Fluoroquinolones

1. Nelson Origa
Pharm.D. Candidate
TTUHSC Schoolof Pharmacy

2.  List examples of fluoroquinolones
 Describe common uses fluoroquinolones
 Describe drug-drug and drug-food interactions
 Name common side effects of fluoroquinolones
 Educate a patient on fluoroquinolones

3.  Ciprofloxacin Cipro®
Common dose 500mg PO q 12 hours
 Levofloxacin Levaquin®
common dose 500mg -750mg PO, IV q 24 hours

4.  Moxifloxacin Avelox®
 Norfloxacin Noroxin®
 Ofloxacin Floxin®
 Besifloxacin Besivance®
 Gemifloxacin Factive®

5.  Pneumonia
 UTI
 Prostatitis
 GI and Abdominal Infection
 Susceptible gram-/+, atypical, mycobacteria

6.  Antacids
 Multivitamins
 Dairy products
 Juice-Ca++
Ca

7.  Cipro + Zanaflex = ↓BP + ↑Sedation
 Levaquin
↑ Drowsiness

8.  Watch

9.  Warfarin: Increased effect
 NSAIDs: ↑CNS Stimulation and Seizures
 Sucralfate: ↓ Absorption of Cipro, Levaquin
 Methadone: ↑ Levels of methadone
 Amiodarone: Faster heart beat

10.  GI: Nausea, vomiting, diarrhea
 Rash with prolonged use and with NSAIDs
 Headache, lightheadness,dizziness aggravated by
NSAIDs
 Achilles tendon rupture if >60yo + Steroids
 QT interval increase → increased heart rhythm

11.  Tendonitis
 Tendon rupture
 Myasthenia gravis

12.  Take with adequate amount of fluids
 Take full course of therapy even if you feel better
 Monitor any bothersome side effects such as
diarrhea and report to MD
 Monitor signs/symptoms for improvement
 Take dairy products, MV, Antacids separately

13.  Cipro
250mg @ $0.13
500mg @ $0.06
 Levaquin
250mg @ $0.10
500mg @ $0.18
750mg @ $0.27
 Thanks: Dr. Raj