ofloxacin (Rx)

Brand and Other Names:Floxin

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 200mg
  • 300mg
  • 400mg

Bronchitis Exacerbation

400 mg PO q12hr for 10 days

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

Community Acquired Pneumonia

400 mg PO q12hr for 10 days

Skin & Skin Structure Infections

400 mg PO q12hr for 10 days

Acute, Uncomplicated Urethral and Cervical Gonorrhea

No longer recommended for gonorrhea owing to widespread resistance in the US

400 mg PO single dose

Nongonococcal Cervicitis/Urethritis or Mixed Infection of Cervix/Urethra

300 mg PO q12hr for 7 days

Acute Pelvic Inflammatory Disease

400 mg PO q12hr for 10-14 days

Uncomplicated Cystitis

Due to E. coli or K. pneumoniae: 200 mg PO q12hr for 3 days

Due to other approved pathogens: 200 mg PO q12hr for 7 days

Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for uncomplicated urinary tract infections

Complicated UTIs

200 mg PO q12hr for 10 days

Prostatitis Due to E. Coli

300 mg PO q12hr for 6 weeks

Traveler's Diarrhea (Off-label)

300 mg PO q12hr for 1-3 days

Dosage Modifications

Renal impairment

  • CrCl 20-50 mL/min: Give q24hr
  • CrCl <20 mL/min: Give one-half usual dose q24hr

Other Indications and Uses

Mild to moderate infection due to susceptible strains of designated microorganisms

Chlamydia trachomatis, Citrobacter spp, Enterobacter spp, E. coli, Klebsiella pneumoniae, N. gonorrhoeae, Proteus mirabilis, Pseudomonas aeruginosa, S. aureus, S. pneumoniae

Culture and susceptibility tests needed to isolate and identify organisms

Safety and efficacy not established

Next:

Interactions

Interaction Checker

and ofloxacin

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              Serious - Use Alternative (72)

              • adagrasib

                adagrasib, ofloxacin. 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 ofloxacin 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, ofloxacin. 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

                ofloxacin 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 ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

              • amisulpride

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

              • anagrelide

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

              • apomorphine

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

              • arsenic trioxide

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

              • artemether

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

              • asenapine

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

              • asenapine transdermal

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

              • BCG vaccine live

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

              • buprenorphine

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

              • buprenorphine buccal

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

              • buprenorphine subdermal implant

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

              • buprenorphine transdermal

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

              • buprenorphine, long-acting injection

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

              • carbonyl iron

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

              • ceritinib

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

              • cholera vaccine

                ofloxacin, 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.

              • desflurane

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

              • didanosine

                didanosine decreases levels of ofloxacin 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; separate by 4-8 hours.

              • disopyramide

                disopyramide and ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

              • encorafenib

                encorafenib and ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

              • entrectinib

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

              • eribulin

                eribulin and ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

              • ferric maltol

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

              • fexinidazole

                fexinidazole and ofloxacin 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.

              • glasdegib

                ofloxacin 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 ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

              • ibutilide

                ibutilide and ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

              • indapamide

                indapamide and ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

              • inotuzumab

                inotuzumab and ofloxacin 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 ofloxacin 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 ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug.

              • isoflurane

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

              • ivosidenib

                ivosidenib and ofloxacin 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 ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

              • macimorelin

                macimorelin and ofloxacin 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.

              • methyl aminolevulinate

                ofloxacin, 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

                ofloxacin 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. .

              • mobocertinib

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

              • ondansetron

                ofloxacin 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 ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

              • panobinostat

                ofloxacin 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.

              • pentamidine

                ofloxacin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

              • pimozide

                ofloxacin and pimozide both increase QTc interval. Avoid or Use Alternate Drug.

              • pitolisant

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

              • polysaccharide iron

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

              • procainamide

                ofloxacin and procainamide both increase QTc interval. Avoid or Use Alternate Drug.

              • quinidine

                quinidine and ofloxacin both increase QTc interval. Avoid or Use Alternate Drug.

              • ribociclib

                ribociclib increases toxicity of ofloxacin by QTc interval. Avoid or Use Alternate Drug.

              • rose hips

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

              • selinexor

                selinexor, ofloxacin. 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.

