Moxifloxacin

Moxifloxacin Brand Names

Avelox | Avelox ABC Pack | Avelox I.V. | MOXEZA | Vigamox

What is Moxifloxacin

Moxifloxacin is an ophthalmic, oral, and intravenous broad-spectrum anti-infective agent. It belongs to a group known as 8-methoxy fluoroquinolones and is effective against both gram-positive and gram negative bacteria.

Compared to other fluoroquinolones, moxifloxacin and other 8-methoxyfluoroquinolones (e.g., gatifloxacin) have markedly improved activity against penicillin-susceptible and -resistant pneumococci but slightly less activity against pseudomonal species and Enterobacteriaceae.

The spectrum of activity of moxifloxacin is similar to that of trovafloxacin.

Disabling and potentially irreversible serious adverse reactions associated with quinolones include tendinitis, tendon rupture, peripheral neuropathy, and central nervous system effects.

Other significant adverse events include potential QT prolongation and myasthenia gravis exacerbation. Systemic moxifloxacin is FDA-approved for the treatment of community-acquired pneumonia, skin and skin structure infections, complicated intra-abdominal infections, and plague.

Moxifloxacin is also FDA-approved for acute sinusitis and acute exacerbation of chronic bronchitis; however, due to the potential for serious adverse events, quinolones should only be used for these infection types when alternative treatment options cannot be used.

Systemic moxifloxacin was FDA-approved in December 1999; the first ophthalmic formulation was FDA-approved in April 2003.

Indications

1. Acinetobacter baumannii
2. Acinetobacter calcoaceticus
3. Acinetobacter lwoffii
4. anthrax
5. anthrax prophylaxis
6. Bacillus anthracis
7. bacterial conjunctivitis
8. Bacteroides fragilis
9. Bacteroides thetaiotaomicron
10. bronchitis
11. campylobacteriosis
12. Chlamydia trachomatis
13. chlamydial conjunctivitis
14. Chlamydophila pneumoniae
15. Citrobacter freundii
16. Citrobacter koseri
17. Clostridium perfringens
18. community-acquired pneumonia
19. Corynebacterium sp.
20. Enterobacter cloacae
21. Enterococcus faecalis
22. Escherichia coli
23. Fusobacterium sp.
24. gastroenteritis
25. Haemophilus influenzae (beta-lactamase negative)
26. Haemophilus influenzae (beta-lactamase positive)
27. Haemophilus parainfluenzae
28. infectious diarrhea
29. intraabdominal infections
30. Klebsiella aerogenes
31. Klebsiella oxytoca
32. Klebsiella pneumoniae
33. Legionella pneumophila
34. Listeria monocytogenes
35. Micrococcus luteus
36. Moraxella catarrhalis
37. Morganella morganii
38. Mycobacterium avium
39. Mycobacterium avium complex infection
40. Mycobacterium marinum
41. Mycoplasma pneumoniae
42. Neisseria gonorrhoeae
43. non-gonococcal urethritis (NGU)
44. pelvic inflammatory disease (PID)
45. Peptostreptococcus sp.
46. plague
47. plague prophylaxis
48. Prevotella sp.
49. Propionibacterium acnes
50. Proteus mirabilis
51. Proteus vulgaris
52. Pseudomonas stutzeri
53. salmonellosis
54. shigellosis
55. sinusitis
56. skin and skin structure infections
57. Staphylococcus aureus (MSSA)
58. Staphylococcus epidermidis
59. Staphylococcus haemolyticus
60. Staphylococcus hominis
61. Staphylococcus saprophyticus
62. Staphylococcus warneri
63. Streptococcus agalactiae (group B streptococci)
64. Streptococcus anginosus
65. Streptococcus constellatus
66. Streptococcus mitis
67. Streptococcus pneumoniae
68. Streptococcus pyogenes (group A beta-hemolytic streptococci)
69. Streptococcus sp.
70. surgical infection prophylaxis
71. tuberculosis infection
72. Viridans streptococci
73. Yersinia pestis

