Dosing & Uses
Dosage Forms & Strengths
tablets
- 320mg
Acute Exacerbations of Chronic Bronchitis
320 mg PO qDay x5 days
Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for acute bacterial exacerbation of chronic bronchitis
Pneumonia (community-acquired)
(Multidrug resistant S. pneumoniae; K. pneumoniae; M. catarrhalis): 320 mg PO qDay x7 days
(S. pneumoniae; M. pneumoniae; H. influenzae; C. pneumoniae): 320 mg PO qDay x 5days
Dosage Modifications
Renal impairment
- CrCl <40 mL/min: Decrease dose by 50%
Other Indications & Uses
Mild-to-moderate community-acquired pneumonia caused by Streptococcus pneumoniae (including multi-drug resistant), H. influenzae, H. parainfluenzae, K. pneumoniae, Chlamydia pneumoniae, Moraxella catarrhalis, Mycoplasma pneumoniae
Possibly effective against S. aureus (MSSA), S. pyogenes, Acinetobacter lwoffi, Klebsiella oxytoca, Legionella pneumophila, Proteus vulgaris
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (3)
- dronedarone
gemifloxacin and dronedarone both increase QTc interval. Contraindicated.
- quinidine
gemifloxacin and quinidine both increase QTc interval. Contraindicated.
- thioridazine
gemifloxacin and thioridazine both increase QTc interval. Contraindicated.
Serious - Use Alternative (93)
- adagrasib
adagrasib, gemifloxacin. 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.
- aluminum hydroxide
aluminum hydroxide decreases levels of gemifloxacin 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, gemifloxacin. 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
gemifloxacin 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
gemifloxacin and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.
- amisulpride
gemifloxacin and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- anagrelide
gemifloxacin and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.
- arsenic trioxide
gemifloxacin and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
artemether and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- artemether/lumefantrine
gemifloxacin and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine
gemifloxacin and asenapine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- BCG vaccine live
gemifloxacin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
- buprenorphine
gemifloxacin and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- carbonyl iron
carbonyl iron decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- ceritinib
ceritinib and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
gemifloxacin and ceritinib both increase QTc interval. Avoid or Use Alternate Drug. - chlorpromazine
gemifloxacin and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.
- cholera vaccine
gemifloxacin, 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 gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- desflurane
desflurane and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- didanosine
didanosine decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 4-8 hours.
- disopyramide
gemifloxacin and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.
- dofetilide
dofetilide increases toxicity of gemifloxacin by QTc interval. Avoid or Use Alternate Drug.
- droperidol
gemifloxacin and droperidol both increase QTc interval. Avoid or Use Alternate Drug.
- encorafenib
encorafenib and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
gemifloxacin and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- eribulin
gemifloxacin and eribulin both increase QTc interval. Avoid or Use Alternate Drug.
eribulin and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug. - erythromycin base
gemifloxacin and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
gemifloxacin and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin lactobionate
gemifloxacin and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin stearate
gemifloxacin and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.
- ferric maltol
ferric maltol decreases levels of gemifloxacin 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 gemifloxacin 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 gemifloxacin 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 gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole and gemifloxacin 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.
- flecainide
gemifloxacin and flecainide both increase QTc interval. Avoid or Use Alternate Drug.
- foscarnet
gemifloxacin and foscarnet both increase QTc interval. Avoid or Use Alternate Drug.
- glasdegib
gemifloxacin and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.
- hydroxychloroquine sulfate
hydroxychloroquine sulfate and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- ibutilide
gemifloxacin and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.
- iloperidone
gemifloxacin and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.
- inotuzumab
inotuzumab and gemifloxacin 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 gemifloxacin 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 gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- isoflurane
gemifloxacin and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- ivosidenib
ivosidenib and gemifloxacin 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.
- lefamulin
lefamulin and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- lofexidine
gemifloxacin and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.
- lopinavir
gemifloxacin and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.
- macimorelin
macimorelin and gemifloxacin 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.
- methadone
gemifloxacin and methadone both increase QTc interval. Avoid or Use Alternate Drug.
- methyl aminolevulinate
gemifloxacin, 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.
- midostaurin
gemifloxacin and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
- mobocertinib
mobocertinib and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.
- nilotinib
gemifloxacin and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
- ondansetron
gemifloxacin 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
gemifloxacin and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- panobinostat
gemifloxacin 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.
- pazopanib
gemifloxacin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.
- pentamidine
gemifloxacin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.
- pimavanserin
gemifloxacin and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.
