Moxifloxacin Noridem Uses

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What is Moxifloxacin Noridem?

Moxifloxacin Noridem injection is used to treat bacterial infections in many different parts of the body.

Moxifloxacin Noridem belongs to the class of medicines known as quinolone antibiotics. It works by killing bacteria or preventing their growth. However, Moxifloxacin Noridem will not work for colds, flu, or other virus infections.

Moxifloxacin Noridem is to be given only by or under the direct supervision of your doctor.

Moxifloxacin Noridem indications

infoAn indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Moxifloxacin Noridem and I.V. are indicated for the treatment of adults ( ≥ 18 years of age) with infections caused by susceptible strains of the designated microorganisms in the conditions listed below. Acute Bacterial Sinusitis caused by Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis.

Acute Bacterial Exacerbation of Chronic Bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, methicillin-susceptible Staphylococcus aureus, or Moraxella catarrhalis.

Community Acquired Pneumonia caused by Streptococcus pneumoniae (including multi-drug resistant strains*), Haemophilus influenzae, Moraxella catarrhalis, methicillin-susceptible Staphylococcus aureus, Klebsiella pneumoniae, Mycoplasma pneumoniae, or Chlamydia pneumoniae.

* MDRSP, Multi-drug resistant Streptococcus pneumoniae includes isolates previously known as PRSP (Penicillin-resistant S. pneumoniae), and are strains resistant to two or more of the following antibiotics: penicillin (MIC ≥ 2 μg/mL), 2nd generation cephalosporins (e.g., cefuroxime), macrolides, tetracyclines, and trimethoprim/sulfamethoxazole.

Uncomplicated Skin and Skin Structure Infections caused by methicillin-susceptible Staphylococcus aureus or Streptococcus pyogenes.

Complicated Intra-Abdominal Infections including polymicrobial infections such as abscess caused by Escherichia coli, Bacteroides fragilis, Streptococcus anginosus, Streptococcus constellatus, Enterococcus faecalis, Proteus mirabilis, Clostridium perfringens, Bacteroides thetaiotaomicron, or Peptostreptococcus species.

Complicated Skin and Skin Structure Infections caused by methicillin-susceptible Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, or Enterobacter cloacae.

Appropriate culture and susceptibility tests should be performed before treatment in order to isolate and identify organisms causing infection and to determine their susceptibility to Moxifloxacin Noridem. Therapy with Moxifloxacin Noridem may be initiated before results of these tests are known; once results become available, appropriate therapy should be continued.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Moxifloxacin Noridem and other antibacterial drugs, Moxifloxacin Noridem 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 Noridem?

Use Moxifloxacin Noridem as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Moxifloxacin Noridem comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Moxifloxacin Noridem refilled.
  • Take Moxifloxacin Noridem by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Drink plenty of liquids while taking Moxifloxacin Noridem.
  • 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 Noridem. 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 Noridem from a certain food or product.
  • Take Moxifloxacin Noridem on a regular schedule to get the most benefit from it.
  • To clear up your infection completely, take Moxifloxacin Noridem 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 Noridem, 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 Noridem.

Uses of Moxifloxacin Noridem in details

infoThere are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Moxifloxacin Noridem is used to treat bacterial infections of the respiratory tract, infections of female upper genital tract, abdominal infections and infections of skin and eye.

Moxifloxacin Noridem description

Each tablet contains Moxifloxacin Noridem HCl 436.8 mg equivalent to Moxifloxacin Noridem 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 Noridem HCl 436.8 mg equivalent to Moxifloxacin Noridem 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.

Moxifloxacin Noridem dosage

DOSAGE AND ADMINISTRATION

The dose of Moxifloxacin Noridem 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 below.

For Complicated Intra-Abdominal Infections, therapy should usually be initiated with the intravenous formulation.

When switching from intravenous to oral dosage administration, no dosage adjustment is necessary. Patients whose therapy is started with Moxifloxacin Noridem I.V. may be switched to Moxifloxacin Noridem Tablets when clinically indicated at the discretion of the physician.

Oral doses of Moxifloxacin Noridem should be administered at least 4 hours before or 8 hours after antacids containing magnesium or aluminum, as well as sucralfate, metal cations such as iron, and multivitamin preparations with zinc, or VIDEX® (didanosine) chewable/buffered tablets or the pediatric powder for oral solution.

Impaired Renal Function

No dosage adjustment is required in renally impaired patients, including those on either hemodialysis or continuous ambulatory peritoneal dialysis.

Impaired Hepatic Function

No dosage adjustment is recommended for mild, moderate, or severe hepatic insufficiency (Child-Pugh Classes A, B, or C).

Moxifloxacin Noridem I.V. should be administered by INTRAVENOUS infusion only. It is not intended for intra-arterial, intramuscular, intrathecal, intraperitoneal, or subcutaneous administration.

Moxifloxacin Noridem I.V. should be administered 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. CAUTION: RAPID OR BOLUS INTRAVENOUS INFUSION MUST BE AVOIDED.

Since only limited data are available on the compatibility of Moxifloxacin Noridem intravenous injection with other intravenous substances, additives or other medications should not be added to Moxifloxacin Noridem I.V. 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 Noridem I.V. with an infusion solution compatible with Moxifloxacin Noridem I.V. as well as with other drug(s) administered via this common line.

Preparation for administration of Moxifloxacin Noridem I.V. injection premix in flexible containers:

  1. Close flow control clamp of administration set.
  2. Remove cover from port at bottom of container.
  3. Insert piercing pin from an appropriate transfer set (e.g. one that does not require excessive force, such as ISO compatible administration set) into port with a gentle twisting motion until pin is firmly seated.