Side Effects

1. abdominal pain
2. agitation
3. agranulocytosis
4. anaphylactic shock
5. anaphylactoid reactions
6. anemia
7. angina
8. angioedema
9. anorexia
10. anxiety
11. aortic dissection
12. aplastic anemia
13. arthralgia
14. arthropathy
15. asthenia
16. atrial fibrillation
17. back pain
18. blurred vision
19. bradycardia
20. bronchospasm
21. candidiasis
22. cardiac arrest
23. chest pain (unspecified)
24. chills
25. coagulopathy
26. coma
27. confusion
28. conjunctivitis
29. constipation
30. cough
31. dehydration
32. delirium
33. depression
34. diarrhea
35. dizziness
36. drowsiness
37. dysesthesia
38. dysgeusia
39. dyspepsia
40. dyspnea
41. dysuria
42. edema
43. elevated hepatic enzymes
44. eosinophilia
45. erythema
46. fatigue
47. fever
48. flatulence
49. gastritis
50. gastroesophageal reflux
51. hallucinations
52. headache
53. hearing loss
54. heart failure
55. hemolytic anemia
56. hepatic failure
57. hepatic necrosis
58. hepatitis
59. hyperamylasemia
60. hyperemia
61. hyperglycemia
62. hyperhidrosis
63. hyperlipidemia
64. hypertension
65. hyperuricemia
66. hypoesthesia
67. hypoglycemia
68. hypokalemia
69. hypotension
70. increased intracranial pressure
71. infection
72. insomnia
73. interstitial nephritis
74. jaundice
75. keratitis
76. lacrimation
77. laryngeal edema
78. lethargy
79. leukocytosis
80. leukopenia
81. malaise
82. memory impairment
83. musculoskeletal pain
84. myasthenia gravis
85. nausea
86. neurotoxicity
87. neutropenia
88. night sweats
89. nightmares
90. ocular hemorrhage
91. ocular irritation
92. ocular pain
93. ocular pruritus
94. palpitations
95. pancytopenia
96. paranoia
97. paresthesias
98. peripheral neuropathy
99. pharyngitis
100. phlebitis
101. photosensitivity
102. pneumonitis
103. pruritus
104. pseudomembranous colitis
105. pseudotumor cerebri
106. psychosis
107. QT prolongation
108. rash
109. renal failure (unspecified)
110. restlessness
111. rhinitis
112. seizures
113. serum sickness
114. sinus tachycardia
115. Stevens-Johnson syndrome
116. suicidal ideation
117. syncope
118. tendinitis
119. tendon rupture
120. thrombocytopenia
121. thrombocytosis
122. thrombotic thrombocytopenic purpura (TTP)
123. tinnitus
124. torsade de pointes
125. toxic epidermal necrolysis
126. tremor
127. urticaria
128. vasculitis
129. ventricular tachycardia
130. vertigo
131. visual impairment
132. vomiting
133. weakness
134. wheezing
135. xerophthalmia
136. xerostomia

Monitoring Parameters

• LFTs
• serum creatinine/BUN

Contraindications

• aneurysm
• aortic dissection
• apheresis
• arteriosclerosis
• atrial fibrillation
• AV block
• bradycardia
• breast-feeding
• cardiomyopathy
• celiac disease
• cerebrovascular disease
• children
• colitis
• contact lenses
• corticosteroid therapy
• diabetes mellitus
• diarrhea
• driving or operating machinery
• females
• fever
• geriatric
• GI disease
• heart failure
• hepatic disease
• hepatitis
• hepatotoxicity
• human immunodeficiency virus (HIV) infection
• hyperparathyroidism
• hypertension
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hypothermia
• hypothyroidism
• infants
• inflammatory bowel disease
• jaundice
• long QT syndrome
• myasthenia gravis
• myocardial infarction
• neonates
• neurotoxicity
• organ transplant
• peripheral neuropathy
• pheochromocytoma
• pregnancy
• pseudomembranous colitis
• psychiatric event
• QT prolongation
• quinolone hypersensitivity
• rheumatoid arthritis
• seizure disorder
• sexually transmitted disease
• sickle cell disease
• sleep deprivation
• sodium restriction
• stroke
• sunlight (UV) exposure
• systemic lupus erythematosus (SLE)
• tendinitis
• tendinopathy
• tendon pain
• tendon rupture
• torsade de pointes
• ulcerative colitis
• viral infection