- pimozide
gemifloxacin and pimozide both increase QTc interval. Contraindicated.
- pitolisant
gemifloxacin and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- polysaccharide iron
polysaccharide iron decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- ponesimod
gemifloxacin and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.
- procainamide
gemifloxacin and procainamide both increase QTc interval. Avoid or Use Alternate Drug.
- propafenone
gemifloxacin and propafenone both increase QTc interval. Avoid or Use Alternate Drug.
- ribociclib
ribociclib increases toxicity of gemifloxacin by QTc interval. Avoid or Use Alternate Drug.
- rose hips
rose hips decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- saquinavir
saquinavir increases levels of gemifloxacin by QTc interval. Avoid or Use Alternate Drug. Potential for increased toxicity. Increased risk of QT prolongation and cardiac arrhythmias.
saquinavir increases levels of gemifloxacin by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potential for increased toxicity. Increased risk of QT prolongation and cardiac arrhythmias. - selinexor
selinexor, gemifloxacin. 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.
- sevoflurane
gemifloxacin and sevoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
gemifloxacin and siponimod both increase QTc interval. Avoid or Use Alternate Drug.
- sodium bicarbonate
sodium bicarbonate decreases levels of gemifloxacin 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 gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- sotalol
gemifloxacin and sotalol both increase QTc interval. Avoid or Use Alternate Drug.
- strontium ranelate
strontium ranelate decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Suspend strontium ranelate during antibiotic therapy.
- tetrabenazine
tetrabenazine and gemifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- toremifene
gemifloxacin and toremifene both increase QTc interval. Avoid or Use Alternate Drug.
- trazodone
gemifloxacin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
- tretinoin
gemifloxacin, tretinoin. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.
- tretinoin topical
gemifloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.
- typhoid vaccine live
gemifloxacin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
- umeclidinium bromide/vilanterol inhaled
gemifloxacin 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
gemifloxacin, 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 gemifloxacin 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
gemifloxacin 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.
- ziprasidone
gemifloxacin and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.
Monitor Closely (186)
- acarbose
gemifloxacin 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 gemifloxacin both increase QTc interval. Use Caution/Monitor.
- alfuzosin
gemifloxacin and alfuzosin both increase QTc interval. Use Caution/Monitor.
alfuzosin and gemifloxacin both increase QTc interval. Use Caution/Monitor. - amifampridine
gemifloxacin 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.
- amitriptyline
gemifloxacin and amitriptyline both increase QTc interval. Use Caution/Monitor.
- apomorphine
apomorphine and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- arformoterol
arformoterol and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- aripiprazole
aripiprazole and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- atomoxetine
atomoxetine and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- azithromycin
azithromycin increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor.
- bazedoxifene/conjugated estrogens
gemifloxacin 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
gemifloxacin and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely
- betamethasone
betamethasone and gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- calcium acetate
calcium acetate, gemifloxacin. 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, gemifloxacin. 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, gemifloxacin. 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, gemifloxacin. 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, gemifloxacin. 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
gemifloxacin, 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 gemifloxacin by QTc interval. Use Caution/Monitor.
- chlorpropamide
gemifloxacin 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.
- citalopram
gemifloxacin and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- clofazimine
gemifloxacin and clofazimine both increase QTc interval. Use Caution/Monitor.
- clomipramine
gemifloxacin and clomipramine both increase QTc interval. Use Caution/Monitor.
- clozapine
clozapine and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- conjugated estrogens
gemifloxacin 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 gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- cortisone
cortisone and gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- crizotinib
crizotinib and gemifloxacin both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- dasatinib
dasatinib and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- degarelix
degarelix and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- desipramine
gemifloxacin and desipramine both increase QTc interval. Use Caution/Monitor.
- deutetrabenazine
deutetrabenazine and gemifloxacin 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 gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- dichlorphenamide
dichlorphenamide and gemifloxacin both decrease serum potassium. Use Caution/Monitor.
- diclofenac
gemifloxacin, diclofenac. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- dienogest/estradiol valerate
gemifloxacin 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
gemifloxacin, diflunisal. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- digoxin
gemifloxacin 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 gemifloxacin both increase QTc interval. Use Caution/Monitor.
- donepezil
donepezil and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- doxepin
doxepin and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- efavirenz
efavirenz and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- eliglustat
gemifloxacin and eliglustat both increase QTc interval. Use Caution/Monitor.
- escitalopram
escitalopram increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor.
