulfate conjugation
- CYP450 not involved in moxifloxacin metabolism
- sulfate conjugate accounts for ~38% of the dose, & is eliminated primarily in the feces
- glucuronide conjugate accounts for ~14% of dose, & is excreted exclusively in the urine
Antimicrobial activity
- Gram-positive (activity enhanced) Streptococcus pneumoniae
- Anaerobes (activity enhanced)
- Mycoplasma pneumoniae[8]
- Chlamydophila pneumoniae
- Haemophilus influenzae
- Haemophilus parainfluenzae
- Klebsiella
- Moraxella catarrhalis
- Escherichia coli
- Enterobacter[8]
Adverse effects
Drug interactions
- drug interaction(s) anticonvulsants with anti-bacterial agents
- drug interaction(s) of antibiotics with warfarin
- drug interaction(s) of theophylline with fluoroquinolone
- drug interaction(s) of beta-adrenergic receptor antagonists with quinolones
- drug interaction(s) of fluroquinolones with amiodarone
- drug interaction(s) of fluroquinolones with sulfonylureas
- drug interaction(s) of fluoroquinolones with hypoglycemic agents
Laboratory
Notes
Manufacturer: Bayer
More general terms
More specific terms
References
- ↑ Prescriber's Letter 7(2):7, Feb. 2000
- ↑ Norman, D, In: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ Prescriber's Letter 9(2):S1, Feb. 2002
- ↑ 4.0 4.1 4.2 Prescriber's Letter 10(5):27 2003
- ↑ 5.0 5.1 Malangoni MA et al, Randomized controlled trial of moxifloxacin compared with piperacillin-tazobactam and amoxicillin-clavulanate for the treatment of complicated intra-abdominal infections. Ann Surg 2006, 244:204 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16858182
- ↑ RxList: Avelox http://www.rxlist.com/avelox-drug.htm
- ↑ 7.0 7.1 Paterson MJ et al Fluoroquinolone therapy and idiosyncrativ acute liver injury: a population-based study CMAJ August 13, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22891208 <Internet> http://www.cmaj.ca/content/early/2012/08/13/cmaj.111823.full.pdf+html
Hayashi PH and Chalasani NP Liver injury in the elderly due to fluoroquinolones: Should these drugs be avoided? CMAJ August 13, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22891207 <Internet> http://www.cmaj.ca/content/early/2012/08/13/cmaj.121270 - ↑ 8.0 8.1 8.2 8.3 8.4 Deprecated Reference
- ↑ 9.0 9.1 FDA News Release. May 8, 2015 FDA approves additional antibacterial treatment for plague http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm446283.htm
- ↑ 10.0 10.1 10.2 Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/