Interactions

• Abarelix
• Acarbose
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetohexamide
• Aclidinium; Formoterol
• Albiglutide
• Albuterol
• Albuterol; Ipratropium
• Alfuzosin
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alpha-glucosidase Inhibitors
• Aluminum Hydroxide
• Aluminum Hydroxide; Magnesium Carbonate
• Aluminum Hydroxide; Magnesium Hydroxide
• Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
• Aluminum Hydroxide; Magnesium Trisilicate
• Amiodarone
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amlodipine; Celecoxib
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Anagrelide
• Apomorphine
• Arformoterol
• Aripiprazole
• Arsenic Trioxide
• Artemether; Lumefantrine
• Asenapine
• Atenolol
• Atenolol; Chlorthalidone
• Atomoxetine
• Azelastine; Fluticasone
• Azithromycin
• Beclomethasone
• Bedaquiline
• Bepridil
• Betamethasone
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Budesonide
• Budesonide; Formoterol
• Buprenorphine
• Buprenorphine; Naloxone
• Calcium
• Calcium Acetate
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Calcium Chloride
• Calcium Gluconate
• Calcium; Vitamin D
• Canagliflozin
• Canagliflozin; Metformin
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Celecoxib
• Ceritinib
• Chloroquine
• Chlorpheniramine; Pseudoephedrine
• Chlorpromazine
• Chlorpropamide
• Choline Salicylate; Magnesium Salicylate
• Chromium
• Ciclesonide
• Cisapride
• Citalopram
• Clarithromycin
• Class IA Antiarrhythmics
• Clindamycin; Tretinoin
• Clofazimine
• Clomipramine
• Clozapine
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• Corticosteroids
• Cortisone
• Crizotinib
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Dasatinib
• Deflazacort
• Degarelix
• Desipramine
• Deutetrabenazine
• Dexamethasone
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Diclofenac
• Diclofenac; Misoprostol
• Didanosine, ddI
• Dienogest; Estradiol valerate
• Diflunisal
• Dipeptidyl Peptidase-4 Inhibitors
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Disopyramide
• Dofetilide
• Dolasetron
• Dolutegravir; Rilpivirine
• Donepezil
• Donepezil; Memantine
• Doxepin
• Dronedarone
• Droperidol
• Drospirenone
• Drospirenone; Estradiol
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Dulaglutide
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elagolix; Estradiol; Norethindrone acetate
• Eliglustat
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Encorafenib
• Entrectinib
• Eribulin
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Escitalopram
• Esomeprazole; Naproxen
• Estradiol; Levonorgestrel
• Estradiol; Norethindrone
• Estradiol; Norgestimate
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
• Ethinyl Estradiol; Ethynodiol Diacetate
• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Etodolac
• Exenatide
• Ezogabine
• Famotidine; Ibuprofen
• Fenoprofen
• Fingolimod
• Flecainide
• Fluconazole
• Fludrocortisone
• Flunisolide
• Fluocinolone; Hydroquinone; Tretinoin
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluphenazine
• Flurbiprofen
• Fluticasone
• Fluticasone; Salmeterol
• Fluticasone; Umeclidinium; Vilanterol
• Fluticasone; Vilanterol
• Fluvoxamine
• Formoterol
• Formoterol; Mometasone
• Foscarnet
• Fostemsavir
• Gemtuzumab Ozogamicin
• Gilteritinib
• Glasdegib
• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Glycopyrrolate; Formoterol
• Goserelin
• Granisetron
• Halobetasol; Tazarotene
• Halofantrine
• Halogenated Anesthetics
• Haloperidol
• Hetastarch; Dextrose; Electrolytes
• Histrelin
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrocodone; Ibuprofen
