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Ofloxacin

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Ofloxacin, Floxin

  • See Also
  1. Ciprofloxacin
  2. Second Generation Fluoroquinolone
  3. Fluoroquinolone
  4. Antibiotic Drops Via Patent Tympanostomy Tube
  5. Ophthalmic Antibiotic
  • Indications
  1. See Second Generation Fluoroquinolone
  2. Complicated Urinary Tract Infections
  3. Specific types of Bacterial Gastroenteritis
  4. Prostatitis
  5. Sexually Transmitted Disease
  6. Avoid in Community Acquired Pneumonia
    1. Risk of pneumococcal bacteremia and Meningitis
  • Contraindications
  1. See Fluoroquinolone
  2. Myasthenia Gravis (exacerbates motor weakness)
  • Mechanism
  1. See Fluoroquinolone
  2. Similar activity to Ciprofloxacin (but without Pseudomonas coverage)
  • Dosing
  1. Complicated Urinary Tract Infection
    1. Take 200 mg orally twice daily for 10 days
  2. Chronic Bacterial Prostatitis or Epididymitis (non-STI, not FDA approved)
    1. Take 300 mg orally twice daily for up to 6 weeks
  3. Traveler's Diarrhea
    1. Take 300 mg orally twice daily for 1 to 3 days
  4. Renal Dosing
    1. eGFR 20 to 50 ml/min: Take typical dose every 24 hours
    2. eGFR <20 ml/min: Take 50% of typical dose every 24 hours
  • Adverse Effects
  1. See Fluoroquinolone
  2. Fluoroquinolones have several serious warnings (e.g. tendon rupture, Neuropathy, Aortic Dissection)
  3. QTc Prolongation
  4. Hypersensitivity
  5. Gastrointestinal symptoms (Vomiting, Anorexia)
  6. Pruritus
  7. Dysgeusia
  8. Other uncommon effects
    1. Vasculitis (rare)
    2. Increased serum transaminases
    3. White cell findings (lymphocytopenia, Eosinophilia)
    4. Urine changes (glucosuria, Proteinuria, Hematuria, pyuria)
  • Safety
  1. Avoided in pregnancy (despite pregnancy Category C)
    1. Cartilage damage risk
  2. Considered safe in Lactation
    1. However, risk of pediatric Arthropathy
  • Pharmacokinetics
  1. Bioavailability 98%
  2. Peaks 1 to 2 hours after oral dose
  3. Serum Half-Life: 5 to 8 hours (twice as long as Ciprofloxacin)
  4. Renal excretion (70 to 80% unchanged, remainder to minor, relatively inactive metabolites)
  5. Protein binding 30%
  6. Broad Distribution
  • Drug Interactions
  1. Warfarin
    1. Ofloxacin potentiates Anticoagulant activity
  2. Drugs that interfere with Ofloxacin absorption (give at least 2 hours before or after Ofloxacin)
    1. Antacids containing Calcium, aluminum or Magnesium
    2. Sucralfate
    3. Iron
    4. Zinc
  3. Opiate urine screening
    1. False Positive
  • Resources
  1. Ofloxacin Tablet (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee1bf431-97fa-4aba-9cc3-0cfcea779ca2
  • References
  1. (1991) Med Lett Drugs Ther 33(849): 71-3
  2. King (2000) Am Fam Physician 61(9):2741-8 [PubMed]
  3. O'Donnell (2000) Infect Dis Clin North Am 14(2):489-513 [PubMed]
  4. Oliphant (2002) Am Fam Physician 65(3):455-64 [PubMed]
  5. Owens (2000) Med Clin North Am 84(6):1447-69 [PubMed]