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
- Bacteroides fragilis
- Bacteroides ovatus
- Chlamydia trachomatis
- Chlamydophila pneumoniae
- Citrobacter freundii
- Clostridium perfringens
- community-acquired pneumonia
- diabetic foot ulcer
- endomyometritis
- Enterococcus faecalis
- Escherichia coli
- Gardnerella vaginalis
- gynecologic infections
- Haemophilus influenzae (beta-lactamase negative)
- Haemophilus influenzae (beta-lactamase positive)
- Haemophilus parainfluenzae
- intraabdominal infections
- Klebsiella aerogenes
- Klebsiella pneumoniae
- Legionella pneumophila
- Moraxella catarrhalis
- Morganella morganii
- Mycoplasma hominis
- Mycoplasma pneumoniae
- Neisseria gonorrhoeae
- nosocomial pneumonia
- Parabacteroides distasonis
- pelvic cellulitis
- Peptostreptococcus sp.
- pneumonia
- Prevotella sp.
- Proteus mirabilis
- Proteus vulgaris
- Pseudomonas aeruginosa
- skin and skin structure infections
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis
- Streptococcus agalactiae (group B streptococci)
- Streptococcus pneumoniae
- Streptococcus pyogenes (group A beta-hemolytic streptococci)
- Ureaplasma urealyticum
- Viridans streptococci
Side Effects
- abdominal pain
- anaphylactic shock
- anemia
- angioedema
- anxiety
- aplastic anemia
- arthralgia
- bronchospasm
- confusion
- depression
- diarrhea
- dizziness
- dyspnea
- elevated hepatic enzymes
- erythema multiforme
- fever
- hallucinations
- headache
- hemolytic anemia
- hepatic failure
- hepatic necrosis
- hepatitis
- hepatotoxicity
- hypotension
- increased intracranial pressure
- injection site reaction
- insomnia
- interstitial nephritis
- jaundice
- leukopenia
- maculopapular rash
- myalgia
- nausea
- nightmares
- pancreatitis
- pancytopenia
- paranoia
- phlebitis
- photosensitivity
- pruritus
- pseudomembranous colitis
- psychosis
- restlessness
- seizures
- serum sickness
- Stevens-Johnson syndrome
- tendon rupture
- thrombocytopenia
- thrombotic thrombocytopenic purpura (TTP)
- toxic epidermal necrolysis
- tremor
- urticaria
- vaginitis
- vasculitis
- 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
