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 antimicrobials#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 antimicrobials#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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            Contraindicated (1)

            • fezolinetant

              ofloxacin will increase the level or effect of fezolinetant by affecting hepatic enzyme CYP1A2 metabolism. Contraindicated. Fezolinetant AUC and peak plasma concentration are increased if coadministered with drugs that are weak, moderate, or strong CYP1A2 inhibitors

            Serious - Use Alternative (74)

            • 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.

            • pirfenidone

              ofloxacin will increase the level or effect of pirfenidone by affecting hepatic enzyme CYP1A2 metabolism. Avoid or Use Alternate Drug. Use of strong CYP1A2 inhibitors should be discontinued before initiating pirfenidone and avoided during treatment; if strong CYP1A2 inhibitors are the only drug of choice, dosage reductions are recommended

            • 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.

            • pomalidomide

              ofloxacin increases levels of pomalidomide by affecting hepatic enzyme CYP1A2 metabolism. 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 (195)

            • 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.

            • eluxadoline

              ofloxacin increases levels of eluxadoline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. As a precautionary measure due to incomplete information on the metabolism of eluxadoline, use caution when coadministered with strong CYP1A2 inhibitors.

            • 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.

            • 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.

            • 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.

            • pentoxifylline

              ofloxacin will increase the level or effect of pentoxifylline by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor.

            • 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.

            • 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.

            • tasimelteon

              ofloxacin will increase the level or effect of tasimelteon by affecting hepatic enzyme CYP1A2 metabolism. Use Caution/Monitor. Avoid coadministration; potentially large increase in tasimelteon exposure and greater risk of adverse reactions with strong CYP1A2 inhibitors

            • telavancin

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

            • terbinafine

              ofloxacin will increase the level or effect of terbinafine by affecting hepatic enzyme CYP1A2 metabolism. 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 antimicrobials#fluoroquinolones in patients who experience any of these serious adverse reactions
            • May exacerbate muscle weakness in patients with myasthenia gravis; antimicrobials#fluoroquinolones should be avoided in patients with known history of myasthenia gravis
            • Because antimicrobials#fluoroquinolones have been associated with serious adverse reactions, reserve drug use in patients who have no alternative treatment options for the following indications: Acute bacterial sinusitis; acute bacterial exacerbation of chronic bronchitis

            Contraindications

            Hypersensitivity to 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 antimicrobials#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 antimicrobials#fluoroquinolones in a single case-controlled study - JAMA 2012;307(13):1414-1419; another study disputes these findings (relative risk, 1.29) - JAMA 2013;310(20):2184-2190

            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 antimicrobials#fluoroquinolones can cause an increase in occurrence of aortic dissections
            • May occur with antimicrobials#fluoroquinolones for systemic use (IV or PO)
            • Patients who have an aortic aneurysm or are at risk for an aortic aneurysm (eg, patients with peripheral atherosclerotic vascular diseases, hypertension, certain genetic conditions [eg, Marfan syndrome, Ehlers-Danlos syndrome], elderly patients)
            • Prescribe antimicrobials#fluoroquinolones to these patients only when no other treatment options are available
            • Advise patients to seek immediate medical treatment for any symptoms associated with aortic aneurysm
            • Stop 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 antimicrobials#fluoroquinolones are disturbances in attention, disorientation, agitation, nervousness, memory impairment, and delirium
            • Inform patients of the potential risk of psychiatric adverse reactions that can occur after just 1 dose
            • Immediately discontinue treatment if CNS adverse effects occur, including psychiatric adverse reactions, or blood glucose disturbances occur and switch to a nonfluoroquinolone antibiotic if possible
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            Pregnancy & Lactation

            Pregnancy 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
            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 oral
            -
            400 mg tablet
            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
            Ocuflox ophthalmic (eye)
            -
            0.3 % drops

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Select a drug:
            Patient Education
            ofloxacin otic (ear)

            OFLOXACIN SOLUTION - OTIC

            (oh-FLOX-a-sin)

            COMMON BRAND NAME(S): Floxin

            USES: Ofloxacin is used to treat outer ear infections (swimmer's ear or ear canal infections) and middle ear infections. It works by stopping the growth of bacteria. This medication belongs to a class of drugs called quinolone antibiotics.This medication treats only bacterial ear infections. It will not work for other types of ear infections. Unnecessary use or overuse of any antibiotic can lead to its decreased effectiveness.

            HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start using ofloxacin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.For accuracy and to avoid contamination, have another person give the drops if possible. Hold the container in your hand for a few minutes to warm it. This will minimize dizziness.To apply ear drops, wash your hands first. To avoid contamination, do not touch the dropper tip or let it touch your ear or any other surface.Lie on your side or tilt the affected ear upward. Place the dropper directly over your ear and administer the prescribed number of drops. If you are using the single-use containers, empty the contents of the prescribed number of containers into your ear. For outer ear infections, to help the drops roll into the ear, adults should hold the earlobe up and back. In children, hold the earlobe down and back. For middle ear infections, gently press down several times on the cartilage that partially covers your ear opening to allow the drops to enter your middle ear (see Patient Information Leaflet).Keep your head tilted for about 5 minutes, or insert a soft cotton plug if so directed. Repeat the above steps for your other ear if so directed.Do not rinse the dropper. Replace the dropper cap on the bottle after each use. If you are using the single-dose containers, discard any unused solution after each application. Do not reuse.Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day. Continue using it for the full time prescribed, even if symptoms disappear after a few days. Stopping this medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection.Inform your doctor if your condition does not improve in 1 week. Report any ear discharge that occurs after the treatment period is completed.Do not use in the eye.

            SIDE EFFECTS: Mild irritation/discomfort in the ear, dizziness, headache, earache, or changes in taste 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: tingling/numbness, hearing changes.Use of this medication for prolonged or repeated periods may result in a new fungal ear infection. Do not use it for longer than prescribed. Contact your doctor if you notice new or worsening 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: Before using 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 (such as preservatives like benzalkonium chloride), 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: other ear problems, two or more ear infections within 6 months.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).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. However, it is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: 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.

            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. This medicine may be harmful if swallowed.

            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.It is important to keep the infected ear(s) clean and dry. Try not to get the infected ear(s) wet when bathing. Avoid swimming unless your doctor tells you otherwise.

            MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

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

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

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

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            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
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.