              • siponimod

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

              • sodium bicarbonate

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

              • sotalol

                ofloxacin and sotalol both increase QTc interval. Avoid or Use Alternate Drug.

              • strontium ranelate

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

              • tetrabenazine

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

              • toremifene

                ofloxacin and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.

              • tretinoin

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

              • tretinoin topical

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

              • typhoid vaccine live

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

              • umeclidinium bromide/vilanterol inhaled

                ofloxacin 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

                ofloxacin, 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 ofloxacin 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

                ofloxacin 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.

              Monitor Closely (194)

              • acarbose

                ofloxacin 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 ofloxacin both increase QTc interval. Use Caution/Monitor.

              • alfuzosin

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

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

              • amifampridine

                ofloxacin 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.

              • amiodarone

                amiodarone will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • amitriptyline

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

              • amoxapine

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

              • arformoterol

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

              • aripiprazole

                aripiprazole and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • artemether/lumefantrine

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

              • atomoxetine

                atomoxetine and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • bazedoxifene/conjugated estrogens

                ofloxacin 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

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

              • betamethasone

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

              • calcium acetate

                calcium acetate, ofloxacin. 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, ofloxacin. 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, ofloxacin. 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, ofloxacin. 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, ofloxacin. 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.

              • chlorpromazine

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

              • chlorpropamide

                ofloxacin 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

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

              • clarithromycin

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

              • clomipramine

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

              • clozapine

                clozapine and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • conjugated estrogens

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

              • cortisone

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

              • crizotinib

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

              • dasatinib

                dasatinib and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • degarelix

                degarelix and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • desipramine

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

              • deutetrabenazine

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

              • dienogest/estradiol valerate

                ofloxacin 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.

              • digoxin

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

                digoxin will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • dofetilide

                dofetilide will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor.

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

              • dolasetron

                dolasetron and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • donepezil

                donepezil and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • doxepin

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

              • dronedarone

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

              • droperidol

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

              • efavirenz

                efavirenz and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • eliglustat

                eliglustat and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • epinephrine

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

              • epinephrine racemic

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

              • erythromycin base

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

              • erythromycin ethylsuccinate

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

              • erythromycin lactobionate

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

              • erythromycin stearate

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

              • escitalopram

                escitalopram increases toxicity of ofloxacin by QTc interval. Use Caution/Monitor.

              • estradiol

                ofloxacin 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

                ofloxacin 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

                ofloxacin 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

                ofloxacin 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

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

              • etrasimod

                etrasimod, ofloxacin. Either increases effects of the other by QTc interval. Modify Therapy/Monitor Closely. Transient decrease in heart rate and AV conduction delays may occur when initiating etrasimod. Owing to potential of additive effect on heart rate, etrasimod may increase risk of QT prolongation and Torsades de Pointes when coadministered with Class Ia or Class III antiarrhythmic drugs, or other drugs that prolong the QT interval. .

              • ezogabine

                ezogabine, ofloxacin. 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 ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • ferric citrate

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

              • fingolimod

                fingolimod and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • flecainide

                flecainide and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • fluconazole

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

              • fludrocortisone

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

              • fluoxetine

                fluoxetine and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • fluphenazine

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

              • fluvoxamine

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

              • formoterol

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

              • foscarnet

                foscarnet and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • fosphenytoin

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

              • fostemsavir

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

              • gemtuzumab

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

              • gepirone

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

              • gilteritinib

                gilteritinib and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • glimepiride

                ofloxacin 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

                ofloxacin 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

                ofloxacin 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 ofloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

              • granisetron

                granisetron and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • haloperidol

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

              • histrelin

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

              • hydrocortisone

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

              • hydroxyzine

                hydroxyzine and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • ibuprofen IV

                ofloxacin, ibuprofen IV. Other (see comment). Use Caution/Monitor. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • iloperidone

                iloperidone and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • imipramine

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

              • indacaterol, inhaled

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

              • insulin aspart

                ofloxacin 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

                ofloxacin 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

                ofloxacin 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

                ofloxacin 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

                ofloxacin 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

                ofloxacin 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

                ofloxacin 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

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

              • ketoconazole

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

              • lanthanum carbonate

                lanthanum carbonate decreases levels of ofloxacin 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 ofloxacin both increase QTc interval. Use Caution/Monitor.