NOTE: Refer to complete directions that have been provided with the administration set.

Moxifloxacin Noridem interactions

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Tablet: For the following substances, absence of a clinically relevant interaction with Moxifloxacin Noridem 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 Noridem with antacids, minerals and multivitamins may result in impaired absorption of Moxifloxacin Noridem 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 Noridem dose.

Ranitidine: The concomitant administration with ranitidine did not change the absorption characteristics of Moxifloxacin Noridem. Absorption parameters (Cmax, tmax, AUC) were comparable, indicating absence of an influence of gastric pH on Moxifloxacin Noridem 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 Noridem is considered as clinically not relevant.

Theophylline: In accordance with in vitro data, no influence of Moxifloxacin Noridem on theophylline pharmacokinetics (and vice versa) at steady state was detected in humans, indicating that Moxifloxacin Noridem 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 Noridem. The infectious disease (and its accompanying inflammatory process), age and general status of the patient are risk factors. Although an interaction between Moxifloxacin Noridem 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 Noridem with oral contraceptives.

Antidiabetics: No clinically relevant interaction was seen between glibenclamide and Moxifloxacin Noridem.

Itraconazole: Exposure (AUC) to itraconazole was only marginally altered under concomitant Moxifloxacin Noridem treatment. Pharmacokinetics of Moxifloxacin Noridem were not significantly altered by itraconazole. No dose adjustment is necessary for itraconazole when given with Moxifloxacin Noridem and vice versa.

Digoxin: The pharmacokinetics of digoxin are not significantly influenced by Moxifloxacin Noridem (and vice versa). After repeated dosing in healthy volunteers, Moxifloxacin Noridem increased Cmax of digoxin by approximately 30% at steady state without affecting AUC or trough levels.

Morphine:

Parenteral administration of morphine with Moxifloxacin Noridem did not reduce the oral bioavailability of Moxifloxacin Noridem and only slighlty decreased Cmax (17 %).

Atenolol: The pharmacokinetics of atenolol are not significantly altered by Moxifloxacin Noridem. 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 Noridem was found in a clinical study investigating the impact of probenecid on renal excretion.

Charcoal: Concomitant dosing of charcoal and oral Moxifloxacin Noridem 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 Noridem was not altered by food intake (including dairy products). Moxifloxacin Noridem can be taken independent from food intake.

Infusion: No interaction during concomitant treatment with warfarin, itraconazole, theophylline, digoxin and oral contraceptives.

Moxifloxacin Noridem side effects

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Applies to Moxifloxacin Noridem ophthalmic: ophthalmic solution

In addition to its needed effects, some unwanted effects may be caused by Moxifloxacin Noridem ophthalmic (the active ingredient contained in Moxifloxacin Noridem). 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 Noridem ophthalmic:

Incidence not known:

  • Fainting or loss of consciousness
  • fast or irregular breathing
  • itching
  • 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 Noridem 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:

More common:

  • 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
  • tearing
Less common:
  • Body aches or pain
  • congestion
  • 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
  • rash
  • 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)

Moxifloxacin Noridem contraindications

Hypersensitivity to other quinolones, Moxifloxacin Noridem or any of the excipients of Moxifloxacin Noridem.

Use in pregnancy: The safe use of Moxifloxacin Noridem in human pregnancy has not been established. Reversible joint injuries are described in children receiving some quinolones. However, this effect has not been reported as occurring on exposed foetuses. Animal studies have shown reproductive toxicity. The potential risk for humans is unknown.

Consequently, the use of Moxifloxacin Noridem during pregnancy is contraindicated.

Use in lactation: As with other quinolones, Moxifloxacin Noridem has been shown to cause lesions in the cartilage of the weight bearing joints of immature animals. Preclinical evidence indicates that small amounts of Moxifloxacin Noridem may be secreted in human milk. There is no data available in lactating or nursing women. Therefore, the use of Moxifloxacin Noridem in nursing mothers is contraindicated.

Use in children: Safety and efficacy of Moxifloxacin Noridem in children and adolescents have not been established.



Active ingredient matches for Moxifloxacin Noridem:

Moxifloxacin in Poland.


List of Moxifloxacin Noridem substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
MOXIFORD EYE DROP 1 packet / 5 ML eye drop each (Leeford Healthcare Ltd)$ 1.05
Moxiford 400mg Tablet (Leeford Healthcare Ltd)$ 0.62
Moxifresh NA Eye Drop (Smart Laboratories Pvt Ltd)$ 0.30
MOXIGEN EYE DROP 1 packet / 5 ML eye drop each (Renova Life sciences Pvt Ltd)$ 1.13
Moxigen 0.5% w/v Eye Drop (Renova Life sciences Pvt Ltd)$ 1.13
MOXIGOOD 400 MG TABLET 1 strip / 5 tablets each (Cadila Pharmaceuticals Ltd)$ 1.75
Moxigood 400mg Tablet (Cadila Pharmaceuticals Ltd)$ 0.35
Moxigood 400mg Injection (Cadila Pharmaceuticals Ltd)$ 0.03
Moxigram 0.5% EYE-DPS / 5ml (Micro Vision)$ 1.16
0.5 % x 5ml (Micro Vision)$ 1.16
MOXIGRAM 400 MG TABLET 1 strip / 5 tablets each (Micro Vision)$ 1.84
MOXIGRAM D EYE DROP 1 packet / 10 ML eye drop each (Micro Vision)$ 1.71

References

  1. PubChem. "moxifloxacin". https://pubchem.ncbi.nlm.nih.gov/compoun... (accessed September 18, 2017).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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