- estradiol
gemifloxacin 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
gemifloxacin 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
gemifloxacin 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
gemifloxacin 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
gemifloxacin decreases effects of ethotoin by unknown mechanism. Use Caution/Monitor. There are also case reports of quinolones increasing phenytoin levels.
- etodolac
gemifloxacin, etodolac. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- ezogabine
ezogabine, gemifloxacin. 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 gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- fenoprofen
gemifloxacin, 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 gemifloxacin by drug binding in GI tract. Use Caution/Monitor. Administer at least 2 hours before or after ferric citrate
- fingolimod
fingolimod and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- fluconazole
gemifloxacin and fluconazole both increase QTc interval. Use Caution/Monitor.
- fludrocortisone
fludrocortisone and gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- fluoxetine
gemifloxacin and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.
- fluphenazine
gemifloxacin and fluphenazine both increase QTc interval. Use Caution/Monitor.
- flurbiprofen
gemifloxacin, flurbiprofen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- fluvoxamine
gemifloxacin and fluvoxamine both increase QTc interval. Use Caution/Monitor.
- formoterol
gemifloxacin and formoterol both increase QTc interval. Use Caution/Monitor.
- fosphenytoin
gemifloxacin decreases effects of fosphenytoin by unknown mechanism. Use Caution/Monitor. There are also case reports of quinolones increasing phenytoin levels.
- fostemsavir
gemifloxacin and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- gadobenate
gadobenate and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- gemtuzumab
gemifloxacin and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- gilteritinib
gemifloxacin and gilteritinib both increase QTc interval. Use Caution/Monitor.
- glimepiride
gemifloxacin 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
gemifloxacin 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
gemifloxacin 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 gemifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- granisetron
gemifloxacin and granisetron both increase QTc interval. Use Caution/Monitor.
- haloperidol
haloperidol and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- histrelin
histrelin increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- hydrocortisone
hydrocortisone and gemifloxacin 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 gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- hydroxyzine
gemifloxacin and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- ibuprofen
gemifloxacin, ibuprofen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- ibuprofen IV
gemifloxacin, ibuprofen IV. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- imipramine
gemifloxacin and imipramine both increase QTc interval. Use Caution/Monitor.
- indacaterol, inhaled
indacaterol, inhaled, gemifloxacin. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.
- indomethacin
gemifloxacin, indomethacin. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- insulin aspart
gemifloxacin 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
gemifloxacin 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
gemifloxacin 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
gemifloxacin 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
gemifloxacin 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
gemifloxacin 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
gemifloxacin 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.
- itraconazole
gemifloxacin and itraconazole both increase QTc interval. Use Caution/Monitor.
- ketoprofen
gemifloxacin, ketoprofen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- ketorolac
gemifloxacin, ketorolac. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- ketorolac intranasal
gemifloxacin, ketorolac intranasal. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- lapatinib
gemifloxacin and lapatinib both increase QTc interval. Use Caution/Monitor.
- lenvatinib
gemifloxacin 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 gemifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- levalbuterol
gemifloxacin and levalbuterol both increase QTc interval. Use Caution/Monitor.
- levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
gemifloxacin 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.
- lithium
gemifloxacin and lithium both increase QTc interval. Use Caution/Monitor.
- loperamide
gemifloxacin and loperamide both increase QTc interval. Use Caution/Monitor.
- magnesium chloride
magnesium chloride decreases levels of gemifloxacin 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 gemifloxacin 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 gemifloxacin 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 gemifloxacin 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 gemifloxacin 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 gemifloxacin by Other (see comment). Modify Therapy/Monitor Closely. Formation of an insoluble complex reduces absorption of the drug through intestinal tract; administer magnesium 2hr before the quinolone or 3hr after the quinolone
- maprotiline
gemifloxacin and maprotiline both increase QTc interval. Use Caution/Monitor.
- meclofenamate
gemifloxacin, meclofenamate. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- mefenamic acid
gemifloxacin, mefenamic acid. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- mefloquine
gemifloxacin and mefloquine both increase QTc interval. Use Caution/Monitor.
- meloxicam
gemifloxacin, meloxicam. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- mestranol
gemifloxacin 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
gemifloxacin 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.
- methylprednisolone
methylprednisolone and gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- mifepristone
mifepristone, gemifloxacin. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.
- miglitol
gemifloxacin 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.
- mirtazapine
gemifloxacin and mirtazapine both increase QTc interval. Use Caution/Monitor.
