Floxin, Floxin Otic, Ocuflox
Classifications: antibiotic, quinolone; Therapeutic: antibiotic, quinolone
Pregnancy Category: C
200 mg, 300 mg, 400 mg tablets; 40 mg/mL injection; 0.3% ophthalmic solution; 0.3% otic solution
A fluoroquinolone antibiotic that inhibits DNa gyrase, an enzyme necessary for bacterial DNA replication and some aspects
of its transcription, repair, recombination, and transposition.
Has a broad spectrum of activity against gram-positive and gram-negative bacteria. Most effective against gram-negative
organisms including aerobic and anaerobic bacteria.
Chlamydia trachomatis infection, uncomplicated gonorrhea, prostatitis, respiratory tract infections, skin and skin structure infections, urinary
tract infections due to susceptible bacteria, superficial ocular infections, pelvic inflammatory disease. Otic: otitis externa,
otitis media with perforated tympanic membranes.
EENT infections, Helicobacter pylori infections, Salmonella gastroenteritis.
Hypersensitivity to ofloxacin or other quinolone antibacterial agents; tendon pain; sunlight (UV) exposure; QT prolongation;
viral infection; pregnancy (category C).
Renal disease; patients with a history of epilepsy, psychosis, or increased intracranial pressure, cerebrovascular disease,
CNS disorders such as seizures, epilepsy, myasthenia gravis; GI disease, colitis, dehydration; syphilis; atrial fibrillation;
acute MI; CVA; children and adolescents <18 y (except for otic preparation).
Route & Dosage
Adult: PO 400 mg for 1 dose
Urinary Tract, Respiratory Tract, and Skin and Skin Structure Infections
Adult: PO 200400 mg q12h x 710 d IV 400 mg q12h x 7 d
Adult: PO 300 mg b.i.d. x 6 wk
Superficial Ocular Infections
Adult: Ophthalmic Instill 12 drops q24h for first 2 d, then q.i.d. for up to 5 additional d
Otitis Media with Perforation
Adult: Otic 10 drops (0.5 mL) q12h for 14 d
Child (≥1 y): Otic 5 drops (0.25 mL) q12h for 14 d
Adult: Otic 10 drops (0.5 mL) q12h for 7 d
Child (6 mo13 y): Otic 5 drops (0.25 mL) q12h for 7 d
Clcr 2050mL/min: dose should be given q24h; <20 mL/min: ? the dose q24h
Severe impairment: 400 mg qd
- Do not give with meals.
- Avoid administering mineral supplements or vitamins with iron or zinc within 2 h of drug.
- Do not give antacids with magnesium, aluminum, or sucralfate within 4 h before or 2 h after drug.
- Do NOT allow tip of dropper for ocular preparation to contact any surface.
PREPARE: Intermittent: Withdraw the required dose from a 10 mL (40 mg/mL) or 20 mL (20 mg/mL) vial and add to 100 mL D5W, NS, D5/NS or other compatible
solution. Final concentration may range from 0.4 mg/mL to 4 mg/mL.
ADMINISTER: Intermittent: Give a single dose over at least 60 min. Avoid rapid infusion.
INCOMPATIBILITIES Y-site: Amphotericin B cholesteryl sulfate complex, cefepime, doxorubicin liposome.
Adverse Effects (≥1%)CNS: Headache, dizziness, insomnia,
Nausea, vomiting, diarrhea, GI discomfort. Urogenital:
Pruritus, pain, irritation, burning, vaginitis
, vaginal discharge, dysmenorrhea, menorrhagia, dysuria, urinary frequency. Skin:
Pruritus, rash. Other:
Diagnostic Test Interference
May cause false positive on opiate screening tests.
Ofloxacin absorption decreased when it is administered with magnesium-
or aluminum-containing antacids
. Other cations
, including calcium, iron,
also appear to interfere with ofloxacin absorption. May have additive effect with ANTIDIABETICS
9098% from GI tract. Peak:
12 h. Distribution:
Distributes to most tissues; 50% crosses into CSF with inflamed meninges; 2032% protein bound; crosses placenta;
distributed into breast milk. Metabolism:
Slightly in liver. Elimination:
7298% in urine within 48 h. Half-Life:
Assessment & Drug Effects
- Lab tests: Do C&S tests prior to initial dose. Treatment may be implemented pending results.
- Determine history of hypersensitivity reactions to quinolones or other drugs before therapy is started.
- Withhold ofloxacin and notify physician at first sign of tendon pain, a skin rash, or other allergic reaction.
- Monitor for seizures, especially in patients with known or suspected CNS disorders. Discontinue ofloxacin and notify physician
immediately if seizure occurs.
- Assess for signs and symptoms of superinfection (see Appendix F).
Patient & Family Education
- Drink fluids liberally unless contraindicated.
- Be aware that dizziness or light-headedness may occur; use appropriate caution.
- Avoid excessive sunlight or artificial ultraviolet light because of the possibility of phototoxicity.