Avelox (moxifloxacin HCl)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Moxifloxacin is a fluoroquinolone anti-infective agent.
Moxifloxacin is a fluoroquinolone anti-infective agent. Like other commercially available fluoroquinolones, moxifloxacin contains a fluorine at the C-6 position of the quinolone nucleus. Moxifloxacin, like gatifloxacin (no longer commercially available in the US), contains an 8-methoxy group and has been termed an 8-methoxy fluoroquinolone.
The 8-methoxy and 7-diazabicyclo moieties on the quinolone nucleus of moxifloxacin appear to enhance activity against gram-positive bacteria and decrease selection of resistant mutants in gram-positive bacteria.
Like other fluoroquinolone anti-infectives, moxifloxacin inhibits DNA synthesis in susceptible organisms via inhibition of type II DNA topoisomerases (DNA gyrase, topoisomerase IV). In susceptible S. pneumoniae, moxifloxacin principally targets DNA gyrase.
Moxifloxacin is well absorbed following oral administration, and has an absolute bioavailability of approximately 90%. The drug has a mean serum elimination half-life of 11.5-15.6 or 8.2-15.4 hours following oral or IV administration, respectively, allowing once-daily dosing. Moxifloxacin is metabolized principally via sulfate and glucuronide conjugation; the drug is not metabolized by and does not appear to affect the cytochrome P-450 (CYP) enzyme system. (See Drug Interactions.)
USES: Moxifloxacin is used to treat a variety of bacterial infections. This medication belongs to a class of drugs called quinolone antibiotics. It works by stopping the growth of bacteria.
This antibiotic treats only bacterial infections. It will not work for virus infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.
Generic name: moxifloxacin HCl
Pronunciation: (mox-ih-FLOX-uh-sin)
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Avelox
Indications
The following indications are listed for Avelox:
- Acute Bacterial Sinusitis
- Acute Haemophilus Influenzae Bacterial Sinusitis
- Acute Moraxella Catarrhalis Bacterial Sinusitis
- Acute Streptococcus Pneumoniae Bacterial Sinusitis
- Bacterial Pneumonia
- Chlamydial Pneumonia
- Chronic Bronchitis With Bacterial Exacerbation
- Complicated Skin And Skin Structure E. Coli Infection
- Complicated Skin And Skin Structure Infection
- Complicated Skin And Skin Structure Staphylococcus Aureus Infection
- Haemophilus Influenzae Chronic Bronchitis
- Haemophilus Influenzae Pneumonia
- Haemophilus Parainfluenzae Chronic Bronchitis
- Intra-Abdominal Abscess
- Klebsiella Pneumonia
- Klebsiella Pneumoniae Chronic Bronchitis
- Moraxella Catarrhalis Chronic Bronchitis
- Moraxella Catarrhalis Pneumonia
- Mycoplasmal Pneumonia
- Peritonitis
- Plague
- Pneumococcal Pneumonia
- Postexposure Plague Prophylaxis
- Skin And Skin Structure Enterobacter Infection
- Skin And Skin Structure Infection
- Skin And Skin Structure Klebsiella Infection
- Skin And Skin Structure Streptococcus Pyogenes Infection
- Staphylococcal Pneumonia
- Staphylococcus Aureus Skin And Skin Structure Infection
- Staphylococcus Chronic Bronchitis
- Streptococcal Pneumonia
- Streptococcus Pneumoniae Chronic Bronchitis