- mometasone inhaled
mometasone inhaled and gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- nabumetone
gemifloxacin, nabumetone. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- naproxen
gemifloxacin, naproxen. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- nateglinide
gemifloxacin 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.
- nortriptyline
gemifloxacin and nortriptyline both increase QTc interval. Use Caution/Monitor.
- octreotide
gemifloxacin and octreotide both increase QTc interval. Use Caution/Monitor.
- olanzapine
gemifloxacin and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances
- olodaterol inhaled
gemifloxacin 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 gemifloxacin both increase QTc interval. Use Caution/Monitor.
- osimertinib
osimertinib and gemifloxacin 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 gemifloxacin 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
gemifloxacin, oxaprozin. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- ozanimod
ozanimod and gemifloxacin 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
gemifloxacin and paliperidone both increase QTc interval. Use Caution/Monitor.
- pasireotide
gemifloxacin and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.
- perphenazine
gemifloxacin and perphenazine both increase QTc interval. Use Caution/Monitor.
- phenytoin
gemifloxacin decreases effects of phenytoin by unknown mechanism. Use Caution/Monitor. There are also case reports of quinolones increasing phenytoin levels.
- pioglitazone
gemifloxacin 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
gemifloxacin, piroxicam. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- posaconazole
gemifloxacin and posaconazole both increase QTc interval. Use Caution/Monitor.
- prednisolone
prednisolone and gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- prednisone
prednisone and gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- primaquine
gemifloxacin and primaquine both increase QTc interval. Use Caution/Monitor.
- prochlorperazine
gemifloxacin and prochlorperazine both decrease QTc interval. Use Caution/Monitor.
- promethazine
gemifloxacin and promethazine both decrease QTc interval. Use Caution/Monitor.
- protriptyline
gemifloxacin and protriptyline both increase QTc interval. Use Caution/Monitor.
- quetiapine
quetiapine, gemifloxacin. 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
gemifloxacin and quinine both increase QTc interval. Use Caution/Monitor.
- ranolazine
gemifloxacin and ranolazine both increase QTc interval. Use Caution/Monitor.
- repaglinide
gemifloxacin 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
rilpivirine increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.
- risperidone
gemifloxacin and risperidone both increase QTc interval. Use Caution/Monitor.
- romidepsin
gemifloxacin and romidepsin both increase QTc interval. Use Caution/Monitor.
- rosiglitazone
gemifloxacin 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.
- salmeterol
gemifloxacin and salmeterol both increase QTc interval. Use Caution/Monitor.
- saxagliptin
gemifloxacin 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 gemifloxacin by QTc interval. Use Caution/Monitor.
- sertraline
gemifloxacin and sertraline both increase QTc interval. Use Caution/Monitor.
- sitagliptin
gemifloxacin 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
gemifloxacin 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 gemifloxacin 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 gemifloxacin 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 gemifloxacin 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 zirconium cyclosilicate
sodium zirconium cyclosilicate will decrease the level or effect of gemifloxacin by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.
- solifenacin
gemifloxacin and solifenacin both increase QTc interval. Use Caution/Monitor.
- sorafenib
sorafenib and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- sucralfate
sucralfate decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- sulindac
gemifloxacin, sulindac. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- sunitinib
gemifloxacin and sunitinib both increase QTc interval. Use Caution/Monitor.
- tacrolimus
gemifloxacin and tacrolimus both increase QTc interval. Use Caution/Monitor.
- telavancin
gemifloxacin and telavancin both increase QTc interval. Use Caution/Monitor.
- tolazamide
gemifloxacin 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
gemifloxacin 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
gemifloxacin, 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 gemifloxacin both increase Other (see comment). Use Caution/Monitor. Coadministration of quinolone antibiotics and corticosteroids may increase risk of tendon rupture.
- triclabendazole
gemifloxacin and triclabendazole both increase QTc interval. Use Caution/Monitor.
- trifluoperazine
gemifloxacin and trifluoperazine both decrease QTc interval. Use Caution/Monitor.
- trimagnesium citrate anhydrous
trimagnesium citrate anhydrous decreases levels of gemifloxacin 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.
- trimipramine
gemifloxacin and trimipramine both increase QTc interval. Use Caution/Monitor.
- triptorelin
triptorelin increases toxicity of gemifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- valbenazine
valbenazine and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- vardenafil
gemifloxacin and vardenafil both increase QTc interval. Use Caution/Monitor.
- venlafaxine
gemifloxacin and venlafaxine both decrease QTc interval. Use Caution/Monitor.
