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What is Moxifloxacin?
Moxifloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic that fights bacteria in the body.
Moxifloxacin ophthalmic (for use in the eyes) is used to treat bacterial infections of the eyes.
Moxifloxacin will not treat a viral or fungal infection of the eye. This medicine is for use in treating only bacterial infections.
Moxifloxacin ophthalmic may also be used for purposes not listed in this medication guide.
Community Acquired Pneumonia
Moxifloxacin is indicated in adult patients for the treatment of Community Acquired Pneumonia caused by susceptible isolates of Streptococcus pneumoniae (including multi-drug resistant Streptococcus pneumoniae [MDRSP]), Haemophilus influenzae, Moraxella catarrhalis, methicillin-susceptible Staphylococcus aureus, Klebsiella pneumoniae, Mycoplasma pneumoniae, or Chlamydophila pneumonia .
MDRSP isolates are isolates resistant to two or more of the following antibacterial drugs: penicillin (minimum inhibitory concentrations [MIC] ≥ 2 mcg/mL), 2nd generation cephalosporins (for example, cefuroxime), macrolides, tetracyclines, and trimethoprim/sulfamethoxazole.
Uncomplicated Skin And Skin Structure Infections
Moxifloxacin is indicated in adult patients for the treatment of Uncomplicated Skin and Skin Structure Infections caused by susceptible isolates of methicillin-susceptible Staphylococcus aureus or Streptococcus pyogenes.
Complicated Skin And Skin Structure Infections
Moxifloxacin is indicated in adult patients for the treatment of Complicated Skin and Skin Structure Infections caused by susceptible isolates of methicillin-susceptible Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, or Enterobacter cloacae.
Complicated Intra-Abdominal Infections
Moxifloxacin is indicated in adult patients for the treatment of Complicated Intra-Abdominal Infections including polymicrobial infections such as abscess caused by susceptible isolates of Escherichia coli, Bacteroides fragilis, Streptococcus anginosus, Streptococcus constellatus, Enterococcus faecalis, Proteus mirabilis, Clostridium perfringens, Bacteroides thetaiotaomicron, or Peptostreptococcus species.
Moxifloxacin is indicated in adult patients for the treatment of plague, including pneumonic and septicemic plague, due to susceptible isolates of Yersinia pestis and prophylaxis of plague in adult patients. Efficacy studies of Moxifloxacin could not be conducted in humans with plague for feasibility reasons. Therefore this indication is based on an efficacy study conducted in animals only.
Acute Bacterial Sinusitis
Moxifloxacin is indicated in adult patients (18 years of age and older) for the treatment of acute bacterial sinusitis (ABS) caused by susceptible isolates of Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis.
Because fluoroquinolones, including Moxifloxacin, have been associated with serious adverse reactions and for some patients ABS is self-limiting, reserve Moxifloxacin for treatment of ABS in patients who have no alternative treatment options.
Acute Bacterial Exacerbation Of Chronic Bronchitis
Moxifloxacin is indicated in adult patients for the treatment of Acute Bacterial Exacerbation of Chronic Bronchitis (ABECB) caused by susceptible isolates of Streptococcus pneumoniae, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, methicillin-susceptible Staphylococcus aureus, or Moraxella catarrhalis.
Because fluoroquinolones, including Moxifloxacin, have been associated with serious adverse reactions and for some patients ABECB is self-limiting, reserve Moxifloxacin for treatment of ABECB in patients who have no alternative treatment options.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Moxifloxacin and other antibacterial drugs, Moxifloxacin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
How should I use Moxifloxacin?
Use Moxifloxacin tablets as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Moxifloxacin tablets comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Moxifloxacin tablets refilled.
- Take Moxifloxacin tablets by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
- Drink plenty of liquids while taking Moxifloxacin tablets.
- Do not take a product that has magnesium, aluminum, calcium, zinc, iron, or sucralfate in it within 8 hours before or 4 hours after you take Moxifloxacin tablets. Examples of these products include antacids, multivitamins, chewable/buffered didanosine, didanosine suspension, and quinapril. Check with your doctor or pharmacist if you have a question about whether you should separate Moxifloxacin tablets from a certain food or product.
- Take Moxifloxacin tablets on a regular schedule to get the most benefit from it.
- To clear up your infection completely, take Moxifloxacin tablets for the full course of treatment. Keep taking it even if you feel better in a few days.
- If you miss a dose of Moxifloxacin tablets, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take more than 1 dose in the same day.
Ask your health care provider any questions you may have about how to use Moxifloxacin tablets.
Uses of Moxifloxacin in details
Moxifloxacin is used to treat bacterial infections of the respiratory tract, infections of female upper genital tract, abdominal infections and infections of skin and eye.