Also known as: Abdominal Abscess, Acute Bacterial Exacerbation Of Chronic Bronchitis, Acute Sinusitis Due To B. Catarrhalis, Acute Sinusitis Due To Branhamella Catarrhalis, Acute Sinusitis Due To Diplococcus Pneumoniae, Acute Sinusitis Due To Fraenkel's Pneumococcus, Acute Sinusitis Due To Fraenkel's Pneumonococcus, Acute Sinusitis Due To H. Flu, Acute Sinusitis Due To H. Influenzae, Acute Sinusitis Due To Haemophilus Influenzae, Acute Sinusitis Due To Hemophilus Influenzae, Acute Sinusitis Due To Influenza Bacillus, Acute Sinusitis Due To M. Catarrhalis, Acute Sinusitis Due To Moraxella Catarrhalis, Acute Sinusitis Due To Neisseria Catarrhalis, Acute Sinusitis Due To Pfeiffer's Bacillus, Acute Sinusitis Due To Pneumococcus, Acute Sinusitis Due To Streptococcus Pneumoniae, Acute Sinusitis From Fraenkel-Weichselbaum Pneumococcus, Bacterial Exacerbation Of Chronic Bronchitis, Chronic Bronchitis Due To B. Catarrhalis, Chronic Bronchitis Due To Branhamella Catarrhalis, Chronic Bronchitis Due To Diplococcus Pneumoniae, Chronic Bronchitis Due To Fraenkel's Pneumococcus, Chronic Bronchitis Due To H. Flu, Chronic Bronchitis Due To H. Influenzae, Chronic Bronchitis Due To Haemophilus Influenzae, Chronic Bronchitis Due To Haemophilus Parainfluenzae, Chronic Bronchitis Due To Hemophilus Influenzae, Chronic Bronchitis Due To Hemophilus Parainfluenzae, Chronic Bronchitis Due To Influenza Bacillus, Chronic Bronchitis Due To Klebsiella Pneumoniae, Chronic Bronchitis Due To M. Catarrhalis, Chronic Bronchitis Due To Moraxella Catarrhalis, Chronic Bronchitis Due To Neisseria Catarrhalis, Chronic Bronchitis Due To Pfeiffer's Bacillus, Chronic Bronchitis Due To Pneumococcus, Chronic Bronchitis Due To Pneumonococcus, Chronic Bronchitis Due To Staphylococcus Species, Chronic Bronchitis Due To Streptococcus Pneumoniae, Complicated Bacterial Skin And Skin Structure Infection, Complicated E. Coli Skin And Skin Structure Infection, Complicated Skin And Skin Soft Tissue Infection, Complicated Skin And Skin Structure Bacterial Infection, Complicated Skin And Skin Structure Escherichia Coli Infection, Complicated Staphylococcus Aureus Skin And Skin Soft Tissue Infection, Eaton Agent Pneumonia, Fraenkel-Weichselbaum Pneumococcal Chronic Bronchitis, H. Flu Pneumonia, H. Influenzae Pneumonia, Hemophilus Influenzae Pneumonia, Infection Of Skin And/Or Subcutaneous Tissue, Infection Of The Lungs Due To Chlamydia, Influenza Bacillus Pneumonia, Pfeiffer's Bacillus Pneumonia, Pneumonia Due To B. Catarrhalis, Pneumonia Due To Branhamella Catarrhalis, Pneumonia Due To Haemophilus Influenzae, Pneumonia Due To Klebsiella Species, Pneumonia Due To Klebsiella Spp., Pneumonia Due To M. Catarrhalis, Pneumonia Due To Moraxella Catarrhalis, Pneumonia Due To Neisseria Catarrhalis, Pneumonia Due To Staphylococcus Species, Pneumonia Due To Staphylococcus Spp., Pneumonia Due To Streptococcus Pneumoniae, Pneumonia Due To Streptococcus Species, Pneumonia Due To Streptococcus Spp., Post Exposure Plague Prophylaxis, Post-Exposure Plague Prophylaxis, Primary Atypical Pneumonia, Skin & Skin Soft Tissue Streptococcus Pyogenes Infection, Skin And Skin Soft Tissue Enterobacter Infection, Skin And Skin Soft Tissue Infection Due To Aerobacter, Skin And Skin Soft Tissue Infection Due To Enterobacter, Skin And Skin Soft Tissue Infection Due To Klebsiella, Skin And Skin Soft Tissue Staphylococcus Aureus Infection, Skin And Soft Tissue Skin Infection.
Dosing
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.
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.
Drug interactions
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.
Contraindications
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.
There are no moderate contraindications for this drug.
Adverse reactions
Adverse effects occurring in 3% or more of patients receiving moxifloxacin include nausea (7%), diarrhea (6%), headache (4%), and dizziness (3%).
There are no severe adverse reactions for this drug.
There are no less severe adverse reactions for this drug.
Precautions
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.)
ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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