              • lenvatinib

                ofloxacin 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 ofloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

              • levofloxacin

                levofloxacin and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • levoketoconazole

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

              • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

                ofloxacin 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

                lithium and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • lofepramine

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

              • lumefantrine

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

              • magnesium chloride

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

              • maprotiline

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

              • mestranol

                ofloxacin 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

                ofloxacin 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 ofloxacin both increase QTc interval. Use Caution/Monitor.

              • methylprednisolone

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

              • mifepristone

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

              • miglitol

                ofloxacin 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

                mirtazapine and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • mometasone inhaled

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

              • moxifloxacin

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

              • nateglinide

                ofloxacin 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.

              • nilotinib

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

              • nortriptyline

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

              • octreotide

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

              • octreotide (Antidote)

                octreotide (Antidote) and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

              • olanzapine

                olanzapine and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • olodaterol inhaled

                ofloxacin 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 ofloxacin both increase QTc interval. Use Caution/Monitor.

              • osimertinib

                osimertinib and ofloxacin 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 ofloxacin by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

              • ozanimod

                ozanimod and ofloxacin 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

                ofloxacin and paliperidone both increase QTc interval. Use Caution/Monitor.

              • paroxetine

                ofloxacin and paroxetine both increase QTc interval. Use Caution/Monitor.

              • pasireotide

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

              • perphenazine

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

              • phenytoin

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

              • pioglitazone

                ofloxacin 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.

              • posaconazole

                ofloxacin and posaconazole both increase QTc interval. Use Caution/Monitor.

              • prednisolone

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

              • prednisone

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

              • primaquine

                primaquine and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • procainamide

                ofloxacin will increase the level or effect of procainamide by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • prochlorperazine

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

              • promazine

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

              • promethazine

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

              • protriptyline

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

              • quetiapine

                quetiapine, ofloxacin. 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.

              • quinidine

                quinidine will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Use Caution/Monitor.

              • quinine

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

              • quizartinib

                quizartinib, ofloxacin. Either increases effects of the other by QTc interval. Modify Therapy/Monitor Closely. Monitor patients more frequently with ECG if coadministered with QT prolonging drugs.

              • ranolazine

                ofloxacin and ranolazine both increase QTc interval. Use Caution/Monitor.

              • repaglinide

                ofloxacin 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 ofloxacin 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

                ofloxacin and risperidone both increase QTc interval. Use Caution/Monitor.

              • romidepsin

                ofloxacin and romidepsin both increase QTc interval. Use Caution/Monitor.

              • rosiglitazone

                ofloxacin 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.

              • saquinavir

                saquinavir increases levels of ofloxacin by QTc interval. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Increased risk of QT prolongation and cardiac arrhythmias.

              • saxagliptin

                ofloxacin 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 ofloxacin by QTc interval. Use Caution/Monitor.

              • sertraline

                sertraline and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • sitagliptin

                ofloxacin 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

                ofloxacin 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 ofloxacin 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 ofloxacin 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 ofloxacin 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. .

              • solifenacin

                solifenacin and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • sorafenib

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

              • sucralfate

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

              • sulfamethoxazole

                sulfamethoxazole and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • sunitinib

                sunitinib and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • tacrolimus

                tacrolimus and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • telavancin

                ofloxacin and telavancin both increase QTc interval. Use Caution/Monitor.

              • thioridazine

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

              • tolazamide

                ofloxacin 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

                ofloxacin 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.

              • trazodone

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

              • triamcinolone acetonide injectable suspension

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

              • triclabendazole

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

              • trifluoperazine

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

              • trimagnesium citrate anhydrous

                trimagnesium citrate anhydrous decreases levels of ofloxacin 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

                ofloxacin and trimethoprim both increase QTc interval. Use Caution/Monitor.

              • trimipramine

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

              • triptorelin

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

              • tropisetron

                ofloxacin and tropisetron both increase QTc interval. Use Caution/Monitor.

              • valbenazine

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

              • venlafaxine

                ofloxacin and venlafaxine both increase QTc interval. Use Caution/Monitor.

              • vildagliptin

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

              • voriconazole

                ofloxacin and voriconazole both increase QTc interval. Use Caution/Monitor.

