LOMEFLOXACIN
| LOMEFLOXACIN (lo-me-flox'a-cin) Maxaquin Classifications: quinolone antibiotic; Therapeutic: antibiotic Prototype: Ciprofloxacin Pregnancy Category: C |
Availability
400 mg tablets
Action
An oral fluoroquinolone broad spectrum bactericidal agent that inhibits DNA gyrase, an enzyme necessary for bacterial DNA replication and some aspects of its transcription, repair, recombination, and transposition.
Therapeutic Effect
Inhibits replication of susceptible gram-negative and gram-positive bacteria. Antibiotic spectrum of activity is similar to that of other fluoroquinolones.
Uses
Urinary tract infections, transurethral surgery prophylaxis.
Unlabeled Uses
Lower respiratory tract infections.
Contraindications
Known hypersensitivity to lomefloxacin or any other quinolone; tendon pain; QT prolongation; renal failure or Clcr <10 mL/min; pregnancy (category C), lactation.
Cautious Use
Kidney disease; acute MI, atrial fibrillation, bradycardia; cerebrovascular disease; myasthenia gravis; patients with a history of epilepsy, psychosis, or increased intracranial pressure; children and adolescents.
Route & Dosage
| Urinary Tract & Lower Respiratory Tract Infections Adult: PO 400 mg q.d. x 10 d Transurethral Surgery Prophylaxis Adult: PO 400 mg 2–6 h before surgery |
Administration
Oral- Avoid giving mineral supplements or vitamins with iron or zinc within 2 h of lomefloxacin.
- Do not give antacids with magnesium, aluminum, or sucralfate within 4 h before or 2 h after drug.
- Give hemodialysis patients an initial 400 mg loading dose followed by a 200 mg/d maintenance dose.
Adverse Effects (≥1%)
CNS: Headache, peripheral neuropathy. GI: Nausea, abdominal discomfort. Skin: Photosensitivity. Musculoskeletal: Risk of tendon rupture (rare).Diagnostic Test Interference
May cause false positive on opiate screening tests.
Interactions
Drug: aluminum- and magnesium-containing antacids decrease systemic bioavailability of lomefloxacin. Concurrent corticosteroid use may increase the risk of tendon rupture.Pharmacokinetics
Absorption: Readily from GI tract. Peak: 1–2 h. Distribution: Crosses placenta; distributed into breast milk. Elimination: 76% in urine within 48 h. Half-Life: 6.35–7.77 h.Nursing Implications
Assessment & Drug Effects
- Lab tests: Draw C&S prior to first dose; drug may be started pending results of C&S.
- Take thorough history of hypersensitivity reactions to quinolones or other drugs prior to therapy.
- Discontinue lomefloxacin and notify physician at the first sign of a skin rash or other allergic reaction.
- Monitor for tendon pain. If it occurs, hold the drug and report to physician.
- Monitor for seizures, especially in patients with known or suspected CNS disorders. Discontinue lomefloxacin and notify physician immediately if a seizure occurs.
- Assess for S&S of superinfection (see Appendix F).
Patient & Family Education
- Notify physician of loose stools or diarrhea promptly.
- Drink fluids liberally, if not contraindicated.
- Take appropriate cautions, dizziness or light-headedness may occur.
- Be aware of the possibility of phototoxicity; avoid excessive sunlight or artificial ultraviolet light.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug