moxifloxacin (Rx)

Brand and Other Names:Avelox, Moxifloxacin Systemic

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 400mg/250mL

tablet

  • 400mg

Acute Bacterial Sinusitis

400 mg PO/IV qDay for 5-10 days

Limitations-of-use: Reserve antimicrobials#fluoroquinolones for patients who do not have other available treatment options for acute sinusitis

Community-Acquired Pneumonia

400 mg PO/IV qDay for 7-14 days

Acute Exacerbation of Chronic Bronchitis

Indicated for acute exacerbations of chronic bronchitis caused by bacterial infections

400 mg PO/IV qDay for 5 days

Limitations-of-use: Reserve antimicrobials#fluoroquinolones for patients who do not have other available treatment options for acute bacterial exacerbation of chronic bronchitis

Skin & Skin Structure Infections

Uncomplicated: 400 mg PO/IV qDay for 7 days

Complicated: 400 mg PO/IV qDay for 7-21 days

Intra-abdominal Infections

Complicated: 400 mg PO/IV qDay for 5-14 days

Pneumonic & Septicemic Plague

Indicated in adults for the treatment of plague, including pneumonic and septicemic plague, caused by susceptible isolates of Yersinia pestis; it is also indicated for prophylaxis of plague in adults

400 mg PO/IV qDay x10-14 days

Begin administration as soon as possible after suspected or confirmed exposure to Yersinia pestis

Dosing Considerations

Initial IV administration may be changed to PO administration at same dosage to complete therapy, depending on patient's clinical status

Susceptible organisms

  • Aeromonas hydrophila, Bacillus anthracis, Bacteroides fragilis, Bacteroides thetaiotaomicron, Campylobacter jejuni, Citrobacter diversus, Citrobacter freundii, Clostridium perfringens, Escherichia coli, Enterobacter spp, Haemophilus influenzae, Hafnia alvei, Klebsiella pneumoniae, Legionella pneumophila, Morganella morganii, Moraxella catarrhalis, Mycobacterium pneumoniae, Mycobacterium tuberculosis, Neisseria gonorrhoeae, Peptostreptococcus spp, Proteus mirabilis, Proteus vulgaris, Providencia spp, Pseudomonas aeruginosa, Salmonella typhi, Shigella spp, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus anginosus, Streptococcus constellatus, Streptococcus pneumoniae, Vibrio cholerae, Yersinia pestis
  • First-line therapy: C jejuni; no unanimity on others (eg, L pneumophila, M morganii)

<18 years: Safety and efficacy not established

Next:

Interactions

Interaction Checker

and moxifloxacin

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            Contraindicated (8)

            • disopyramide

              disopyramide and moxifloxacin both increase QTc interval. Contraindicated.

            • ibutilide

              ibutilide and moxifloxacin both increase QTc interval. Contraindicated.

            • indapamide

              indapamide and moxifloxacin both increase QTc interval. Contraindicated.

            • pentamidine

              moxifloxacin and pentamidine both increase QTc interval. Contraindicated.

            • pimozide

              moxifloxacin and pimozide both increase QTc interval. Contraindicated.

            • procainamide

              moxifloxacin and procainamide both increase QTc interval. Contraindicated.

            • quinidine

              quinidine and moxifloxacin both increase QTc interval. Contraindicated.

            • sotalol

              moxifloxacin and sotalol both increase QTc interval. Contraindicated.

            Serious - Use Alternative (124)

            • adagrasib

              adagrasib, moxifloxacin. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.

            • alfuzosin

              alfuzosin and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • aluminum hydroxide

              aluminum hydroxide decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • aminolevulinic acid oral

              aminolevulinic acid oral, moxifloxacin. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

            • aminolevulinic acid topical

              moxifloxacin increases toxicity of aminolevulinic acid topical by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of photosensitizing drugs may enhance the phototoxic reaction to photodynamic therapy with aminolevulinic acid.

            • amiodarone

              amiodarone and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • amisulpride

              amisulpride and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

            • amitriptyline

              amitriptyline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • amoxapine

              amoxapine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • anagrelide

              anagrelide and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • apomorphine

              apomorphine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • aripiprazole

              aripiprazole and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • arsenic trioxide

              arsenic trioxide and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • artemether

              artemether and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • artemether/lumefantrine

              artemether/lumefantrine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • asenapine

              asenapine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • asenapine transdermal

              asenapine transdermal and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • BCG vaccine live

              moxifloxacin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

            • buprenorphine

              buprenorphine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine buccal

              buprenorphine buccal and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine subdermal implant

              buprenorphine subdermal implant and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine transdermal

              buprenorphine transdermal and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • buprenorphine, long-acting injection

              buprenorphine, long-acting injection and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • carbonyl iron

              carbonyl iron decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • ceritinib

              ceritinib and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • chlorpromazine

              chlorpromazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • cholera vaccine

              moxifloxacin, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

            • clarithromycin

              clarithromycin and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • clomipramine

              clomipramine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • clozapine

              clozapine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • degarelix

              degarelix and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • desflurane

              desflurane and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • desipramine

              desipramine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • didanosine

              didanosine decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration.

            • dofetilide

              dofetilide and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • donepezil

              donepezil and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • doxepin

              doxepin and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • dronedarone

              dronedarone and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • droperidol

              droperidol and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • efavirenz

              efavirenz and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • eliglustat

              eliglustat and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • encorafenib

              encorafenib and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug. Encorafenib is associated with dose-dependent QTc interval prolongation. Avoid with drugs known to prolong QT interval.

            • entrectinib

              moxifloxacin and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

            • epinephrine

              epinephrine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • epinephrine racemic

              epinephrine racemic and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • eribulin

              eribulin and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug. Potential for enhanced QTc-prolonging effects; if concurrent use is necessary then ECG monitoring is recommended.

            • erythromycin base

              erythromycin base and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin ethylsuccinate

              erythromycin ethylsuccinate and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin lactobionate

              erythromycin lactobionate and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • erythromycin stearate

              erythromycin stearate and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • ferric maltol

              ferric maltol decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • ferrous fumarate

              ferrous fumarate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • ferrous gluconate

              ferrous gluconate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • ferrous sulfate

              ferrous sulfate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • fexinidazole

              fexinidazole and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels and/or prolong QT interval.

            • fingolimod

              fingolimod and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • fluconazole

              fluconazole and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • fluphenazine

              fluphenazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • formoterol

              formoterol and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • gilteritinib

              gilteritinib and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • glasdegib

              moxifloxacin and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

            • granisetron

              granisetron and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • haloperidol

              haloperidol and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • hydroxychloroquine sulfate

              hydroxychloroquine sulfate and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • imipramine

              imipramine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • inotuzumab

              inotuzumab and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

            • iron dextran complex

              iron dextran complex decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • iron sucrose

              iron sucrose decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • isoflurane

              isoflurane and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • ivosidenib

              ivosidenib and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.

            • ketoconazole

              ketoconazole and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • lefamulin

              lefamulin and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • levoketoconazole

              levoketoconazole and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • lithium

              lithium and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • lofepramine

              lofepramine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • lumefantrine

              lumefantrine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • macimorelin

              macimorelin and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

            • maprotiline

              maprotiline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • methyl aminolevulinate

              moxifloxacin, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

            • microbiota oral

              moxifloxacin decreases effects of microbiota oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Microbiota oral contains bacterial spores. Antibacterial agents may decrease efficacy if coadministered. Complete antibiotic regimens 2-4 days before initiating microbiota oral. .

            • mirtazapine

              mirtazapine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • mobocertinib

              mobocertinib and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

            • nilotinib

              moxifloxacin and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

            • nortriptyline

              nortriptyline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • octreotide

              moxifloxacin and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

            • octreotide (Antidote)

              moxifloxacin and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

            • olanzapine

              olanzapine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • ondansetron

              moxifloxacin and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

            • oxaliplatin

              oxaliplatin and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • panobinostat

              moxifloxacin and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

            • perphenazine

              perphenazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • pitolisant

              moxifloxacin and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.

            • polysaccharide iron

              polysaccharide iron decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • primaquine

              primaquine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • prochlorperazine

              prochlorperazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • promazine

              promazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • promethazine

              promethazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • protriptyline

              protriptyline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • ribociclib

              ribociclib and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • rose hips

              rose hips decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

            • saquinavir

              saquinavir increases levels of moxifloxacin by QTc interval. Avoid or Use Alternate Drug. Potential for increased toxicity. Increased risk of QT prolongation and cardiac arrhythmias.

            • selinexor

              selinexor, moxifloxacin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

            • sertraline

              sertraline and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • sevoflurane

              sevoflurane and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • siponimod

              siponimod and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • sodium bicarbonate

              sodium bicarbonate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • sodium citrate/citric acid

              sodium citrate/citric acid decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.

            • strontium ranelate

              strontium ranelate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Suspend strontium ranelate during antibiotic therapy.

            • sunitinib

              sunitinib and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • tacrolimus

              tacrolimus and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • tetrabenazine

              tetrabenazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • thioridazine

              thioridazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • trazodone

              trazodone and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • tretinoin

              moxifloxacin, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

            • tretinoin topical

              moxifloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

            • trifluoperazine

              trifluoperazine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • trimipramine

              trimipramine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • typhoid vaccine live

              moxifloxacin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

            • umeclidinium bromide/vilanterol inhaled

              moxifloxacin increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

            • vandetanib

              moxifloxacin, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

            • vemurafenib

              vemurafenib and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.

            • vilanterol/fluticasone furoate inhaled

              moxifloxacin increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

            • vorinostat

              vorinostat and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

            • ziprasidone

              moxifloxacin and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

            Monitor Closely (154)

            • acarbose

              moxifloxacin increases effects of acarbose by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • albuterol

              albuterol and moxifloxacin both increase QTc interval. Use Caution/Monitor.

            • alfuzosin

              moxifloxacin and alfuzosin both increase QTc interval. Use Caution/Monitor.

            • amifampridine

              moxifloxacin increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.

            • arformoterol

              arformoterol and moxifloxacin both increase QTc interval. Use Caution/Monitor.

            • azithromycin

              azithromycin and moxifloxacin both increase QTc interval. Use Caution/Monitor.

            • bazedoxifene/conjugated estrogens

              moxifloxacin will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • bedaquiline

              moxifloxacin and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

            • betamethasone

              betamethasone and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • calcium acetate

              calcium acetate, moxifloxacin. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

            • calcium carbonate

              calcium carbonate, moxifloxacin. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

            • calcium chloride

              calcium chloride, moxifloxacin. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

            • calcium citrate

              calcium citrate, moxifloxacin. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

            • calcium gluconate

              calcium gluconate, moxifloxacin. Either decreases levels of the other by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

            • celecoxib

              moxifloxacin, celecoxib. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • chloroquine

              chloroquine increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor.

            • chlorpropamide

              moxifloxacin increases effects of chlorpropamide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • ciprofloxacin

              ciprofloxacin and moxifloxacin both increase QTc interval. Use Caution/Monitor. Ciprofloxacin elicits minimal effects on QT interval. Caution if used in combination with other drugs known to affect QT interval or in patients with other risk factors.

            • citalopram

              moxifloxacin and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

            • conjugated estrogens

              moxifloxacin will decrease the level or effect of conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • corticotropin

              corticotropin and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • cortisone

              cortisone and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • crizotinib

              crizotinib and moxifloxacin both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

            • dasatinib

              dasatinib and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • deutetrabenazine

              moxifloxacin and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

            • dexamethasone

              dexamethasone and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • dichlorphenamide

              dichlorphenamide and moxifloxacin both decrease serum potassium. Use Caution/Monitor.

            • diclofenac

              moxifloxacin, diclofenac. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • dienogest/estradiol valerate

              moxifloxacin will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.

            • diflunisal

              moxifloxacin, diflunisal. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • digoxin

              moxifloxacin will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

            • dolasetron

              dolasetron and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • escitalopram

              escitalopram and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

              moxifloxacin and escitalopram both increase QTc interval. Modify Therapy/Monitor Closely.

            • estradiol

              moxifloxacin will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • estrogens conjugated synthetic

              moxifloxacin will decrease the level or effect of estrogens conjugated synthetic by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • estropipate

              moxifloxacin will decrease the level or effect of estropipate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • ethinylestradiol

              moxifloxacin will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • ethotoin

              moxifloxacin decreases effects of ethotoin by unknown mechanism. Use Caution/Monitor. There are also case reports of quinolones increasing phenytoin levels.

            • etodolac

              moxifloxacin, etodolac. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • ezogabine

              ezogabine, moxifloxacin. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

            • fennel

              fennel decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • fenoprofen

              moxifloxacin, fenoprofen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • ferric citrate

              ferric citrate will decrease the level or effect of moxifloxacin by drug binding in GI tract. Use Caution/Monitor. Administer at least 2 hours before or after ferric citrate

            • flecainide

              flecainide and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • fludrocortisone

              fludrocortisone and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • fluoxetine

              fluoxetine and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • flurbiprofen

              moxifloxacin, flurbiprofen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • fluvoxamine

              fluvoxamine and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • foscarnet

              foscarnet and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • fosphenytoin

              moxifloxacin decreases effects of fosphenytoin by unknown mechanism. Use Caution/Monitor. There are also case reports of quinolones increasing phenytoin levels.

            • fostemsavir

              moxifloxacin and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

            • gadobenate

              gadobenate and moxifloxacin both increase QTc interval. Use Caution/Monitor.

            • gemtuzumab

              moxifloxacin and gemtuzumab both increase QTc interval. Use Caution/Monitor.

            • glimepiride

              moxifloxacin increases effects of glimepiride by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • glipizide

              moxifloxacin increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • glyburide

              moxifloxacin increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • goserelin

              goserelin increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

            • histrelin

              histrelin increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

            • hydrocortisone

              hydrocortisone and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • hydrocortisone rectal

              hydrocortisone rectal and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • hydroxyzine

              hydroxyzine increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

            • ibuprofen

              moxifloxacin, ibuprofen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • ibuprofen IV

              moxifloxacin, ibuprofen IV. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • iloperidone

              iloperidone and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • indacaterol, inhaled

              indacaterol, inhaled, moxifloxacin. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

            • indomethacin

              moxifloxacin, indomethacin. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • insulin aspart

              moxifloxacin increases effects of insulin aspart by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • insulin detemir

              moxifloxacin increases effects of insulin detemir by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • insulin glargine

              moxifloxacin increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • insulin glulisine

              moxifloxacin increases effects of insulin glulisine by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • insulin lispro

              moxifloxacin increases effects of insulin lispro by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • insulin NPH

              moxifloxacin increases effects of insulin NPH by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • insulin regular human

              moxifloxacin increases effects of insulin regular human by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • ketoprofen

              moxifloxacin, ketoprofen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • ketorolac

              moxifloxacin, ketorolac. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • ketorolac intranasal

              moxifloxacin, ketorolac intranasal. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • lanthanum carbonate

              lanthanum carbonate decreases levels of moxifloxacin by cation binding in GI tract. Use Caution/Monitor. Administer oral quinolone antibiotics at least 1 hr before or 4 hr after lanthanum. Interaction applies only to oral quinolones.

