Adult Dosing
Acute Bacterial Sinusitis
Acute Bacterial Exacerbation of Chronic Bronchitis
Community Acquired Pneumonia
- 400 mg PO qd for 7-14 days
Uncomplicated Skin and Skin Structure Infections
Complicated Skin and Skin Structure Infections
- 400 mg PO qd for 7–21 days
Complicated Intra-Abdominal infections
- 400 mg PO qd for 5-14 days
Bronchiectasis [Not FDA Approved]
Note: Administer 4 hrs before or 8 hrs after antacids, sucralfate, multivitamins and other products with multivalent cations
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Fluoroquinolones are associated with an increased risk of tendinitis and tendon rupture in patients of all ages. Older patients (usually >60 yrs of age), patients taking corticosteroids, and patients who have had kidney, heart or lung transplants, are at increased risk [US Black Box Warning]. Such adverse reaction most frequently involves the achilles tendon. Rupture of the achilles tendon requires surgical repair. Tendinitis and tendon rupture in the rotator cuff (the shoulder), the hand, the bicep, the thumb, and other tendon sites have occurred. Strenuous physical activity, renal failure, and previous tendon disorders such as rheumatoid arthritis are the factors associated with increased tendon rupture. Tendinitis and tendon rupture have also occurred in patients without above risk factors
- Tendon ruptures have occurred during or after completion of therapy; cases occurring for up to several months after completion of therapy have occurred. Discontinue therapy if the patient experiences pain, swelling, inflammation or rupture of a tendon
- Safety and efficacy of moxifloxacin in patients < 18 yrs of age, pregnant women, and lactating women have not been established
- Convulsions, increased intracranial pressure, and toxic psychosis have occurred in patients receiving this drug
- Stimulates CNS leading to tremors, restlessness/agitation, nervousness/anxiety, lightheadedness, confusion, hallucinations, paranoia and depression, nightmares, insomnia, and rare suicidal thoughts or acts. Discontinue therapy and institute appropriate measures on occurrence of these events. Insomnia is more common among these events
- Serious and occasionally fatal hypersensitivity and/or anaphylactic reactions have occurred in patients receiving therapy with this drug. Cardiovascular collapse, hypotension, shock, seizure, loss of consciousness, tingling, angioedema (including tongue, laryngeal, throat or facial edema/swelling), airway obstruction (including bronchospasm, shortness of breath and acute respiratory distress), dyspnea, urticarias, itching, and other serious skin reactions have occurred
- Immediately discontinue therapy at the first instance of appearance of a skin rash or any other sign of hypersensitivity
- Provide treatment with epinephrine and other resuscitative measures, including oxygen, intravenous fluids, antihistamines, corticosteroids, pressor amines, and airway management, as clinically indicated on occurrence of serious acute hypersensitivity reactions
- Fever, rash or severe dermatologic reactions, vasculitis, arthralgia, myalgia, serum sickness, allergic pneumonitis, interstitial nephritis, acute renal insufficiency/failure, hepatitis, jaundice, acute hepatic necrosis/failure, anemia, including hemolytic and aplastic, thrombocytopenia, including thrombotic thrombocytopenic purpura, leukopenia, agranulocytosis, pancytopenia, and/or other hematologic abnormalities have occurred
- Rare occasions of sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paresthesias, hypoesthesias, dysesthesias and weakness have occurred in patients
- Discontinue therapy if the patient experiences symptoms of neuropathy including pain, burning, tingling, numbness, and/or weakness or other alterations of sensation including light touch, pain, temperature, position sense, and vibratory sensation in order to prevent the development of an irreversible condition
- Clostridium difficile associated diarrhea (CDAD) which may range from mild diarrhea to fatal colitis has been reported. It can occur during therapy or >2mo after discontinuation. Consider diagnosis if diarrhea presents after antibiotic administration
- Reserve use for serious infections where less toxic agents are inappropriate; avoid use in nonbacterial infections such as most URTIs
- Antibiotics may alter colon flora, leading to C. difficile overgrowth. C. difficile produces toxins A and B which contribute to CDAD. Hypertoxin producing strains cause increased morbidity and mortality since these infections can be refractory to antibiotic therapy and may require colectomy
- On suspection/confirmation of CDAD, discontinue use. Patients may need fluid, electrolyte, and protein supplementation along with antibiotics for C. difficile, surgical evaluation as needed
- To reduce the development of drug-resistant bacteria, use only to treat infections proven or strongly suspected to be caused by susceptible bacteria. Obtain susceptibility tests before starting therapy
- Therapy is ineffective for the treatment of syphilis. Conduct serologic test for syphilis at the time of diagnosis in all patients with gonorrhea. Conduct follow-up serologic test for syphilis after three months and, if positive, institute treatment with an appropriate antimicrobial
- Maintain adequate hydration to prevent the formation of a highly concentrated urine
- Carefully monitor and conduct appropriate laboratory tests in patients with known or suspected renal or hepatic insufficiency/impairment
- Moderate to severe photosensitivity/phototoxicity reactions have occurred
- Potentiation of hypoglycemia has occurred on concomitant use of oral hypoglycemic drugs or insulin with fluoroquinolone
- Periodically assess organ system function including renal, hepatic, and hematopoietic
- Prolongation of the QT interval on the electrocardiogram and infrequent cases of arrhythmia has occurred. Rare cases of torsades de pointes have been reported during post-marketing surveillance. Avoid use in patients with known prolongation of the QT interval, patients with uncorrected hypokalemia, and patients receiving class IA (quinidine, procainamide), or class III (amiodarone, sotalol) antiarrhythmic agents
Cautions: Use cautiously in
- Renal dysfunction
- Hepatic insufficiency
- Dehydration
- Seizure disorder
- CNS disorder
- Known or suspected CNS disorder
- Severe cerebral arteriosclerosis
- Epilepsy
- Use with drug therapy lowering seizure threshold
- Diabetes mellitus
- kidney transplant
- Heart transplant
- Lung transplant
- Proarrhythmic condition
- Patients >60 yrs
Supplemental Patient Information
- Advise patients to rest at the first sign of tendinitis or tendon rupture, and to communicate their healthcare provider regarding changing to a non-quinolone antimicrobial drug
Pregnancy Category:C
Breastfeeding: Limited published data evaluating the safety of breastfeeding; however, it is preferable to use an alternative drug for which safety information is available. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 6 April 2011). Due to the potential for possible serious adverse reactions in nursing infants; manufacturer recommends discontinuation of nursing or discontinuation of drug (taking into account the importance of the drug to the mother).
Pricing data from www.DrugStore.com in U.S.A.
- Avelox 400 MG TABS [Bottle] (SCHERING)
30 mg = $562.01
90 mg = $1581.89
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
