Drospirenone; Estetrol: (Moderate) It would be prudent to recommend alternative or additional contraception when oral contraceptives (OCs) are used in conjunction with antibiotics. Consider taking steps to minimize the risk for QT/QTc interval prolongation and TdP, such as electrolyte monitoring and repletion and ECG monitoring, if concomitant use is necessary. Consider taking steps to minimize the risk for QT/QTc interval prolongation and TdP, such as electrolyte monitoring and repletion and ECG monitoring, if concomitant use is necessary. If you have diabetes, your doctor may ask you to check your blood sugar more often while taking moxifloxacin. Photo: Andreas Neumann. Avoid concomitant use if possible, especially in patients with additional risk factors for TdP. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. [61094] [65619]. Insulin Glargine; Lixisenatide: (Moderate) Monitor blood glucose during concomitant incretin mimetic and quinolone use. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. Do not wear contact lenses while you have any signs or symptoms of an eye infection. These authors concluded that because females most at risk for OC failure or noncompliance may not be easily identified and the true incidence of such events may be under-reported, and given the serious consequence of unwanted pregnancy, that recommending an additional method of contraception during short-term antibiotic use may be justified. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with donepezil include moxifloxacin. Quinolones have been associated with a risk of QT prolongation. Moxiflox Eye Drop is an antibiotic, used in the treatment of bacterial infections of the eye. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Hypoglycemia, sometimes resulting in coma, can occur. Medically reviewed by Drugs.com. Monotherapy can be considered for mild-to-moderate disease in patients with naturally occurring plague. Preferred therapies are ciprofloxacin or doxycycline. After 3 days of ritonavir 400 mg twice daily plus moxifloxacin (400 mg once daily), ritonavir exposure was approximately 1.5 times higher than exposure that has been observed with ritonavir 600 mg twice-daily alone. Prolongation of the QT interval has also been reported with moxifloxacin. Avoid concomitant use if possible, especially in patients with additional risk factors for TdP. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Because of this risk for serious and potentially permanent side effects, use quinolones for the treatment of acute bacterial exacerbation of chronic bronchitis or acute bacterial sinusitis only in cases where alternative treatment options cannot be used. What Are Warnings and Precautions for Moxifloxacin ophthalmic? Treat for 2 to 6 weeks for recurrent infections. Moxifloxacin has also been associated with prolongation of the QT interval. Use dual therapy with 2 distinct classes of antimicrobials for initial treatment in patients with severe disease and patients infected after intentional release of Y. pestis. Do not store for later use.- Do not refrigerate- Protect from freezing- Protect from light. The systemic exposure (AUC) and peak serum concentrations (Cmax) of moxifloxacin were reduced by 31% and 32%, respectively. Silent mutations and genetic polymorphisms in potassium channels may further increase the risk of QT prolongation in patients taking fluoroquinolones. Generic name: MOXIFLOXACIN HYDROCHLORIDE 5mg in 1mL. Moxifloxacin may also be used to treat bronchitis or sinus infections but should not be used for these conditions if there are other treatment options available. Take moxifloxacin exactly as directed. Examples of compounds that may interfere with quinolone bioavailability include multivitamins that contain iron. Fluoroquinolones Moxifloxacin Overview Moxifloxacin is used to treat certain infections such as pneumonia, bronchitis, and sinus, skin, and abdominal (stomach area) infections caused by bacteria. The likelihood of QT prolongation may increase with increasing concentrations of moxifloxacin, therefore the recommended dose or infusion rate should not be exceeded. Moxifloxacin absorption may be reduced as quinolone antibiotics can chelate with divalent or trivalent cations. Severe hepatotoxicity (including acute hepatitis and fatal events) has been reported in patients taking moxifloxacin and other quinolones. Ozanimod has not been studied in patients taking concurrent QT prolonging drugs; however, QT prolonging drugs have been associated with TdP in patients with bradycardia. Norgestrel: (Moderate) It would be prudent to recommend alternative or additional contraception when oral contraceptives (OCs) are used in conjunction with antibiotics. The likelihood of QT prolongation may increase with increasing concentrations of moxifloxacin, therefore the recommended dose or infusion rate should not be exceeded. These reports generally involved patients with concurrent medical conditions or concomitant medications that may have been contributory. [28423] [34362] [64669] Guidelines recommend moxifloxacin as monotherapy for hospitalized patients with nonsevere pneumonia and as part of combination therapy for hospitalized patients with severe pneumonia. During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances. Use dual therapy with 2 distinct classes of antimicrobials for initial treatment in patients with severe disease and patients infected after intentional release of Y. pestis. [28423], Instill topically in the affected eye(s).Do not touch the dropper tip to any surface to avoid contaminating the contents. For oral dosage form (tablets): For infections: Adults400 milligrams (mg) once every 24 hours. Disturbances of blood glucose, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with quinolones and an antidiabetic agent. It was previously thought that antibiotics may decrease the effectiveness of OCs containing estrogens due to stimulation of metabolism or a reduction in enterohepatic circulation via changes in GI flora. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. In addition, high fluid intake may increase lithium excretion. Hypoglycemia, sometimes resulting in coma, can occur. Lopinavir is associated with QT prolongation. Lopinavir; Ritonavir: (Major) Avoid coadministration of lopinavir with moxifloxacin due to the potential for additive QT prolongation. Amiodarone: (Major) Concomitant use of amiodarone and moxifloxacin increases the risk of QT/QTc prolongation and torsade de pointes (TdP). After 3 days of ritonavir 400 mg twice daily plus moxifloxacin (400 mg once daily), ritonavir exposure was approximately 1.5 times higher than exposure that has been observed with ritonavir 600 mg twice-daily alone. Monotherapy can be considered for mild-to-moderate disease in patients with naturally occurring plague. These reports generally involved patients with concurrent medical conditions or concomitant medications that may have been contributory. Polyethylene Glycol; Electrolytes; Ascorbic Acid: (Major) Administer quinolones at least 2 hours before or 6 hours after administration of magnesium sulfate; potassium sulfate; sodium sulfate. Additionally, post-marketing surveillance has identified very rare cases of ventricular arrhythmias including TdP, usually in patients with severe underlying proarrhythmic conditions. Cases of long QT syndrome and TdP tachycardia have been described with maprotiline use, but rarely occur when the drug is used alone in normal prescribed doses and in the absence of other known risk factors for QT prolongation. Additionally, post-marketing surveillance has identified very rare cases of ventricular arrhythmias including TdP, usually in patients with severe underlying proarrhythmic conditions. The majority of cases reported use of moxifloxacin after cataract surgery, but some case reports did not specify the type of ocular surgery. It is not yet clear if bismuth subsalicylate (Pepto-Bismol) can interfere with fluoroquinolone bioavailability. Disturbances of blood glucose, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with quinolones and an antidiabetic agent. It was previously thought that antibiotics may decrease the effectiveness of OCs containing estrogens due to stimulation of metabolism or a reduction in enterohepatic circulation via changes in GI flora. Moxifloxacin may cause other side effects. Separate multiple email address with a comma. During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances. There are no adequate and well-controlled studies of moxifloxacin use during human pregnancy. Moxifloxacin ophthalmic solution is for topical ophthalmic use. Relugolix; Estradiol; Norethindrone acetate: (Major) Avoid coadministration of moxifloxacin with relugolix as concurrent use may increase the risk of QT prolongation and torsade de pointes (TdP). Tell your doctor if you have ever had peripheral neuropathy (a type of nerve damage that causes tingling, numbness, and pain in the hands and feet). Moxifloxacin has also been associated with prolongation of the QT interval. Naproxen; Pseudoephedrine: (Moderate) Use quinolones and nonsteroidal anti-inflammatory drugs (NSAIDs) concomitantly with caution due to potential increased risk of CNS stimulation and convulsive seizures. If you still have symptoms of infection after you finish taking moxifloxacin, call your doctor. The systemic exposure (AUC) and peak serum concentrations (Cmax) of moxifloxacin were reduced by 31% and 32%, respectively. Moxifloxacin has been reported to cause QT prolongation, however, no cardiovascular morbidity or deaths have been reported. Hypoglycemia, sometimes resulting in coma, can occur. One retrospective study reviewed the literature to determine the effects of oral antibiotics on the pharmacokinetics of contraceptive estrogens and progestins, and also examined clinical studies in which the incidence of pregnancy with OCs and antibiotics was reported. Monotherapy can be considered for mild-to-moderate disease in patients with naturally occurring plague. Ethinyl Estradiol; Norethindrone Acetate: (Moderate) It would be prudent to recommend alternative or additional contraception when oral contraceptives (OCs) are used in conjunction with antibiotics. Post-marketing surveillance has identified very rare cases of ventricular arrhythmias including torsade de pointes (TdP), usually in patients with severe underlying proarrhythmic conditions. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. Queens of the Stone Age will bring Phantogram, Viagra Boys, the Armed, and Savages Jehnny Beth on their fall North American tour. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Examples of compounds that may interfere with quinolone bioavailability include multivitamins that contain zinc. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. VIGAMOX is for topical ophthalmic use. Isoniazid, INH; Rifampin: (Minor) Intermittent rifampin administration during tuberculosis treatment in Indonesian patients resulted in reduced plasma concentrations of moxifloxacin. Tolvaptan: (Moderate) Coadministration of tolvaptan and hypertonic saline (e.g., 3% NaCl injection solution) is not recommended. Saquinavir boosted with ritonavir increases the QT interval in a dose-dependent fashion, which may increase the risk for serious arrhythmias such as TdP. Store it at room temperature and away from excess heat and moisture (not in the bathroom). It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. 