Trovafloxacin and Alatrofloxacin

What is Trovafloxacin and Alatrofloxacin combination medicine

NOTE: This drug is discontinued in the US.

Trovafloxacin and its prodrug alatrofloxacin are fluoronaphthyridones related to fluoroquinolone antibiotics. ‘Trovafloxacin’ represents the active drug and is the generic name for the oral tablets. ‘Alatrofloxacin’ is the generic name of the L-alanyl-L-alanyl salt which is a prodrug that is administered intravenously. Trovafloxacin is active against a wide range of gram-positive and gram-negative bacteria. It is also highly effective against resistant organisms.

Plasma concentrations of trovafloxacin are similar after intravenous administration of alatrofloxacin or oral administration of trovafloxacin, therefore, no dosage adjustments are required when switching from intravenous to oral therapy.

Trovafloxacin is the first antibiotic to be approved for oral use as surgical prophylaxis. Trovafloxacin has no significant pharmacokinetic interactions with cimetidine, cyclosporine, digoxin, theophylline, or warfarin. Final FDA approval was granted December 20, 1997. Since February 1998, post-market surveillance has revealed 140 cases of hepatic damage, including 14 cases of hepatic failure, that are causally associated with trovafloxacin use.

Approximately 300,000 prescriptions have been dispensed monthly in the US. In June 1999, the FDA restricted the sale and usage of trovafloxacin to hospitals and long-term-care facilities.

Under the new regulations, trovafloxacin administration will be restricted to certain life- or limb- threatening infections for which the need for the antibiotic outweighs the potential risk of hepatic disease.

The course of trovafloxacin treatment should not exceed 14 days.

The manufacturer discontinued the distribution and marketing of the drug in subsequent years following the FDA restrictions.

Brand Name

Trovan

Indications

  1. Bacteroides fragilis
  2. Bacteroides ovatus
  3. Chlamydia trachomatis
  4. Chlamydophila pneumoniae
  5. Citrobacter freundii
  6. Clostridium perfringens
  7. community-acquired pneumonia
  8. diabetic foot ulcer
  9. endomyometritis
  10. Enterococcus faecalis
  11. Escherichia coli
  12. Gardnerella vaginalis
  13. gynecologic infections
  14. Haemophilus influenzae (beta-lactamase negative)
  15. Haemophilus influenzae (beta-lactamase positive)
  16. Haemophilus parainfluenzae
  17. intraabdominal infections
  18. Klebsiella aerogenes
  19. Klebsiella pneumoniae
  20. Legionella pneumophila
  21. Moraxella catarrhalis
  22. Morganella morganii
  23. Mycoplasma hominis
  24. Mycoplasma pneumoniae
  25. Neisseria gonorrhoeae
  26. nosocomial pneumonia
  27. Parabacteroides distasonis
  28. pelvic cellulitis
  29. Peptostreptococcus sp.
  30. pneumonia
  31. Prevotella sp.
  32. Proteus mirabilis
  33. Proteus vulgaris
  34. Pseudomonas aeruginosa
  35. skin and skin structure infections
  36. Staphylococcus aureus (MSSA)
  37. Staphylococcus epidermidis
  38. Streptococcus agalactiae (group B streptococci)
  39. Streptococcus pneumoniae
  40. Streptococcus pyogenes (group A beta-hemolytic streptococci)
  41. Ureaplasma urealyticum
  42. Viridans streptococci

Side Effects

  1. abdominal pain
  2. anaphylactic shock
  3. anemia
  4. angioedema
  5. anxiety
  6. aplastic anemia
  7. arthralgia
  8. bronchospasm
  9. confusion
  10. depression
  11. diarrhea
  12. dizziness
  13. dyspnea
  14. elevated hepatic enzymes
  15. erythema multiforme
  16. fever
  17. hallucinations
  18. headache
  19. hemolytic anemia
  20. hepatic failure
  21. hepatic necrosis
  22. hepatitis
  23. hepatotoxicity
  24. hypotension
  25. increased intracranial pressure
  26. injection site reaction
  27. insomnia
  28. interstitial nephritis
  29. jaundice
  30. leukopenia
  31. maculopapular rash
  32. myalgia
  33. nausea
  34. nightmares
  35. pancreatitis
  36. pancytopenia
  37. paranoia
  38. phlebitis
  39. photosensitivity
  40. pruritus
  41. pseudomembranous colitis
  42. psychosis
  43. restlessness
  44. seizures
  45. serum sickness
  46. Stevens-Johnson syndrome
  47. tendon rupture
  48. thrombocytopenia
  49. thrombotic thrombocytopenic purpura (TTP)
  50. toxic epidermal necrolysis
  51. tremor
  52. urticaria
  53. vaginitis
  54. vasculitis
  55. vomiting

Monitoring Parameters

  • LFTs

Contraindications

  • arteriosclerosis
  • breast-feeding
  • cerebrovascular disease
  • children
  • colitis
  • corticosteroid therapy
  • diarrhea
  • geriatric
  • GI disease
  • hepatic disease
  • hepatitis
  • hepatotoxicity
  • hypotension
  • infants
  • inflammatory bowel disease
  • jaundice
  • myasthenia gravis
  • neonates
  • organ transplant
  • pregnancy
  • pseudomembranous colitis
  • quinolone hypersensitivity
  • requires a specialized care setting
  • seizures
  • sexually transmitted disease
  • sunlight (UV) exposure
  • tendinitis
  • tendinopathy
  • tendon pain
  • tendon rupture
  • ulcerative colitis
  • viral infection

Interactions

  • Acetohexamide
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-glucosidase Inhibitors
  • Chlorpropamide
  • Dapagliflozin; Saxagliptin
  • Didanosine, ddI
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Enflurane
  • Ertugliflozin; Sitagliptin
  • Etomidate
  • food
  • Fospropofol
  • General anesthetics
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Halothane
  • Isoflurane
  • Ketamine
  • Linagliptin
  • Linagliptin; Metformin
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methohexital
  • Propofol
  • Saxagliptin
  • Sevoflurane
  • SGLT2 Inhibitors
  • Simvastatin; Sitagliptin
  • Sitagliptin
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Sulfonylureas
  • Thiopental
  • Tolazamide
  • Tolbutamide
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top