Moxifloxacin

Mechanism :

The bactericidal action of moxifloxacin results from inhibition of the enzymes topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.

Indication :

• Drug resistant tuberculosis
• Bacterial conjunctivitis

Contraindications :

Hypersensitivity, Prolonged QT interval, Hypokalemia, Myasthenia gravis.

Dosing :

Adverse Effect :

Phototoxicity, superinfection, Clostridium difficile associated diarrhea, seizures, toxic psychosis, depression, suicidal ideation, severe vasculitis, serum sickness, pneumonitis,

myelosuppression, blood dyscrasias, nephrotoxicity, hepatotoxicity, QT prolongation, torsades de pointes, peripheral neuropathy, tendon rupture, arthropathy (animal studies), myasthenia gravis exacerbation, nausea, diarrhea, headache, dizziness, vomiting, constipation.

Interaction :

Acenocoumarol: The quinolone antibiotic, moxifloxacin, may increase the anticoagulant effect of acenocoumarol.
Aluminium: Formation of non-absorbable complexes.
Amiodarone: Increased risk of cardiotoxicity and arrhythmias.
Anisindione: The quinolone antibiotic, moxifloxacin, may increase the anticoagulant effect of anisindione.
Artemether: Additive QTc-prolongation may occur. Concomitant therapy should be avoided.
Bepridil: Increased risk of cardiotoxicity and arrhythmias.
Bretylium: Increased risk of cardiotoxicity and arrhythmias.
Calcium: Formation of non-absorbable complexes.
Dicoumarol: The quinolone antibiotic, moxifloxacin may increase the anticoagulant effect of dicumarol.
Dihydroquinidine Barbiturate: Increased risk of cardiotoxicity and arrhythmias.
Disopyramide: Increased risk of cardiotoxicity and arrhythmias.
Erythromycin: Increased risk of cardiotoxicity and arrhythmias.
Iron: Formation of non-absorbable complexes.
Iron Dextran: Formation of non-absorbable complexes.
Josamycin: Increased risk of cardiotoxicity and arrhythmias.
Lumefantrine: Additive QTc-prolongation may occur. Concomitant therapy should be avoided.
Magnesium: Formation of non-absorbable complexes.
Magnesium Oxide: Formation of non-absorbable complexes.
Quinidine: Increased risk of cardiotoxicity and arrhythmias.
Quinidine barbiturate: Increased risk of cardiotoxicity and arrhythmias.
Quinupristin: This combination presents an increased risk of toxicity.
Sotalol: Increased risk of cardiotoxicity and arrhythmias.
Sucralfate: Formation of non-absorbable complexes.
Tacrolimus: Additive QTc-prolongation may occur increasing the risk of serious ventricular arrhythmias. Concomitant therapy should be used with caution .
Thiothixene: May cause additive QTc-prolonging effects. Increased risk of ventricular arrhythmias. Consider alternate therapy. Thorough risk:benefit assessment is required prior to co-administration.
Tizanidine: Moxifloxacin may decrease the metabolism and clearance of Tizanidine. Consider alternate therapy or use caution during co-administration.
Toremifene: Additive QTc-prolongation may occur, increasing the risk of serious ventricular arrhythmias. Consider alternate therapy. A thorough risk:benefit assessment is required prior to co-administration.
Trimipramine: Additive QTc-prolongation may occur, increasing the risk of serious ventricular arrhythmias. Concomitant therapy should be used with caution .
Voriconazole: Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Vorinostat: Additive QTc prolongation may occur. Consider alternate therapy or monitor for QTc prolongation as this can lead to Torsade de Pointes (TdP).
Warfarin: The quinolone antibiotic, moxifloxacin, may increase the anticoagulant effect of warfarin.
Zinc: Formation of non-absorbable complexes.
Ziprasidone: Additive QTc-prolonging effects may increase the risk of severe arrhythmias. Concomitant therapy is contraindicated.
Zuclopenthixol: Additive QTc prolongation may occur. Consider alternate therapy or use caution and monitor for QTc prolongation as this can lead to Torsade de Pointes.

Renal Dose :

Hepatic Dose :