              • vorinostat

                vorinostat and ofloxacin both increase QTc interval. Use Caution/Monitor.

              • warfarin

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

              • zinc

                zinc will decrease the level or effect of ofloxacin by cation binding in GI tract. Modify Therapy/Monitor Closely. Administer oral ofloxacin 2 hr before or after administration of polyvalent cation containing products.

              • ziprasidone

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

              Minor (92)

              • acarbose

                ofloxacin, acarbose. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • aceclofenac

                ofloxacin, aceclofenac. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • acemetacin

                ofloxacin, acemetacin. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • alprazolam

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

              • aspirin

                ofloxacin, aspirin. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • aspirin rectal

                ofloxacin, aspirin rectal. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • aspirin/citric acid/sodium bicarbonate

                ofloxacin, aspirin/citric acid/sodium bicarbonate. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • azithromycin

                azithromycin and ofloxacin both increase QTc interval. Minor/Significance Unknown.

              • balsalazide

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

              • biotin

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

              • celecoxib

                ofloxacin, celecoxib. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • chlordiazepoxide

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

              • chloroquine

                chloroquine increases toxicity of ofloxacin by QTc interval. Minor/Significance Unknown.

              • chlorpropamide

                ofloxacin, chlorpropamide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • choline magnesium trisalicylate

                ofloxacin, choline magnesium trisalicylate. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • clonazepam

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

              • clorazepate

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

              • diclofenac

                ofloxacin, diclofenac. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • diflunisal

                ofloxacin, diflunisal. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • estazolam

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

              • etodolac

                ofloxacin, etodolac. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • fenbufen

                ofloxacin, fenbufen. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • fenoprofen

                ofloxacin, fenoprofen. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • flurazepam

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

              • flurbiprofen

                ofloxacin, flurbiprofen. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • foscarnet

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

              • glimepiride

                ofloxacin, glimepiride. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • glipizide

                ofloxacin, glipizide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • glyburide

                ofloxacin, glyburide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • hydrochlorothiazide

                hydrochlorothiazide will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • ibuprofen

                ofloxacin, ibuprofen. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • indomethacin

                ofloxacin, indomethacin. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • insulin aspart

                ofloxacin, insulin aspart. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • insulin detemir

                ofloxacin, insulin detemir. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • insulin glargine

                ofloxacin, insulin glargine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • insulin glulisine

                ofloxacin, insulin glulisine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • insulin lispro

                ofloxacin, insulin lispro. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • insulin NPH

                ofloxacin, insulin NPH. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • insulin regular human

                ofloxacin, insulin regular human. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • isotretinoin

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

              • ketoprofen

                ofloxacin, ketoprofen. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • ketorolac

                ofloxacin, ketorolac. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • ketorolac intranasal

                ofloxacin, ketorolac intranasal. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • loprazolam

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

              • lorazepam

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

              • lormetazepam

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

              • lornoxicam

                ofloxacin, lornoxicam. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • meclofenamate

                ofloxacin, meclofenamate. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • mefenamic acid

                ofloxacin, mefenamic acid. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • meloxicam

                ofloxacin, meloxicam. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • memantine

                memantine will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • metformin

                metformin will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.

                ofloxacin, metformin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • methyclothiazide

                methyclothiazide will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • midazolam

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

              • midodrine

                midodrine will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • miglitol

                ofloxacin, miglitol. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • nabumetone

                ofloxacin, nabumetone. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • naproxen

                ofloxacin, naproxen. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • nateglinide

                ofloxacin, nateglinide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • oxaprozin

                ofloxacin, oxaprozin. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • oxazepam

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

              • pantothenic acid

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

              • parecoxib

                ofloxacin, parecoxib. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • pazopanib

                ofloxacin and pazopanib both increase QTc interval. Minor/Significance Unknown.

              • pioglitazone

                ofloxacin, pioglitazone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • piroxicam

                ofloxacin, piroxicam. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • pyridoxine

                ofloxacin 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)

                ofloxacin 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

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

              • quercetin

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

              • quinine

                ofloxacin will increase the level or effect of quinine by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • repaglinide

                ofloxacin, repaglinide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • rosiglitazone

                ofloxacin, rosiglitazone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • salicylates (non-asa)

                ofloxacin, salicylates (non-asa). Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • salsalate

                ofloxacin, salsalate. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • saxagliptin

                ofloxacin, saxagliptin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • sevoflurane

                sevoflurane and ofloxacin both increase QTc interval. Minor/Significance Unknown.