            • lapatinib

              lapatinib and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • lenvatinib

              moxifloxacin and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

            • leuprolide

              leuprolide increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

            • levofloxacin

              levofloxacin and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

              moxifloxacin will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.

            • lofexidine

              moxifloxacin and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended.

            • magnesium chloride

              magnesium chloride decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

            • magnesium citrate

              magnesium citrate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

            • magnesium hydroxide

              magnesium hydroxide decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

            • magnesium oxide

              magnesium oxide decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

            • magnesium sulfate

              magnesium sulfate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

            • magnesium supplement

              magnesium supplement will decrease the level or effect of moxifloxacin by Other (see comment). Modify Therapy/Monitor Closely. Formation of an insoluble complex reduces absorption of the drug through intestinal tract; administer magnesium 4hr before the quinolone or 8hr after the quinolone

            • meclofenamate

              moxifloxacin, meclofenamate. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • mefenamic acid

              moxifloxacin, mefenamic acid. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • meloxicam

              moxifloxacin, meloxicam. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • mestranol

              moxifloxacin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

            • metformin

              moxifloxacin increases effects of metformin by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • methadone

              methadone and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • methylprednisolone

              methylprednisolone and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • mifepristone

              mifepristone, moxifloxacin. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

            • miglitol

              moxifloxacin increases effects of miglitol by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • mometasone inhaled

              mometasone inhaled and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • nabumetone

              moxifloxacin, nabumetone. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • naproxen

              moxifloxacin, naproxen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • nateglinide

              moxifloxacin increases effects of nateglinide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • ofloxacin

              moxifloxacin and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • olodaterol inhaled

              moxifloxacin and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

            • osilodrostat

              osilodrostat and moxifloxacin both increase QTc interval. Use Caution/Monitor.

            • osimertinib

              osimertinib and moxifloxacin both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

            • oxaliplatin

              oxaliplatin will increase the level or effect of moxifloxacin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

            • oxaprozin

              moxifloxacin, oxaprozin. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • ozanimod

              ozanimod and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

            • paliperidone

              moxifloxacin and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.

            • paroxetine

              moxifloxacin and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.

              paroxetine and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • pasireotide

              moxifloxacin and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

            • pazopanib

              moxifloxacin and pazopanib both increase QTc interval. Use Caution/Monitor.

            • phenytoin

              moxifloxacin decreases effects of phenytoin by unknown mechanism. Use Caution/Monitor. There are also case reports of quinolones increasing phenytoin levels.

            • pioglitazone

              moxifloxacin increases effects of pioglitazone by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • piroxicam

              moxifloxacin, piroxicam. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • posaconazole

              moxifloxacin and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • prednisolone

              prednisolone and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • prednisone

              prednisone and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • quetiapine

              quetiapine, moxifloxacin. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

            • quinine

              moxifloxacin and quinine both increase QTc interval. Use Caution/Monitor.

            • ranolazine

              moxifloxacin and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

            • repaglinide

              moxifloxacin increases effects of repaglinide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • rilpivirine

              moxifloxacin increases toxicity of rilpivirine by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.

              rilpivirine increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.

            • risperidone

              moxifloxacin and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.

            • romidepsin

              moxifloxacin and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.

            • rosiglitazone

              moxifloxacin increases effects of rosiglitazone by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • saxagliptin

              moxifloxacin increases effects of saxagliptin by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • selpercatinib

              selpercatinib increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor.

            • sitagliptin

              moxifloxacin increases effects of sitagliptin by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • sodium picosulfate/magnesium oxide/anhydrous citric acid

              moxifloxacin decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

              sodium picosulfate/magnesium oxide/anhydrous citric acid decreases levels of moxifloxacin by cation binding in GI tract. Use Caution/Monitor. Take at least 2 hours before and not less than 6 hours after administration of sodium picosulfate, magnesium oxide and anhydrous citric acid to avoid magnesium chelation.

            • sodium sulfate/?magnesium sulfate/potassium chloride

              sodium sulfate/?magnesium sulfate/potassium chloride decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

            • sodium sulfate/potassium sulfate/magnesium sulfate

              sodium sulfate/potassium sulfate/magnesium sulfate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Administer fluoroquinolones at least 2 hr before and no less than 6 hr after each dose to avoid chelation with magnesium. .

            • sorafenib

              sorafenib and moxifloxacin both increase QTc interval. Use Caution/Monitor.

            • sucralfate

              sucralfate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • sulfamethoxazole

              sulfamethoxazole and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

            • sulindac

              moxifloxacin, sulindac. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • telavancin

              moxifloxacin and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.

            • tolazamide

              moxifloxacin increases effects of tolazamide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • tolbutamide

              moxifloxacin increases effects of tolbutamide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • tolmetin

              moxifloxacin, tolmetin. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.