6 mg/kg/dose PO every 12 hours for 7 days as an alternative therapy. Nirmatrelvir; Ritonavir: (Moderate) Concomitant use of ritonavir with moxifloxacin may increase ritonavir adverse effects. 400 mg PO every 24 hours for 7 to 10 days as an alternative; add an aminoglycoside and treat for at least 14 days if concurrent bacteremia. Intravenous Sol: 1.6-0.8%Avelox I.V./Moxifloxacin Hydrochloride/Moxifloxacin Hydrochloride, Sodium Chloride Intravenous Inj Sol: 1mL, 1.6mg, 1.6-0.8%Avelox/Avelox ABC Pack/Moxifloxacin Hydrochloride Oral Tab: 400mgMOXEZA/Moxifloxacin Hydrochloride/Vigamox Ophthalmic Sol: 0.5%. Paliperidone: (Major) Concurrent use of paliperidone and moxifloxacin should be avoided if possible due to an increased risk for QT prolongation and torsade de pointes (TdP). What Other Drugs Interact with Moxifloxacin ophthalmic? Ertugliflozin; Sitagliptin: (Moderate) Monitor blood glucose during concomitant dipeptidyl peptidase-4 inhibitors and quinolone use. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Avoid concomitant use if possible, especially in patients with additional risk factors for TdP. Moxifloxacin hydrochloride is an 8-methoxy fluoroquinolone anti-infective, with a diazabicyclononyl ring at the C7 position. These reports generally involved patients with concurrent medical conditions or concomitant medications that may have been contributory. Vonoprazan; Amoxicillin; Clarithromycin: (Major) Concurrent use of clarithromycin and moxifloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes (TdP). Risperidone: (Major) Concurrent use of risperidone and moxifloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes (TdP). Moxifloxacin can also treat bacterial eye infections. Porfimer: (Major) Avoid the concomitant use of porfimer with other drugs known to cause photosensitivity, such as moxifloxacin. Granisetron has been associated with QT prolongation. Magnesium Citrate: (Major) Administer oral moxifloxacin at least 4 hours before or 8 hours after magnesium citrate. It was previously thought that antibiotics may decrease the effectiveness of OCs containing estrogens due to stimulation of metabolism or a reduction in enterohepatic circulation via changes in GI flora. Sorafenib: (Major) Avoid coadministration of sorafenib with moxifloxacin due to the risk of additive QT prolongation. 400 mg PO every 24 hours for 60 days after exposure. Triptorelin: (Major) Consider whether the benefits of androgen deprivation therapy (i.e., triptorelin) outweigh the potential risks of QT prolongation in patients receiving moxifloxacin. eye pain or discomfort; blurred vision; or. Use one drop in the affected eye (s) 3 times a day while awake, for 7 days. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. The likelihood of QT prolongation may increase with increasing concentrations of moxifloxacin, therefore the recommended dose or infusion rate should not be exceeded. NSAIDs in combination with very high doses of quinolones have been shown to provoke convulsions in preclinical studies and postmarketing. Antituberculous drugs (e.g., rifampin) were the only agents associated with OC failure and pregnancy. Throw away any unused medicine after the expiration date. He armed himself with a balaclava, latex gloves, condoms and Viagra pills and posed as a cab driver in a Mercedes to roam the streets of Brighton, East Sussex. Linagliptin; Metformin: (Moderate) Monitor blood glucose carefully when systemic quinolones and antidiabetic agents, including metformin, are coadministered. Moxeza (R): Instill 1 drop in the affected eye (s) twice a day. 400 mg IV every 24 hours for 7 to 10 days as an alternative; add an aminoglycoside and treat for at least 14 days if concurrent bacteremia. Hypoglycemia, sometimes resulting in coma, can occur. Due to the extremely long half-life of amiodarone, a drug interaction is possible for days to weeks after drug discontinuation. Prolongation of the QT interval has been reported with administration of moxifloxacin. NSAIDs in combination with very high doses of quinolones have been shown to provoke convulsions in preclinical studies and postmarketing. It was concluded that the antibiotics ampicillin, ciprofloxacin, clarithromycin, doxycycline, metronidazole, ofloxacin, roxithromycin, temafloxacin, and tetracycline did not alter plasma concentrations of OCs. Fluconazole: (Major) Concomitant use of fluconazole and moxifloxacin increases the risk of QT/QTc prolongation and torsade de pointes (TdP). During long-term antibiotic administration, the risk for drug interaction with OCs is less clear, but alternative or additional contraception may be advisable in selected circumstances. Ibuprofen; Pseudoephedrine: (Moderate) Use quinolones and nonsteroidal anti-inflammatory drugs (NSAIDs) concomitantly with caution due to potential increased risk of CNS stimulation and convulsive seizures. 4 mg/kg/dose PO every 12 hours for 10 to 14 days as an alternative therapy. WebVIGAMOX (moxifloxacin hydrochloride ophthalmic solution) 0.5% is a sterile solution for topical ophthalmic use. Additionally, post-marketing surveillance has identified very rare cases of ventricular arrhythmias including TdP, usually in patients with severe underlying proarrhythmic conditions. 4 to 11 months: 3 drops/eye/day for Vigamox and 2 drops/eye/day for Moxeza. Another review concurred with these data, but noted that individual patients have been identified who experienced significant decreases in plasma concentrations of combined OC components and who appeared to ovulate; the agents most often associated with these changes were rifampin, tetracyclines, and penicillin derivatives. 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