Names and pronunciation
(mocks-ah-flox′a-sin) Avelox
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Individual generic drug information
Extracted information for moxifloxacin only.
(mocks-ah-flox′a-sin) Avelox
Source page 917
Func. class.: Antiinfective
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Chem. class.: Fluoroquinolone
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ACTION: Interferes with conversion of intermediate DNA fragments into high- molecular-weight DNA in bacteria; DNA gyrase inhibitor
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USES: Acute bacterial sinusitis: Strepto- coccus pneumoniae, Haemophilus influ- enzae, Moraxella catarrhalis; acute bacte- rial exacerbation of chronic bronchitis: S. M pneumoniae, H. influenzae, Haemophilus parainfluenzae, Klebsiella pneumo niae, Staphylococcus aureus, M. catarrh- alis; community-acquired pneumonia: S. pneumoniae, H. influenzae, Myco- plasma pneumoniae, Chlamydia pneu- moniae, M. catarrhalis; uncomplicated skin/skin-structure infections: S. aureus, Streptococcus pyogenes; complicated intraabdominal infections including polymi- crobial infections: E. coli, Bacterioides fra- gilis, S. anginosus, S. constellatus, Entero- coccus faecalis, Proteus mirabilis, Clostridium perfringens, Bacteroides the- taiotaomicron, Peptostreptococcus sp; complicated skin, skin-structure infections caused by methicillin-susceptible bacteria: S. aureus, E. coli, K. pneumoniae, Entero- bacter cloacae; prophylaxis and treatment of plague caused by Yersinia pestis, includ- ing pneumonic and septicemic plague
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Unlabeled uses: Anthrax treatment/ prophylaxis, gastroenteritis, MAC, non- gonococcal urethritis, shigellosis, surgi- cal infection prophylaxis, TB
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Extracted information for moxifloxacin only.
CONTRAINDICATIONS: Hyper- sensitivity to quinolones Precautions: Pregnancy, breastfeeding, children, hepatic/cardiac/renal/GI dis- ease, epilepsy, uncorrected hypokalemia, prolonged QT interval; patients receiving class IA, III antidysrhythmics; seizure dis- order, CDAD, diabetes mellitus
Source pages 917, 918
Black Box Warning: Tendon pain, rup- ture; tendinitis, myasthenia gravis, neu- rotoxicity, peripheral neuropathy, psychi- atric events Black Box Warning: Increase: tendon rupture—corticosteroids Increase: anticoagulant level—warfarin; monitor PT/INR Decrease: moxifloxacin absorption— magnesium antacids, aluminum hydrox- ide, zinc, iron, sucralfate, calcium, enteral feeding, didanosine Drug/Lab Test Increase: glucose, lipids, triglycerides, uric acid, LDH ALT, ionized calcium, chloride, globulin, albumin, PT, INR, WBC Decrease: potassium, glucose, amylase, RBC, eosinophils, Hb, Hct Black Box Warning: Tendon pain, rup- ture, tendinitis; if tendon becomes in- flamed, product should be discontinued; more common in Achilles tendon • Cardiac status: prolonged QT or use of products that increase QT prolongation • CDAD: assess for diarrhea, abdominal pain, fever, fatigue, anorexia; possible ane- mia, elevated WBC, low serum albumin; stop product; usually either vancomycin or IV metroNIDAZOLE given • Increased fluids to 3 L/day to avoid crystallization in kidneys Black Box Warning: Myasthenia gravis: assess for increased weakness when using this product; avoid using in this condition Black Box Warning: Peripheral neurop- athy: assess for pain, numbness, tingling in extremities; report • Pregnancy/breastfeeding: risks to fe- tus are unknown; adverse events ob- served in some animal studies; discuss risks, benefits of treatment Black Box Warning: To notify prescriber of tendon pain, inflammation, or burning, tingling, weakness; stop drug • Not to take any products containing magnesium or calcium (such as antac- ids), iron, or aluminum with this product or 4 hr before or 8 hr after • That photosensitivity may occur; to avoid sunlight or use sunscreen to pre- vent burns • To use frequent rinsing of mouth, sug- arless candy or gum for dry mouth • To take as prescribed; not to double or M miss doses; to take without regard to meals • To report immediately rash, diarrhea, rapid heartbeat • If dizziness occurs, to ambulate, per- form activities with assistance • To complete full course of product therapy • To contact prescriber if abnormal heart rhythm or seizures occur
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SIDE EFFECTS CNS: Headache, dizziness, fatigue, insomnia, depression, restlessness, sei- zures, confusion, increased intracranial pressure, peripheral neuropathy, pseu- dotumor cerebri, fever CV: Prolonged QT interval, dysrhythmias, torsades de pointes, tachycardia EENT: Blurred vision, tinnitus, taste changes GI: Nausea, diarrhea, increased ALT, AST, flatulence, heartburn, vomiting, oral candidiasis, dysphagia, CDAD, abdominal pain, dyspepsia, constipation, gastroenteritis, xerostomia GU: Renal failure INTEG: Rash, pruritus, urticaria, photo- sensitivity, flushing, fever, chills, injec- tion-site reactions MISC: Candidiasis vaginitis MS: Tremor, arthralgia, tendinitis, ten- don rupture, myalgia SYST: Anaphylaxis, Stevens-Johnson syndrome, angioedema, toxic epidermal necrolysis
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INTERACTIONS Increase: QT prolongation—drugs that increase QT interval; avoid using concurrently Increase: moxifloxacin serum levels—probenecid Increase: warfarin, cycloSPORINE effect Increase: seizure risk—NSAIDs; moni- tor, adjust or use different product
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Extracted information for moxifloxacin only.
