Dexamethasone-Moxifloxacin (dexamethasone sod ph/moxifloxacin HCl in NaCl,iso-osmotic/PF)

Dosage of moxifloxacin hydrochloride is expressed in terms of moxifloxacin.

Dosage of oral and IV moxifloxacin is identical.

When IV moxifloxacin is used initially, therapy may be changed to oral moxifloxacin (when appropriate) using the same dosage to complete therapy.

The route of administration and dosage of dexamethasone and its derivatives depend on the condition being treated and the response of the patient. IM or IV therapy is generally reserved for patients who are not able to take the drugs orally or for use in an emergency situation. Dosage for infants and children should be based on the severity of the disease and the response of the patient rather than on strict adherence to dosage indicated by age, body weight, or body surface area. After a satisfactory response is obtained, dosage should be decreased in small decrements to the lowest level that maintains an adequate clinical response, and the drug should be discontinued as soon as possible. Patients should be continually monitored for signs that indicate dosage adjustment is necessary, such as remissions or exacerbations of the disease and stress (surgery, infection, trauma). Following long-term therapy, dexamethasone should be withdrawn gradually. (See the Corticosteroids General Statement 68:04.)

Moxifloxacin hydrochloride is administered orally or by IV infusion. The drug should not be given IM, subcutaneously, intrathecally, or intraperitoneally.

IV administration of moxifloxacin is indicated in patients who do not tolerate or are unable to take the drug orally and in other patients in whom the IV route offers a clinical advantage.

Patients receiving oral or IV moxifloxacin should be well hydrated and instructed to drink fluids liberally.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

Moxifloxacin is contraindicated in patients with a history of hypersensitivity to moxifloxacin or other quinolones.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

• No disease contraindications

Adverse effects occurring in 3% or more of patients receiving moxifloxacin include nausea (7%), diarrhea (6%), headache (4%), and dizziness (3%).

More Frequent

• Conjunctivitis
• Keratitis
• Ocular itching
• Ocular pain
• Reduced visual acuity
• Subconjunctival hemorrhage

Less Frequent

• Conjunctival hyperemia

Rare or Very Rare

• Acute bacterial otitis media
• Fever
• Hypersensitivity drug reaction
• Infection

More Frequent

• Dry eye
• Eye tearing

Less Frequent

• Ocular discomfort

Rare or Very Rare

• Cough
• Pharyngitis
• Rhinitis
• Skin rash

No enhanced messaging available.

Efficacy of moxifloxacin has not been established for any indication in pediatric patients younger than 18 years of age.

Limited data available from a clinical study in pediatric patients 3 months of age or older indicate that the overall safety profile of moxifloxacin in pediatric patients is comparable to that reported in adults. The most frequently reported adverse effects in pediatric patients were QT interval prolongation, vomiting, diarrhea, arthralgia, and phlebitis.

Fluoroquinolones, including moxifloxacin, cause arthropathy in juvenile animals. (See Musculoskeletal Effects under Warnings/Precautions: Warnings, in Cautions.)

The American Academy of Pediatrics (AAP) states that use of a systemic fluoroquinolone may be justified in children younger than 18 years of age in certain specific circumstances when there are no safe and effective alternatives and the drug is known to be effective. For information regarding when fluoroquinolones may be a preferred option in children, see Cautions: Pediatric Precautions in Ciprofloxacin 8:12.18.

Human data for moxifloxacin are insufficient to inform any drug-associated risk regarding use of the drug during pregnancy.

Based on animal studies, moxifloxacin may cause fetal harm. Although moxifloxacin was not teratogenic when administered to pregnant rats, rabbits, and monkeys at exposures up to 2.5 times higher than human exposures reported with the usual dosage of the drug, embryofetal toxicity (e.g., decreased neonatal body weights, increased incidence of skeletal variations (rib and vertebra combined), increased fetal loss) was observed when moxifloxacin was administered to pregnant rats or rabbits at dosages associated with maternal toxicity.

Pregnant women should be advised of the potential risk to the fetus.

It is not known whether moxifloxacin is distributed into human milk; the drug is distributed into milk in rats.

The developmental and health benefits of breast-feeding should be considered along with the mother's clinical need for moxifloxacin and potential adverse effects on the breast-fed infant from the drug or from the underlying maternal condition.

Adjustment of moxifloxacin dosage based solely on age is not necessary in geriatric patients 65 years of age and older.

Approximately 23 or 42% of patients were 65 years of age or older and 9 or 23% of patients were 75 years of age or older in clinical studies of oral or IV moxifloxacin, respectively. No overall differences in safety or efficacy were observed between geriatric individuals and younger adults.

The risk of developing severe tendon disorders, including tendon rupture, is increased in older adults (usually those older than 60 years of age). This risk is further increased in those receiving concomitant corticosteroids. (See Tendinitis and Tendon Rupture under Warnings/Precautions: Warnings, in Cautions.) Caution is advised if moxifloxacin is used in geriatric adults, especially those receiving concomitant corticosteroids.

The risk of QT interval prolongation may be increased in geriatric patients. Concomitant use of moxifloxacin and class IA (e.g., quinidine, procainamide) or class III (e.g., amiodarone, sotalol) antiarrhythmic agents and use in patients with risk factors for torsades de pointes (e.g., known QT prolongation, uncorrected hypokalemia) should be avoided. (See Prolongation of QT Interval under Warnings/Precautions: Warnings, in Cautions.)

The risk of aortic aneurysm and dissection may be increased in geriatric patients. (See Risk of Aortic Aneurysm and Dissection under Warnings/Precautions: Other Warnings/Precautions, in Cautions.)