• Hydrocortisone
• Hydroxychloroquine
• Hydroxyzine
• Ibuprofen
• Ibuprofen; Oxycodone
• Ibuprofen; Pseudoephedrine
• Ibutilide
• Iloperidone
• Imipramine
• Incretin Mimetics
• Indacaterol
• Indacaterol; Glycopyrrolate
• Indomethacin
• Inotuzumab Ozogamicin
• Insulin Aspart
• Insulin Aspart; Insulin Aspart Protamine
• Insulin Degludec
• Insulin Degludec; Liraglutide
• Insulin Detemir
• Insulin Glargine
• Insulin Glargine; Lixisenatide
• Insulin Glulisine
• Insulin Lispro
• Insulin Lispro; Insulin Lispro Protamine
• Insulin, Inhaled
• Insulins
• Iron
• Iron Salts
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isophane Insulin (NPH)
• Itraconazole
• Ivosidenib
• Ketoconazole
• Ketoprofen
• Ketorolac
• Lansoprazole; Naproxen
• Lanthanum Carbonate
• Lapatinib
• Lefamulin
• Lente Insulin
• Lenvatinib
• Leuprolide
• Leuprolide; Norethindrone
• Levalbuterol
• Levomethadyl
• Levonorgestrel
• Linagliptin
• Linagliptin; Metformin
• Liraglutide
• Lithium
• Lixisenatide
• Lofexidine
• Long-acting beta-agonists
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Macimorelin
• Magnesium
• Magnesium Citrate
• Magnesium Hydroxide
• Magnesium Salicylate
• Maprotiline
• Meclofenamate Sodium
• Mefenamic Acid
• Mefloquine
• Meglitinides
• Meloxicam
• Meperidine; Promethazine
• Mequinol; Tretinoin
• Mesoridazine
• Mestranol; Norethindrone
• Metaproterenol
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methadone
• Methylprednisolone
• Metronidazole
• Midostaurin
• Mifepristone
• Miglitol
• Mirtazapine
• Mometasone
• Nabumetone
• Naproxen
• Naproxen; Pseudoephedrine
• Naproxen; Sumatriptan
• Nateglinide
• Nilotinib
• Nonsteroidal antiinflammatory drugs
• Norethindrone
• Norfloxacin
• Norgestrel
• Nortriptyline
• Octreotide
• Olanzapine
• Olodaterol
• Ombitasvir; Paritaprevir; Ritonavir
• Ondansetron
• Oral Contraceptives
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Oxaprozin
• Ozanimod
• Paliperidone
• Pasireotide
• Pazopanib
• Pentamidine
• Perphenazine
• Perphenazine; Amitriptyline
• Phenylephrine; Promethazine
• Pimavanserin
• Pimozide
• Pioglitazone
• Pirbuterol
• Piroxicam
• Pitolisant
• Polycarbophil
• Polysaccharide-Iron Complex
• Porfimer
• Posaconazole
• Pramlintide
• Prednisolone
• Prednisone
• Primaquine
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Protriptyline
• Quetiapine
• Quinapril
• Quinidine
• Quinine
• Ranolazine
• Regular Insulin
• Regular Insulin; Isophane Insulin (NPH)
• Repaglinide
• Ribociclib
• Ribociclib; Letrozole
• Rifampin
• Rilpivirine
• Risperidone
• Ritonavir
• Rofecoxib
• Romidepsin
• Rosiglitazone
• Salmeterol
• Saquinavir
• Saxagliptin
• Segesterone Acetate; Ethinyl Estradiol
• Selpercatinib
• Semaglutide
• Sertraline
• Sevelamer
• SGLT2 Inhibitors
• Short-acting beta-agonists
• Simvastatin; Sitagliptin
• Siponimod
• Sitagliptin
• Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• Solifenacin
• Sorafenib
• Sotalol
• St. John’s Wort, Hypericum perforatum
• Sucralfate
• Sulfonylureas
• Sulindac
• Sunitinib
• Tacrolimus
• Tamoxifen
• Tazarotene
• Telavancin
• Telithromycin
• Terbutaline
• Tetrabenazine
• Thiazolidinediones
• Thioridazine
• Tiotropium; Olodaterol
• Tolazamide
• Tolbutamide
• Tolmetin
• Tolterodine
• Tolvaptan
• Toremifene
• Trazodone
• Tretinoin, ATRA
• Triamcinolone
• Triclabendazole
• Tricyclic antidepressants
• Trifluoperazine
• Trimipramine
• Triptorelin
• Ultralente Insulin
• Umeclidinium; Vilanterol
• Valdecoxib
• Vandetanib
• Vardenafil
• Vemurafenib
• Venlafaxine
• Verteporfin
• Voriconazole
• Vorinostat
• Warfarin
• Zinc
• Zinc Salts
• Ziprasidone