            • triamcinolone acetonide injectable suspension

              triamcinolone acetonide injectable suspension and moxifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.

            • triclabendazole

              triclabendazole and moxifloxacin both increase QTc interval. Use Caution/Monitor.

            • trimagnesium citrate anhydrous

              trimagnesium citrate anhydrous decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Multivalent cation-containing products may reduce bioavailability of quinolones; administer quinolone at least 2 hr before or 6 hr after magnesium; use alternatives if available.

            • trimethoprim

              moxifloxacin and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.

            • triptorelin

              triptorelin increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

            • tropisetron

              moxifloxacin and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.

            • valbenazine

              valbenazine and moxifloxacin both increase QTc interval. Use Caution/Monitor.

            • venlafaxine

              moxifloxacin and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.

            • vildagliptin

              moxifloxacin increases effects of vildagliptin by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • voclosporin

              voclosporin, moxifloxacin. Either increases effects of the other by QTc interval. Use Caution/Monitor.

            • voriconazole

              moxifloxacin and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.

            • warfarin

              moxifloxacin increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.

            • zinc

              zinc will decrease the level or effect of moxifloxacin by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer oral moxifloxacin 4 hr before or 8 hr after administration of polyvalent cation containing products.

            Minor (24)

            • alprazolam

              moxifloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.

            • balsalazide

              moxifloxacin will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • biotin

              moxifloxacin will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • chlordiazepoxide

              moxifloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

            • clonazepam

              moxifloxacin increases levels of clonazepam by decreasing metabolism. Minor/Significance Unknown.

            • clorazepate

              moxifloxacin increases levels of clorazepate by decreasing metabolism. Minor/Significance Unknown.

            • estazolam

              moxifloxacin increases levels of estazolam by decreasing metabolism. Minor/Significance Unknown.

            • flurazepam

              moxifloxacin increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.

            • foscarnet

              moxifloxacin, foscarnet. Mechanism: unknown. Minor/Significance Unknown. Risk of tonic clonic seizure.

            • isotretinoin

              moxifloxacin, isotretinoin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.

            • itraconazole

              itraconazole and moxifloxacin both increase QTc interval. Minor/Significance Unknown.

            • loprazolam

              moxifloxacin increases levels of loprazolam by decreasing metabolism. Minor/Significance Unknown.

            • lorazepam

              moxifloxacin increases levels of lorazepam by decreasing metabolism. Minor/Significance Unknown.

            • lormetazepam

              moxifloxacin increases levels of lormetazepam by decreasing metabolism. Minor/Significance Unknown.

            • midazolam

              moxifloxacin increases levels of midazolam by decreasing metabolism. Minor/Significance Unknown.

            • oxazepam

              moxifloxacin increases levels of oxazepam by decreasing metabolism. Minor/Significance Unknown.

            • pantothenic acid

              moxifloxacin will decrease the level or effect of pantothenic acid by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • pyridoxine

              moxifloxacin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • pyridoxine (Antidote)

              moxifloxacin will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • quazepam

              moxifloxacin increases levels of quazepam by decreasing metabolism. Minor/Significance Unknown.

            • quercetin

              quercetin decreases effects of moxifloxacin by pharmacodynamic antagonism. Minor/Significance Unknown.

            • temazepam

              moxifloxacin increases levels of temazepam by decreasing metabolism. Minor/Significance Unknown.

            • thiamine

              moxifloxacin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

            • triazolam

              moxifloxacin increases levels of triazolam by decreasing metabolism. Minor/Significance Unknown.

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            Adverse Effects

            1-10%

            Nausea (7%)

            Diarrhea (6%)

            Dizziness (3%)

            Decreased amylase (2%)

            Decreased basophils, eosinophils, hemoglobin, prothrombin time, red blood cells, neutrophils (2%)

            Decreased serum glucose (2%)

            Increased serum chloride (2%)

            Increased serum ionized calcium (2%)

            Immune hypersensitivity reaction (0.1-2%)

            Prolonged QT interval (0.1-2%)

            <1%

            Acute renal failure

            Agranulocytosis

            Anaphylactoid reaction

            Aplastic anemia

            Extrinsic allergic alveolitis

            Hemolytic anemia

            Hepatic failure

            Hepatic necrosis

            Hepatitis

            Pancytopenia

            Seizure

            Serum sickness due to drug

            Stevens-Johnson syndrome

            Tendon rupture, tendinitis

            Thrombocytopenia

            Torsades de pointes

            Toxic epidermal necrolysis

            Postmarketing Reports

            Blood and lymphatic disorders: Agranulocytosis, pancytopenia

            Vascular disorders: Aortic aneurysm and dissection

            Cardiovascular disorders: Ventricular tachyarrhythmias (including in very rare cases cardiac arrest and torsade de pointes)

            Ear and labyrinth disorders: Hearing impairment, including deafness (reversible in most cases)

            Eye disorders: Vision loss (especially in the course of CNS reactions, transient in majority of cases)

            Hepatobiliary disorders: Hepatitis, hepatic failure, jaundice, acute hepatic necrosis

