Moxifloxacin

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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
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  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Aluminum Hydroxide; Magnesium Trisilicate
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  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
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  • Budesonide
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  • Buprenorphine
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  • Calcium
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  • Lithium
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  • Loperamide; Simethicone
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