- vildagliptin
gemifloxacin 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
gemifloxacin and voclosporin both increase QTc interval. Use Caution/Monitor.
- voriconazole
gemifloxacin and voriconazole both increase QTc interval. Use Caution/Monitor.
- vorinostat
gemifloxacin and vorinostat both increase QTc interval. Use Caution/Monitor.
- warfarin
gemifloxacin increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.
- zinc
zinc will decrease the level or effect of gemifloxacin by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer gemifloxacin 3 hr before or 2 hr after administration of polyvalent cation containing products.
Minor (24)
- alprazolam
gemifloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.
- balsalazide
gemifloxacin will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- biotin
gemifloxacin will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- chlordiazepoxide
gemifloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.
- clonazepam
gemifloxacin increases levels of clonazepam by decreasing metabolism. Minor/Significance Unknown.
- clorazepate
gemifloxacin increases levels of clorazepate by decreasing metabolism. Minor/Significance Unknown.
- estazolam
gemifloxacin increases levels of estazolam by decreasing metabolism. Minor/Significance Unknown.
- flurazepam
gemifloxacin increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.
- foscarnet
gemifloxacin, foscarnet. Mechanism: unknown. Minor/Significance Unknown. Risk of tonic clonic seizure.
- isotretinoin
gemifloxacin, isotretinoin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- loprazolam
gemifloxacin increases levels of loprazolam by decreasing metabolism. Minor/Significance Unknown.
- lorazepam
gemifloxacin increases levels of lorazepam by decreasing metabolism. Minor/Significance Unknown.
- lormetazepam
gemifloxacin increases levels of lormetazepam by decreasing metabolism. Minor/Significance Unknown.
- midazolam
gemifloxacin increases levels of midazolam by decreasing metabolism. Minor/Significance Unknown.
- oxazepam
gemifloxacin increases levels of oxazepam by decreasing metabolism. Minor/Significance Unknown.
- pantothenic acid
gemifloxacin will decrease the level or effect of pantothenic acid by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- probenecid
probenecid increases levels of gemifloxacin by decreasing renal clearance. Minor/Significance Unknown.
- pyridoxine
gemifloxacin 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)
gemifloxacin 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
gemifloxacin increases levels of quazepam by decreasing metabolism. Minor/Significance Unknown.
- quercetin
quercetin decreases effects of gemifloxacin by pharmacodynamic antagonism. Minor/Significance Unknown.
- temazepam
gemifloxacin increases levels of temazepam by decreasing metabolism. Minor/Significance Unknown.
- thiamine
gemifloxacin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.
- triazolam
gemifloxacin increases levels of triazolam by decreasing metabolism. Minor/Significance Unknown.
Adverse Effects
1-10%
Diarrhea (5%)
Headache (4%)
Nausea (4%)
Rash (4%)
Transaminases increased (1-4%)
Abdominal pain (2%)
Dizziness (2%)
Vomiting (2%)
Neutropenia (1%)
Platelets increased (1%)
Thrombocythemia (1%)
GGT increased (1%)
<1%
Peripheral neuropathy
Photosensitivity
Tendon rupture
Postmarketing Reports
Blood and lymphatic disorders: Agranulocytosis, pancytopenia
Cardiovascular disorders: Ventricular tachyarrhythmias (including in very rare cases cardiac arrest and torsade de pointes)
Vascular disorders: Aortic aneurysm and dissection
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, poly neuropathy
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
Endocrine disorders: Blood glucose disturbances
Warnings
Black Box Warnings
Serious adverse effects and limitations-of-use
- 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
- Both oral and injectable fluoroquinolones are associated with disabling side effects involving tendons, muscles, joints, nerves and the central nervous system
- These side effects can occur hours to weeks after exposure to fluoroquinolones and may potentially be permanent
- Discontinue the drug immediately and avoid use of systemic fluoroquinolones in patients who experience any of these serious adverse reactions
- Because the risk of these serious side effects generally outweighs the benefits for patients with acute bacterial sinusitis, acute exacerbation of chronic bronchitis, and uncomplicated UTIs, that fluoroquinolones should be reserved for use in patients with these conditions who have no alternative treatment options
- For some serious bacterial infections, including anthrax, plague, and bacterial pneumonia among others, the benefits of fluoroquinolones outweigh the risks and it is appropriate for them to remain available as a therapeutic option
Contraindications
All drugs or conditions that prolong QT interval
Documented hypersensitivity to gemifloxacin or other fluoroquinolones
Cautions
May prolong QT interval
May cause maculopapular rash
Although not reported in gemifloxacin clinical trials, convulsions, increased intracranial pressure (including pseudotumor cerebri), and toxic psychosis reported with other fluoroquinolones
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
In prolonged therapy, perform periodic evaluations of organ system functions (eg, renal, hepatic, hematopoietic); adjust dose in renal function impairment; superinfections may occur with prolonged or repeated antibiotic therapy
Not drug of first choice in pediatrics due to increased incidence of adverse events compared to controls, including arthropathy; no data exist for dose for pediatric patients with renal impairment (ie, CrCl <50 mL/min)