            Immune system disorders: Anaphylactic reactions including shock, angioedema (including laryngeal edema)

            Musculoskeletal/connective tissue disorders: Tendon rupture, arthralgia, myalgia

            Nervous system disorders: Exacerbation of myasthenia gravis symptoms, altered coordination, abnormal gait, muscle weakness, peripheral neuropathy, polyneuropathy

            Central nervous system effects: Hallucinations, anxiety, depression, insomnia, severe headaches, and confusion

            Psychiatric disorders: Psychotic reaction (very rarely culminating in self-injurious behavior, such as suicidal ideation/thoughts or suicide attempts)

            Renal and urinary disorders: Renal dysfunction, interstitial nephritis

            Respiratory disorders: Allergic pneumonitis

            Skin and tissue disorders: Photosensitivity/phototoxicity reaction, Stevens-Johnson syndrome, Toxic epidermal necrolysis

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            Warnings

            Black Box Warnings

            Serious adverse effects

            • Fluoroquinolones have been associated with disabling and potentially irreversible serious adverse reactions that have occurred together including: tendinitis and tendon rupture, peripheral neuropathy, and CNS effects
            • Discontinue the drug immediately and avoid use of systemic antimicrobials#fluoroquinolones in patients who experience any of these serious adverse reactions
            • May exacerbate muscle weakness in patients with myasthenia gravis; antimicrobials#fluoroquinolones should be avoided in patients with known history of myasthenia gravis
            • Because antimicrobials#fluoroquinolones have been associated with serious adverse reactions, reserve drug use in patients who have no alternative treatment options for the following indications: Acute bacterial sinusitis; acute bacterial exacerbation of chronic bronchitis

            Contraindications

            Hypersensitivity to moxifloxacin or any member of the quinolone class of antibacterials

            Cautions

            Fluoroquinolones been associated with disabling and potentially irreversible serious adverse reactions from different body systems that can occur together in the same patient; adverse reactions include tendinitis, tendon rupture, arthralgia, myalgia, peripheral neuropathy, and central nervous system effects (hallucinations, anxiety, depression, insomnia, severe headaches, and confusion); discontinue treatment immediately at the first signs or symptoms of any serious adverse reaction; avoid use in patients who have experienced any of these serious adverse reactions

            Fluoroquinolones have been associated with an increased risk of tendinitis and tendon rupture in all ages; adverse reaction most frequently involves the Achilles tendon, and has also been reported with the rotator cuff (the shoulder), the hand, the biceps, the thumb, and other tendons (see Black Box Warnings)

            In prolonged therapy, perform periodic evaluations of organ system function (eg, renal, hepatic, hematopoietic); superinfections may occur with prolonged or repeated antibiotic therapy

            Phototoxicity reactions may occur; avoid excessive sunlight

            Peripheral neuropathy: Sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons resulting in paresthesias, hypoesthesias, dysesthesias, and weakness reported; peripheral neuropathy may occur rapidly after initiating and may potentially become permanent

            Serious, sometimes fatal hypoglycemia reported including in patients without a history of hypoglycemia (common with gatifloxacin, which is no longer marketed); monitor glucose levels closely in patients with diabetes; if hypoglycemic reaction occurs, discontinue therapy and initiate appropriate therapy immediately

            Avoid use in presence of drugs or conditions that prolong QT interval, patients with known prolongation of the QT interval, patients with ventricular arrhythmias including torsade de pointes because QT prolongation may lead to an increased risk for these conditions, patients with ongoing proarrhythmic conditions, such as clinically significant bradycardia and acute myocardial ischemia or patients with hypokalemia or hypomagnesemia

            In immature dogs, oral administration of moxifloxacin caused lameness; related quinolone-class drugs also produce erosions of cartilage of weight-bearing joints and other signs of arthropathy in immature animals of various species

            Acute onset of retinal detachment increased 4.5-fold with oral antimicrobials#fluoroquinolones in a single case-controlled study - JAMA 2012;307(13):1414-1419; another study disputes these findings (relative risk, 1.29) - JAMA 2013;310(20):2184-2190

            Prescribing antibiotics in absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to patient and increases risk of development of drug-resistant bacteria

            Clostridium difficile-associated diarrhea (CDAD) has been reported; if CDAD suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued; appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated

            Serious anaphylactic reactions reported in patients receiving fluoroquinolone therapy; discontinue treatment at the first appearance of a skin rash or any other sign of hypersensitivity

            Other serious and sometimes fatal adverse reactions, some due to hypersensitivity, and some due to uncertain etiology, have been reported; reactions may be severe and generally occur following the administration of multiple doses; discontinue treatment immediately at the first appearance of a skin rash, jaundice, or any other sign of hypersensitivity and institute supportive measures