Each tablet contains Moxifloxacin HCl 436.8 mg equivalent to Moxifloxacin 400 mg. It also contains croscarmellose sodium, lactose monohydrate, magnesium stearate, microcrystalline cellulose, hypromellose, macrogol 4000, titanium dioxide (E171) and ferric oxide (E172) as inactive constituents.
Each 250 mL solution for infusion contain Moxifloxacin HCl 436.8 mg equivalent to Moxifloxacin 400 mg. It also contains sodium chloride, 1N hydrochloric acid, 2N sodium hydroxide and water for injection. The solution for infusion (250 mL) contains sodium 34 mmol.
Dosage In Adult Patients
The dose of Moxifloxacin is 400 mg (orally or as an intravenous infusion) once every 24 hours. The duration of therapy depends on the type of infection as described in Table 1.
Table 1: Dosage and Duration of Therapy in Adult Patients
|Type of InfectionDrug administration should begin as soon as possible after suspected or confirmed exposure to Yersinia pestis.|
Oral Dosing In Adults
Intravenous formulation is indicated when it offers a route of administration advantageous to the patient (for example, patient cannot tolerate an oral dosage form). When switching from intravenous to oral formulation, no dosage adjustment is necessary. Patients whose therapy is started with Moxifloxacin Injection may be switched to Moxifloxacin Tablets when clinically indicated at the discretion of the physician.
Important Administration Instructions
With Multivalent Cations
Administer Moxifloxacin Tablets at least 4 hours before or 8 hours after products containing magnesium, aluminum, iron or zinc, including antacids, sucralfate, multivitamins and didanosine buffered tablets for oral suspension or the pediatric powder for oral solution.
Moxifloxacin Tablets can be taken with or without food, drink fluids liberally.
Intravenous infusion only. It is not intended for intra-arterial, intramuscular, intrathecal, intraperitoneal, or subcutaneous administration.
Administer by intravenous infusion over a period of 60 minutes by direct infusion or through a Y-type intravenous infusion set which may already be in place. Avoid rapid or bolus intravenous infusion.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Discard any unused portion because the premix flexible containers are for single-use only.
Drug and Diluent Compatibilities
Because only limited data are available on the compatibility of Moxifloxacin intravenous injection with other intravenous substances, additives or other medications should not be added to Moxifloxacin Injection or infused simultaneously through the same intravenous line. If the same intravenous line or a Y-type line is used for sequential infusion of other drugs, or if the “piggyback” method of administration is used, the line should be flushed before and after infusion of Moxifloxacin Injection with an infusion solution compatible with Moxifloxacin Injection as well as with other drug(s) administered via this common line.
Intravenous Solutions:Moxifloxacin Injection is compatible with the following intravenous solutions at ratios from 1:10 to 10:1:
0.9% Sodium Chloride Injection, USP
1 Molar Sodium Chloride Injection
5% Dextrose Injection, USP
Sterile Water for Injection, USP
10% Dextrose for Injection, USP
Tablet: For the following substances, absence of a clinically relevant interaction with Moxifloxacin was proven: Atenolol, ranitidine, calcium supplements, theophylline, oral contraceptives, glibenclamide, itraconazole, digoxin, morphine, probenecid. No dose adjustment is necessary for these drugs.
Antacids, Minerals and Multivitamins: Concomitant ingestion of Moxifloxacin with antacids, minerals and multivitamins may result in impaired absorption of Moxifloxacin after oral administration due to formation of chelate complexes with the multivalent cations contained in these preparations. This may lead to plasma concentrations considerably lower than desired. Hence, antacids, antiretroviral drugs (eg, didanosine) and other preparations containing magnesium or aluminium, sucralfate and agents containing iron or zinc should be administered at least 4 hours before or 2 hours after ingestion of an oral Moxifloxacin dose.
Ranitidine: The concomitant administration with ranitidine did not change the absorption characteristics of Moxifloxacin. Absorption parameters (Cmax, tmax, AUC) were comparable, indicating absence of an influence of gastric pH on Moxifloxacin uptake from the gastrointestinal tract.
Calcium Supplements: When given with high dose calcium supplements, only a slightly reduced rate of absorption was observed, while extent of absorption remained unaffected. The effect of high-dose calcium supplements on the absorption of Moxifloxacin is considered as clinically not relevant.
Theophylline: In accordance with in vitro data, no influence of Moxifloxacin on theophylline pharmacokinetics (and vice versa) at steady state was detected in humans, indicating that Moxifloxacin does not interfere with the 1A2 subtypes of the CYP450 enzymes.
Warfarin: No interaction during concomitant treatment with warfarin on pharmacokinetics, prothrombin time and other coagulation parameters has been observed.
