Generic Name

Ofloxacin

Precaution

Epilepsy or other predisposition to seizures; known or suspected CNS disorders; renal, hepatic impairment; myasthaenia gravis; superinfection; children <18 yr; exposure to strong sunlight and UV light; ensure adequate hydration; elderly. Lactation: excreted in breast milk, discontinue drug or do not nurse

Indication

Leprosy, chronic bronchitis, Community-acquired pneumonia, Uncomplicated skin infections, anthrax, Legionnaire's disease, Nongonococcal cervicitis, Urethritis, Uncomplicated cystitis, Complicated UTI, Traveller's diarrhea, bacterial prostatis, Typhoid fever, Skin and soft tissue infections, Uncomplicated gonorrhea, Pelvic inflammatory disease, Lower respiratory tract infections, Septicaemia

Contra Indication

Hypersensitivity to quinolones; pregnancy and lactation; prolongation of the QT interval; uncorrected hypokalaemia.

Dose

N/A

Side Effect

1-10% Nausea (3-10%),Headache (1-9%),Insomnia (3-7%),Dizziness (1-5%),Vaginitis (1-5%),Diarrhea (1-4%),Vomiting (1-4%),Appetite decreased (1-3%),Abdominal cramps (1-3%),Abnormal taste (1-3%),Chest pain (1-3%),External genital pruritis in women (1-3%),Fatigue (1-3%),Flatulence (1-3%),GI distress (1-3%),Nervousness (1-3%),Pharyngitis (1-3%),Pyrexia (1-3%),Rash/pruritis (1-3%),Sleep disorders (1-3%),Visual disturbances (1-3%),Xerostomia (1-3%) <1% Prolonged QT interval,Torsades de pointes,Syncope,Vasculitis,Edema,HTN,Palpitations,Vasodilation,Stevens-Johnson syndrome,Toxic epidermal necrolysis,Agranulocytosis,Aplastic anemia,Pancytopenia,Thrombocytopenia,Thrombocytopenic purpura,Acute hepatitis,Hepatic failure,Hepatic necrosiImmune hypersensitivity reaction,Rupture of tendon, Tendinitis,Peripheral neuropathy,Seizure,Acute renal failure,Interstitial nephritis,Renal impairment,Tourette's syndrome,Decrease hearing acuity,Tinnitus Potentially Fatal: Anaphylaxis; rarely seizures.

Pregnancy Category

Mode of Action

Ofloxacin is a fluoroquinolone which inhibits bacterial topoisomerase IV and DNA gyrase enzymes required for DNA replication, transcription, repair and recombination. It has activity against a wide range of gram-negative and gram-positive microorganisms.

Interaction

Concomitant use of class IA (e.g. quinidine, procainamide) or class III (e.g. amiodarone, sotalol) antiarrhythmic agents may increase risk of QT interval prolongation. Decreased serum and urine concentrations w/ antacids containing Mg, Al or Ca. Additive antibacterial activity w/ aminoglycosides (e.g. amikacin, tobramycin). Corticosteroids may increase risk of severe tendon disorders. Increased risk of CNS stimulation (e.g. seizures) w/ NSAIDs. Higher and prolonged serum theophylline concentrations and increased risk of theophylline-related adverse effects.

Pregnancy Category Note

N/A

Adult Dose

Oral Bronchitis Exacerbation, Community Acquired Pneumonia, Skin & Skin Structure Infections Adult: 400 mg bid for 10 days. Uncomplicated gonorrhoea Adult: 400 mg as a single dose. Nongonococcal Cervicitis/Urethritis Adult: 400 mg daily in single or divided doses for 7 days. Uncomplicated Cystitis Adult: 200 mg bid for 3-7 days. Complicated UTIs Adult: 200 mg bid for 10 days. Pelvic inflammatory disease Adult: 400 mg bid for 10-14 days. Prostatitis Adult: Acute or chronic: 200 mg bid for 28 days. Intravenous Complicated urinary tract infections Adult: 200 mg daily by infusion over at least 30 min. Max: 400 mg bid infused over at least 1 hr. Lower respiratory tract infections; Septicaemia Adult: 200 mg bid by infusion over at least 30 min. Max: 400 mg bid infused over at least 1 hr. Skin and soft tissue infections Adult: 400 mg bid infused over at least 1 hr. Hepatic impairment: Severe: Reduce dose. Max: 400 mg daily.

Child Dose

Not indicated

Renal Dose

Renal impairment: CrCl (ml/min) Dosage Recommendation 20-50 Reduce dose by half 24 hrly following usual initial dose. <20 and patients on haemodialysis or peritoneal dialysis 100 mg 24 hrly following usual initial dose..

Administration

May be taken with or without food. Avoid antacids or supplements containing Fe or Znor or dairy products w/in 2 hr before or after ofloxacin. Ensure adequate hydration.