            CNS effects

            • Fluoroquinolones have been associated with an increased risk of CNS effects, including: convulsions, increased intracranial pressure (including pseudotumor cerebri), and toxic psychosis
            • May also cause CNS events including: nervousness, agitation, insomnia, anxiety, nightmares, paranoia, dizziness, confusion, tremors, hallucinations, depression, and psychotic reactions have progressed to suicidal ideations/thoughts and self-injurious behavior such as attempted or completed suicide; reactions may occur following the first dose; advise patients to inform their healthcare provider immediately if these reactions occur, discontinue treatment, and institute appropriate care
            • Fluoroquinolone are also known to trigger seizures or lower the seizure threshold; use with caution in epileptic patients and patients with known or suspected CNS disorders that may predispose to seizures or lower the seizure threshold (eg, severe cerebral arteriosclerosis, previous history of convulsion, reduced cerebral blood flow, altered brain structure, or stroke), or in the presence of other risk factors that may predispose to seizures or lower the seizure threshold (eg, certain drug therapy, renal dysfunction)

            FDA MedWatch Safety Alert

            • Issued 12-20-2018
            • Increase in rate of aortic aneurysm and dissection reported within two months following use of antimicrobials#fluoroquinolones, particularly in elderly patients
            • May occur with antimicrobials#fluoroquinolones for systemic use (IV or PO)
            • Patients who have an aortic aneurysm or are at risk for an aortic aneurysm (eg, patients with peripheral atherosclerotic vascular diseases, hypertension, certain genetic conditions [eg, Marfan syndrome, Ehlers-Danlos syndrome], elderly patients)
            • Prescribe antimicrobials#fluoroquinolones to these patients only when no other treatment options are available
            • Advise patients to seek immediate medical treatment for any symptoms associated with aortic aneurysm
            • Stop treatment immediately if a patient reports side effects suggestive of aortic aneurysm or dissection

            FDA MedWatch Safety Alert

            • Issued July 10, 2018
            • The FDA is strengthening the current warnings in the prescribing information for fluoroquinolone antibiotics to inform clinicians of significant decreases in blood glucose and certain mental health adverse effects
            • Hypoglycemia, sometimes resulting in coma, occurred more frequently in elderly patients or in diabetic patients taking oral hypoglycemic medicine or insulin
            • Alert patients regarding hypoglycemic symptoms and carefully monitor blood glucose levels; instruct patients how to treat themselves if symptoms of hypoglycemia occur
            • This safety alert affects only systemic formulations; early signs and symptoms of low blood glucose include confusion, dizziness, feeling shaky, unusual hunger, headaches, irritability, pounding heart or very fast pulse, pale skin, sweating, trembling, weakness, and/or unusual anxiety
            • Mental health side effects are to be added to or updated across all the antimicrobials#fluoroquinolones are disturbances in attention, disorientation, agitation, nervousness, memory impairment, and delirium
            • Inform patients of the potential risk of psychiatric adverse reactions that can occur after just 1 dose
            • Immediately discontinue treatment if CNS adverse effects occur, including psychiatric adverse reactions, or blood glucose disturbances occur and switch to a nonfluoroquinolone antibiotic if possible
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            Pregnancy & Lactation

            Pregnancy

            There are no available human data establishing a drug associated risk; however, when moxifloxacin was administered to rats during pregnancy and throughout lactation at doses associated with maternal toxicity, decreased neonatal body weights, increased incidence of skeletal variations (rib and vertebra combined), and increased fetal loss were observed

            Advise pregnant women of potential risk to fetus

            Lactation

            Not known if moxifloxacin is present in human milk

            Based on animal studies in rats, moxifloxacin may be excreted in human milk

            Developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on the breastfed child from drug or from the underlying maternal condition

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Inhibits A subunits of DNA gyrase, resulting in inhibition of bacterial DNA replication and transcription

            Absorption

            Well absorbed; absorption is not affected by high-fat meal or yogurt

            Bioavailability: 90%

            Distribution

            Protein bound: 50%

            Vd: 1.7-2.7 L/kg; tissue concentrations often exceed plasma concentrations in respiratory tissues, alveolar macrophages, and sinus tissues

            Metabolism

            Metabolized in liver via glucuronide (14%) and sulfate (38%) conjugation

            Elimination

            Half-life: PO, 12 hr; IV, 15 hr

            Excretion: Feces (25%), urine (20% as unchanged drug)

            Sulfate conjugate metabolites are excreted in feces, glucuronide conjugate metabolites in urine

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            Administration

            IV Preparation

            No further dilution of infusion solution is necessary

            IV Administration

            Infuse over 1 hour

            Do not admix with other drugs or infuse through same tubing simultaneously

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Vigamox ophthalmic (eye)
            -
            0.5 % drops
            moxifloxacin oral
            -
            400 mg tablet
            moxifloxacin oral
            -
            400 mg tablet
            moxifloxacin oral
            -
            400 mg tablet
            moxifloxacin oral
            -
            400 mg tablet
            moxifloxacin oral
            -
            400 mg tablet
            moxifloxacin oral
            -
            400 mg tablet
            moxifloxacin oral
            -
            400 mg tablet
            moxifloxacin oral
            -
            400 mg tablet
            moxifloxacin ophthalmic (eye)
            -
            0.5 % drops
            moxifloxacin ophthalmic (eye)
            -
            0.5 % drops
            moxifloxacin ophthalmic (eye)
            -
            0.5 % drops
            moxifloxacin ophthalmic (eye)
            -
            0.5 % drops
            moxifloxacin ophthalmic (eye)
            -
            0.5 % drops
            moxifloxacin ophthalmic (eye)
            -
            0.5 % drops
            moxifloxacin ophthalmic (eye)
            -
            0.5 % drops