Changes in International Normalized Ratio (INR): Cases of increased anticoagulant activity have been reported in patients receiving anticoagulants concurrently with antibiotics, including Moxifloxacin. The infectious disease (and its accompanying inflammatory process), age and general status of the patient are risk factors. Although an interaction between Moxifloxacin and warfarin was not demonstrated in clinical trials, INR monitoring should be performed and, if necessary, the oral anticoagulant dosage should be adjusted as appropriate.
Oral Contraceptives:No interaction has occured following concomitant oral administration of Moxifloxacin with oral contraceptives.
Antidiabetics: No clinically relevant interaction was seen between glibenclamide and Moxifloxacin.
Itraconazole: Exposure (AUC) to itraconazole was only marginally altered under concomitant Moxifloxacin treatment. Pharmacokinetics of Moxifloxacin were not significantly altered by itraconazole. No dose adjustment is necessary for itraconazole when given with Moxifloxacin and vice versa.
Digoxin: The pharmacokinetics of digoxin are not significantly influenced by Moxifloxacin (and vice versa). After repeated dosing in healthy volunteers, Moxifloxacin increased Cmax of digoxin by approximately 30% at steady state without affecting AUC or trough levels.
Parenteral administration of morphine with Moxifloxacin did not reduce the oral bioavailability of Moxifloxacin and only slighlty decreased Cmax (17 %).
Atenolol: The pharmacokinetics of atenolol are not significantly altered by Moxifloxacin. Following single dose administration in healthy subjects, AUC was marginally increased (by approximately 4%) and peak concentrations were decreased by 10%.
Probenecid: No significant effect on apparent total body clearance and renal clearance of Moxifloxacin was found in a clinical study investigating the impact of probenecid on renal excretion.
Charcoal: Concomitant dosing of charcoal and oral Moxifloxacin 400 mg reduced the systemic availability of the drug by >80% by preventing absorption in vivo. The application of activated charcoal in the early absorption phase prevents further increase of systemic exposure in cases of overdose.
After IV drug administration, carbo medicinalis only slightly reduces systemic exposure (approximately 20%).
Food and Dairy Products: Absorption of Moxifloxacin was not altered by food intake (including dairy products). Moxifloxacin can be taken independent from food intake.
Infusion: No interaction during concomitant treatment with warfarin, itraconazole, theophylline, digoxin and oral contraceptives.
Moxifloxacin side effects
Applies to Moxifloxacin ophthalmic: ophthalmic solution
In addition to its needed effects, some unwanted effects may be caused by Moxifloxacin ophthalmic (the active ingredient contained in Moxifloxacin). In the event that any of these side effects do occur, they may require medical attention.
Major Side Effects
You should check with your doctor immediately if any of these side effects occur when taking Moxifloxacin ophthalmic:
Incidence not known:
- Fainting or loss of consciousness
- fast or irregular breathing
- skin rash
- swelling of the eyes or eyelids
- tightness in the chest or wheezing
- trouble with breathing
Minor Side Effects
Some of the side effects that can occur with Moxifloxacin ophthalmic may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:
- Burning, dry, or itching eyes
- change in vision
- decreased vision
- dry eye
- excessive tearing
- eye discharge
- itching of the eye
- pain in the eye
- red, sore eyes
- redness of the eye
- swelling of the eye, eyelid, or inner lining of the eyelid
- Body aches or pain
- cough or hoarseness
- decreased hearing
- dryness or soreness of the throat
- fever or chills
- general body discomfort
- lower back or side pain
- painful or difficult urination
- rubbing or pulling of the ears (in children)
- runny nose
- sore throat
- tender, swollen glands in the neck
- trouble with swallowing
- voice changes
- vomiting and diarrhea (in infants)
You should not use this medication if you have a history of myasthenia gravis, or if you are allergic to Moxifloxacin or similar antibiotics such as ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), ofloxacin (Floxin), norfloxacin (Noroxin), and others.
Before taking Moxifloxacin, tell your doctor if you have a heart rhythm disorder, kidney or liver disease, joint problems, a history of seizures, low levels of potassium in your blood (hypokalemia), muscle weakness or trouble breathing, a personal or family history of Long QT syndrome, or if you have ever had an allergic reaction to an antibiotic.
Avoid taking antacids, vitamin or mineral supplements, sucralfate (Carafate), or didanosine (Videx) powder or chewable tablets within 8 hours before or 4 hours after you take Moxifloxacin. These other medicines can make Moxifloxacin much less effective when taken at the same time.
Taking Moxifloxacin can make your skin more sensitive to sunlight. Avoid exposure to sunlight, sun lamps, or tanning beds.
Moxifloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles' tendon of the heel. These effects may be more likely to occur if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant. Stop taking Moxifloxacin and call your doctor at once if you have sudden pain, swelling, tenderness, stiffness, or movement problems in any of your joints. Rest the joint until you receive medical care or instructions.
Do not share this medication with another person (especially a child), even if they have the same symptoms you do.