              • sitagliptin

                ofloxacin, sitagliptin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • sulfamethoxazole

                sulfamethoxazole will increase the level or effect of ofloxacin by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • sulfasalazine

                ofloxacin, sulfasalazine. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • sulindac

                ofloxacin, sulindac. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • temazepam

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

              • thiamine

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

              • tolazamide

                ofloxacin, tolazamide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • tolbutamide

                ofloxacin, tolbutamide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • tolfenamic acid

                ofloxacin, tolfenamic acid. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • tolmetin

                ofloxacin, tolmetin. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.

              • triamterene

                ofloxacin will increase the level or effect of triamterene by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • triazolam

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

              • trimethoprim

                ofloxacin will increase the level or effect of trimethoprim by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • verapamil

                ofloxacin will increase the level or effect of verapamil by basic (cationic) drug competition for renal tubular clearance. Minor/Significance Unknown.

              • vildagliptin

                ofloxacin, vildagliptin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

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              Adverse Effects

              1-10%

              Nausea (3-10%)

              Headache (1-9%)

              Insomnia (3-7%)

              Dizziness (1-5%)

              Vaginitis (1-5%)

              Diarrhea (1-4%)

              Vomiting (1-4%)

              Appetite decreased (1-3%)

              Abdominal cramps (1-3%)

              Abnormal taste (1-3%)

              Chest pain (1-3%)

              External genital pruritis in women (1-3%)

              Fatigue (1-3%)

              Flatulence (1-3%)

              GI distress (1-3%)

              Nervousness (1-3%)

              Pharyngitis (1-3%)

              Pyrexia (1-3%)

              Rash/pruritis (1-3%)

              Sleep disorders (1-3%)

              Visual disturbances (1-3%)

              Xerostomia (1-3%)

              <1%

              Prolonged QT interval

              Torsades de pointes

              Syncope

              Vasculitis

              Edema

              HTN

              Palpitations

              Vasodilation

              Stevens-Johnson syndrome

              Toxic epidermal necrolysis

              Agranulocytosis

              Aplastic anemia

              Pancytopenia

              Thrombocytopenia

              Thrombocytopenic purpura

              Acute hepatitis

              Hepatic failure

              Hepatic necrosis

              Immune hypersensitivity reaction

              Rupture of tendon, Tendinitis

              Peripheral neuropathy

              Seizure

              Acute renal failure

              Interstitial nephritis

              Renal impairment

              Tourette's syndrome

              Decr hearing acuity

              Tinnitus

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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 fluoroquinolones in patients who experience any of these serious adverse reactions
              • May exacerbate muscle weakness in patients with myasthenia gravis; fluoroquinolones should be avoided in patients with known history of myasthenia gravis
              • Because 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 ofloxacin 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

              Antimicrobial agents used in high doses for short periods of time to treat gonorrhea may mask or delay symptoms of incubating syphilis; all patients with gonorrhea should have a serologic test for syphilis at time of diagnosis; patients treated for gonorrhea should have a follow-up serologic test for syphilis after three months and, if positive, treatment with an appropriate antimicrobial should be instituted

              Administer ofloxacin with caution in presence of renal or hepatic insufficiency/impairment; in patients with known or suspected renal or hepatic insufficiency/impairment, perform careful clinical observation and appropriate laboratory studies prior to and during therapy; elimination of ofloxacin may be reduced; alteration of the dosage regimen is necessary in patients with impaired renal function (creatinine clearance <50 mg/mL)

              Excessive exposure UV light or sun should be avoided; discontinue therapy if photosensitivity/phototoxicity occurs

              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

              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)

              Convulsions, increased intracranial pressure (including pseudotumor cerebri), and toxic psychosis reported with fluoroquinolones

              Adequate hydration of patients receiving therapy should be maintained to prevent formation of a highly concentrated urine

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

              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

              Clostridium difficile associated diarrhea (CDAD)