DOSAGE AND ROUTES Acute bacterial sinusitis • Adult: PO/IV 400 mg q24hr × 10 days Acute bacterial exacerbation of chronic bronchitis • Adult: PO/IV 400 mg q24hr × 5 days Community-acquired pneumonia • Adult: PO/IV 400 mg q24hr × 7-14 days Uncomplicated skin/skin-structure infections • Adult: PO/IV 400 mg q24hr × 7 days Complicated intraabdominal infections • Adult: IV 400 mg/day × 7-21 days Complicated skin, skin-structure infections • Adult: PO/IV 400 mg/day × 7-21 days Plague • Adult: PO/IV 400 mg q24hr × 10-14 days
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Available forms: Tabs 400 mg; inj premix 400 mg/250 mL
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Administer: PO route • 4 hr before or 8 hr after antacids, zinc, iron, calcium, sucralfate, multivitamins • Without regard to food • Store at room temperature; do not re- frigerate, do not use if particulate is present IV route • Do not use if particulate matter is present • Give PO 4 hr before or 8 hr after ant- acids, sucrasulfate, multivitamins • Do not give SUBCUT, IM • Available as premixed sol; may be diluted at ratios from 1:10 to 10:1; do not refrigerate; give by direct infusion or through Y-type infusion set; do not add other medications to sol or infu- sion through same IV line at same time • Flush line with compatible sol before and after use • Do not admix Solution compatibilities: 0.9% NaCl, D5, D10, LR, sterile water for inj
Source page 918
Extracted information for moxifloxacin only.
Assess: • CNS symptoms: headache, dizziness, fatigue, insomnia, depression, seizures • Renal, hepatic studies: BUN, creati- nine, AST, ALT, electrolytes • I&O ratio, urine pH <5.5 is ideal • Allergic reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylaxis: fever, flushing, rash, urti- caria, pruritus, sore throat, fatigue, ulcers, other lesions; keep EPINEPHrine, emer- gency equipment nearby for anaphylaxis
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Evaluate: • Therapeutic response: decreased pain, C&S; absence of infection
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CLINICAL CONSIDERATIONS
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Patient and caregiver information:
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Extracted information for moxifloxacin only.
PHARMACOKINETICS Excreted in urine as active product, metab- olites; parent product excreted in urine (20%), feces (25%); half-life PO 12-16 hr, IV 8-15 hr, peak 1 hr (PO), 1-3 hr (IV)
Source page 918
Filter the extracted dose blocks for this individual drug.
Acute bacterial sinusitis
• Adult: PO/IV 400 mg q24hr × 10 days Acute bacterial exacerbation of chronic bronchitis
Candidate age grouping · source page 918
Acute bacterial sinusitis
• Adult: PO/IV 400 mg q24hr × 5 days Community-acquired pneumonia
Candidate age grouping · source page 918
Acute bacterial sinusitis
• Adult: PO/IV 400 mg q24hr × 7-14 days Uncomplicated skin/skin-structure infections
Candidate age grouping · source page 918
Acute bacterial sinusitis
• Adult: PO/IV 400 mg q24hr × 7 days Complicated intraabdominal infections
Candidate age grouping · source page 918
Acute bacterial sinusitis
• Adult: IV 400 mg/day × 7-21 days Complicated skin, skin-structure infections
Candidate age grouping · source page 918
Acute bacterial sinusitis
• Adult: PO/IV 400 mg/day × 7-21 days Plague
Candidate age grouping · source page 918
Acute bacterial sinusitis
• Adult: PO/IV 400 mg q24hr × 10-14 days
Candidate age grouping · source page 918