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Select a drug:
            Patient Education
            moxifloxacin oral

            MOXIFLOXACIN - ORAL

            (mox-ih-FLOX-uh-sin)

            COMMON BRAND NAME(S): Avelox

            WARNING: Quinolone antibiotics (including moxifloxacin) may cause serious and possibly permanent tendon damage (such as tendonitis, tendon rupture), nerve problems in the arms and legs (peripheral neuropathy), and nervous system problems. Get medical help right away if you have any of the following symptoms: pain/numbness/burning/tingling/weakness in your arms/hands/legs/feet, changes in how you sense touch/pain/temperature/vibration/body position, severe/lasting headache, vision changes, shaking (tremors), seizures, mental/mood changes (such as agitation, anxiety, confusion, hallucinations, depression, rare thoughts of suicide).Tendon damage may occur during or after treatment with this medication. Stop exercising, rest, and get medical help right away if you develop joint/muscle/tendon pain or swelling. Your risk for tendon problems is greater if you are over 60 years of age, if you are taking corticosteroids (such as prednisone), or if you have a kidney, heart, or lung transplant.This medication may make a certain muscle condition (myasthenia gravis) worse. Tell your doctor right away if you have new or worsening muscle weakness (such as drooping eyelids, unsteady walk) or trouble breathing.Discuss the risks and benefits with your doctor before using this medication.

            USES: Moxifloxacin is used to treat a variety of bacterial infections. This medication belongs to a class of drugs called quinolone antibiotics. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for virus infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.

            HOW TO USE: Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using moxifloxacin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually once daily. The dosage and length of treatment are based on your medical condition and response to treatment. Drink plenty of fluids while taking this drug unless your doctor tells you otherwise.Take this medication at least 4 hours before or 8 hours after taking other products that may bind to it, decreasing its effectiveness. Ask your pharmacist about the other products you take. Some examples include: quinapril, sucralfate, vitamins/minerals (including iron and zinc supplements), and products containing magnesium, aluminum, or calcium (such as antacids, didanosine solution, calcium supplements).For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.

            SIDE EFFECTS: See also Warning section.Nausea, diarrhea, dizziness, lightheadedness, headache, weakness, or trouble sleeping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: unusual bruising/bleeding, signs of a new infection (such as sore throat that doesn't go away, fever), signs of kidney problems (such as change in the amount of urine), signs of liver problems (such as nausea/vomiting that doesn't stop, unusual tiredness, stomach/abdominal pain, yellowing eyes/skin, dark urine).Get medical help right away if you have any very serious side effects, including: severe dizziness, fainting, fast/irregular heartbeat, signs of a tear/break in the main blood vessel called the aorta (such as sudden/severe pain in the stomach/chest/back, shortness of breath).This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: See also Warning section.Before taking moxifloxacin, tell your doctor or pharmacist if you are allergic to it; or to other quinolone antibiotics (such as ciprofloxacin, levofloxacin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, heart problems (such as recent heart attack), joint/tendon problems (such as tendonitis, bursitis), liver disease, mental/mood disorders (such as depression), myasthenia gravis, nerve problems (such as peripheral neuropathy), seizure disorder, conditions that increase your risk of seizures (such as brain/head injury, brain tumors, cerebral atherosclerosis), blood vessel problems (such as aneurysm or blockage of the aorta or other blood vessels, hardening of the arteries), high blood pressure, certain genetic conditions (Marfan syndrome, Ehlers-Danlos syndrome).Moxifloxacin may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using moxifloxacin, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using moxifloxacin safely.This medication may rarely cause serious changes in blood sugar, especially if you have diabetes. Check your blood sugar regularly as directed and share the results with your doctor. Watch for symptoms of high blood sugar, such as increased thirst/urination. Also watch for symptoms of low blood sugar such as sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or by drinking fruit juice or non-diet soda. Tell your doctor right away about the reaction and the use of this product. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Your doctor may need to switch you to another antibiotic or adjust your diabetes medications if any reaction occurs.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Moxifloxacin may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using moxifloxacin before having any immunizations/vaccinations.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Children may be more sensitive to the side effects of this drug, especially joint/tendon problems.Older adults may be at greater risk for tendon problems (especially if they are also taking corticosteroids such as prednisone or hydrocortisone), QT prolongation, and a sudden tear/break in the main blood vessel (aorta).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: See also Warning, How to Use, and Precautions sections.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: "blood thinners" (such as acenocoumarol, warfarin), strontium.Many drugs besides moxifloxacin may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide, procainamide, quinidine, sotalol, ziprasidone, among others.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

            NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.Lab and/or medical tests (such as liver function, complete blood count, blood glucose) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

            MISSED DOSE: If you miss a dose, take it as soon as you remember if it is 8 hours or more until your next dose. If it is less than 8 hours until the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.