              • CDAD reported with use of nearly all antibacterial agents and may range in severity from mild diarrhea to fatal colitis; treatment with antibacterial agents alters normal flora of the colon leading to overgrowth of C. difficile
              • C. difficile produces toxins A and B which contribute to development of CDAD; hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy; CDAD must be considered in all patients who present with diarrhea following antibiotic use; careful medical history is necessary since CDAD has been reported to occur over two months after administration of antibacterial agents
              • If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued; institute appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation as clinically indicated

              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
              • FDA review found fluoroquinolones can cause an increase in occurrence of aortic dissections
              • 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 fluoroquinolone treatment immediately if a patient reports side effects suggestive of aortic aneurysm or dissecti

              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
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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: excreted in breast milk, discontinue drug or do not nurse

              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 bacterial DNA gyrase, which in turn inhibits DNA replication and transcription, DNA repair, recombination and transposicion, causing bacterial cell death.

              Absorption

              Well absorbed; food causes only minor alterations

              Bioavailability: 98%

              Distribution

              Protein Bound: 32%

              Vd: 2.4-3.5 L/kg

              Elimination

              Half-Life: 4-5 hr

              Excretion: Urine (up to 80% unchanged; <5% metabolites); feces 4-8%

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              Administration

              Oral Administration

              Do not take with antacids or dairy products

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Ocuflox ophthalmic (eye)
              -
              0.3 % drops
              ofloxacin oral
              -
              400 mg tablet
              ofloxacin otic (ear)
              -
              0.3 % drops
              ofloxacin otic (ear)
              -
              0.3 % drops
              ofloxacin otic (ear)
              -
              0.3 % drops
              ofloxacin otic (ear)
              -
              0.3 % drops
              ofloxacin otic (ear)
              -
              0.3 % drops
              ofloxacin otic (ear)
              -
              0.3 % drops
              ofloxacin otic (ear)
              -
              0.3 % drops
              ofloxacin ophthalmic (eye)
              -
              0.3 % drops
              ofloxacin ophthalmic (eye)
              -
              0.3 % drops
              ofloxacin ophthalmic (eye)
              -
              0.3 % drops
              ofloxacin ophthalmic (eye)
              -
              0.3 % drops
              ofloxacin ophthalmic (eye)
              -
              0.3 % drops
              ofloxacin ophthalmic (eye)
              -
              0.3 % drops
              ofloxacin ophthalmic (eye)
              -
              0.3 % drops
              ofloxacin ophthalmic (eye)
              -
              0.3 % drops

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Select a drug:
              Patient Education
              ofloxacin oral

              OFLOXACIN - ORAL

              (oh-FLOX-uh-sin)

              COMMON BRAND NAME(S): Floxin

              WARNING: Quinolone antibiotics (including ofloxacin) 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: This medication is used to treat a variety of bacterial infections. Ofloxacin 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 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 ofloxacin 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 twice a day (every 12 hours). The dosage and length of treatment is based on your medical condition and response to treatment.Drink plenty of fluids while taking this medication unless your doctor tells you otherwise.Take this medication at least 2 hours before or 2 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.Upset stomach, nausea, diarrhea, headache, dizziness, lightheadedness, 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: easy 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: hearing changes, unsteadiness, 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 ofloxacin, 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: seizure disorder, conditions that increase your risk of seizures (such as brain/head injury, brain tumors), nerve problems (such as peripheral neuropathy), kidney disease, liver disease, mental/mood disorders (such as depression), myasthenia gravis, joint/tendon problems (such as tendonitis, bursitis), 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).Ofloxacin 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 ofloxacin, 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 ofloxacin 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).Ofloxacin may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using ofloxacin before having any immunizations/vaccinations.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.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.This medication 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 ofloxacin may affect the heart rhythm (QT prolongation), including dofetilide, procainamide, amiodarone, quinidine, sotalol, among others.Ofloxacin is very similar to levofloxacin. Do not use medications containing levofloxacin while using ofloxacin.This medication may interfere with certain lab tests (such as urine screening for opiates), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

              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. Symptoms of overdose may include: severe dizziness.

              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 may 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 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 July 2023. 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.
              OR Other Restrictions
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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.