Fluoroquinolones are associated with increased risk of tendinitis and tendon rupture in all ages, this risk is further increased in older patients usually over 60 yr, in patients taking corticosteroids, and in patients with kidney, heart, or lung transplants (see Black Box Warnings)
May exacerbate muscle weakness in patients with myasthenia gravis; avoid fluoroquinolones with known history of myasthenia gravis
Acute onset of retinal detachment increased 4.5-fold with oral 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
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 fluoroquinolones, particularly in elderly patients
- May occur with 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 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 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
Pregnancy & Lactation
Pregnancy
Limited available human data with use in pregnant women are insufficient to inform an associated risk of miscarriages, major birth defects, and/or adverse maternal or fetal outcomes; based on animal studies with gemifloxacin, therapy, may cause fetal harm; in animal reproduction studies, administration of drug to pregnant mice and rabbits during the period of organogenesis produced embryofetal toxicity at exposures up to 2 and 3 times, respectively, the maximum recommended human dose; advise pregnant women of potential risk to fetus
Lactation
There is no data on presence of gemifloxacin in human milk, effects on milk production, on breastfed infant; drug is excreted in breast milk of rats; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from treatment or from 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.Pharmacology
Mechanism of Action
Acts by inhibiting both DNA gyrase and topoisomerase IV, which are essential for bacterial growth. Because of this dual mechanism, MIC values remain in the susceptible range for some double mutants (eg, S pneumoniae)
Absorption
Bioavailability: 71%
Peak Plasma Time: 0.5-2 hr
Peak Plasma Concentration: 1.61 mcg/mL
AUC: 9.93 mcg•hr/mL
Distribution
Protein bound: 60-70%
Metabolism
Hepatic (limited)
Elimination
Half-Life: 5-9 hr
Dialyzable: yes (20-30%)
Excretion: feces (60%); urine (40%)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Factive oral - | 320 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
gemifloxacin oral
GEMIFLOXACIN - ORAL
(JEM-i-FLOX-a-sin)
COMMON BRAND NAME(S): Factive
WARNING: Quinolone antibiotics (including gemifloxacin) 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: Gemifloxacin is used to treat a variety of bacterial infections. This medication belongs to a class of drugs known as quinolone antibiotics. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral 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 provided by your pharmacist before you start taking gemifloxacin 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 2 hours before or 3 hours after taking other products that may make it work less well. Examples include quinapril, sucralfate, vitamins/minerals (including iron, zinc), and products that contain magnesium or aluminum (such as antacids, didanosine solution), among others. Ask your pharmacist about all the products you take.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time 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, headache, 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 kidney problems (such as change in the amount of urine), signs of liver problems (such as nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine).Get medical help right away if you have any very serious side effects, including: chest pain, 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.Gemifloxacin can commonly cause a mild rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe allergic reaction. The risk of developing a rash is higher in people younger than 40 years, in women (especially if on hormone replacement treatment), or when gemifloxacin is taken for longer than 7 days. Stop taking gemifloxacin and get medical help right away if you develop any rash.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: Before using gemifloxacin, 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, joint/tendon problems (such as tendonitis, bursitis), kidney problems, mental/mood disorders (such as depression), a certain muscle condition (myasthenia gravis), nerve problems (such as peripheral neuropathy), seizure disorder, 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).Gemifloxacin 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 gemifloxacin, 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 gemifloxacin 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.Gemifloxacin may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using gemifloxacin 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 at greater risk for joint/tendon problems while using this drug. Discuss the risks and benefits with the doctor.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.This drug passes into breast milk in small amounts. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also How to Use section.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.A product that may interact with this drug is: strontium.
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 tests (such as kidney function, complete blood count, blood sugar, cultures) may be done before you start taking this medication and while you are taking it. Keep all medical and lab appointments.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of 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 June 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.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