Active ingredient matches for Moxifloxacin:
|Unit description / dosage (Manufacturer)||Price, USD|
|Tablet; Oral; Moxifloxacin Hydrochloride 400 mg|
|Solution; Ophthalmic; Moxifloxacin Hydrochloride 0.5%|
|Vigamox 0.5% Solution 3ml Bottle||$ 90.72|
|Vigamox 0.5% eye drops||$ 27.22|
|Avelox 400 mg tablet||$ 16.68|
|Avelox abc pack 400 mg tablet||$ 16.35|
|Avelox iv 400 mg/250 ml||$ 0.17|
|Tablets; Oral; Moxifloxacin Hydrochloride 400 mg|
|MOXIFLOXACIN 400MG TABLET 1 strip / 5 tablets each (Jan Aushadhi)||$ 1.46|
|Moxifloxacin injection, solution 400 mg/250mL (Fresenius Kabi USA, LLC (US))|
|Moxifloxacin tablet, film coated 400 mg/1 (Major Pharmaceuticals (US))|
List of Moxifloxacin substitutes (brand and generic names):
|Moxiflox (Egypt, Philippines)|
|Moxiflox NA Eye Drop (InnoGen Pharmaceuticals)||$ 1.39|
|Moxifloxacin - 1 A Pharma (Germany)|
|Moxifloxacin AbZ (Germany)|
|Moxifloxacin AL (Germany)|
|Moxifloxacin Apotex (Belgium)|
|Moxifloxacin Aurobindo (Germany)|
|Moxifloxacin Fresenius Kabi (Sweden)|
|Moxifloxacin Heumann (Germany)|
|Moxifloxacin HEXAL (Germany)|
|Moxifloxacin Kabi (Germany)|
|Moxifloxacin Krka (Denmark)|
|Moxifloxacin Noridem (Poland)|
|Moxifloxacin Rivopharm (Switzerland)|
|Moxifloxacin Sabaa (Egypt)|
|Moxifloxacin Sandoz (Switzerland)|
|Moxifloxacin Spirig HC (Switzerland)|
|Moxifloxacin STADA (Germany)|
|Moxifloxacin TAD (Germany)|
|Moxifloxacin Teva (Israel)|
|Moxifloxacin-1A Pharma (Germany)|
|Moxifloxacin-Actavis (Denmark, Germany, Switzerland)|
|Moxifloxacin-ratiopharm (Germany, Hungary)|
|Moxifloxacina Aurobindo (Portugal)|
|Moxifloxacina La Santé (Colombia, Costa Rica, Ecuador, Panama)|
|Moxifloxacina MK (Colombia)|
|Moxifloxacina Vesalius (Colombia)|
|Moxifloxacine Double-E Pharma (Netherlands)|
|Moxifloxacine EG (Belgium, France)|
|Moxifloxacine Fresenius Kabi (Netherlands)|
|Moxifloxacine Krka (France)|
|Moxifloxacine Mylan (Belgium)|
|Moxifloxacine PCH (Netherlands)|
|Moxifloxacine Sandoz (France, Netherlands)|
|Moxifloxacine Teva (Belgium, Netherlands)|
|Moxifloxacino Actavis (Spain)|
|Moxifloxacino Apotex (Spain)|
|Moxifloxacino Aurobindo (Spain)|
- PubChem. "moxifloxacin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "moxifloxacin". http://www.drugbank.ca/drugs/DB00218 (accessed September 17, 2018).
- MeSH. "Anti-Bacterial Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
ReviewsThe results of a survey conducted on ndrugs.com for Moxifloxacin are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Moxifloxacin. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.
Consumer reported usefulNo survey data has been collected yet
1 consumer reported price estimatesWas the price you paid to purchase the drug reasonable? Did you feel it was expensive?
The below mentioned numbers have been reported by ndrugs.com website users about whether the Moxifloxacin drug is expensive or inexpensive. There is a mixed opinion among users. The rating about the cost of the drug depends on factors like which brand drug the patient purchased, how effective it was for the price paid, the country or place the drug is marketed, and the economic condition of the patient. The users who feel the drug is expensive can look for an alternative brand drug or a generic drug to save the cost.
2 consumers reported time for resultsTo what extent do I have to use Moxifloxacin before I begin to see changes in my health conditions?
As part of the reports released by ndrugs.com website users, it takes 2 weeks and a few days before you notice an improvement in your health conditions.
Please note, it doesn't mean you will start to notice such health improvement in the same time frame as other users. There are many factors to consider, and we implore you to visit your doctor to know how long before you can see improvements in your health while taking Moxifloxacin. To get the time effectiveness of using Moxifloxacin drug by other patients, please click here.
9 consumers reported age
There are no reviews yet. Be the first to write one!
Information checked by Dr. Sachin Kumar, MD Pharmacology