A daily dose of up to mg ofloxacin may be given as a single dose. In this case, it is preferable to administer ofloxacin in the morning. Daily doses of more than mg must be divided into two separate doses and be given at approximately equal intervals. Method of administration For oral use. Ofloxacin tablets should be swallowed whole with sufficient liquid before or during meal times.
They should not be taken within two hours of mineral antacids, sucralfate or metal ion preparations aluminium, iron, magnesium or zinc , didanosine chewable or buffered tablets for HIV , since reduction of absorption of ofloxacin can occur see section 4.
Therefore ofloxacin is not recommended for the treatment of known or suspected MRSA infections unless laboratory results have confirmed susceptibility of the organism to ofloxacin and commonly recommended antibacterial agents for the treatment of MRSA-infections are considered inappropriate. Resistance to fluoroquinolones of E.
Prescribers are advised to take into account the local prevalence of resistance in E. Severe bullous reactions Cases of severe bullous skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis have been reported with ofloxacin see section 4.
Tendonitis Tendonitis, rarely observed with quinolones, may occasionally lead to rupture involving Achilles tendon in particular. Tendinitis and tendon rupture, sometimes bilateral, may occur within 48 hours of starting treatment with ofloxacin and have been reported up to several months after discontinuation of ofloxacin. The risk of tendinitis and tendon rupture is increased in patients aged over 60 years and in patients using corticosteroids.
The daily dose should be adjusted in elderly patients based on creatinine clearance see section 4. Close monitoring of these patients is therefore necessary if they are prescribed ofloxacin.
All patients should consult their physician if they experience symptoms of tendinitis. Some quinolones, including ofloxacin, have been associated with QT prolongation and infrequent cases of arrhythmia. Tricyclic antidepressants TCAs share pharmacologic properties similar to the Class IA antiarrhythmic agents and may prolong the QT interval, particularly in overdose or with higher-dose prescription therapy elevated serum concentrations.
Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering clarithromycin with ofloxacin.
Clarithromycin is associated with an established risk for QT prolongation and TdP. Major Torsades de pointes TdP and ventricular tachycardia have been reported during post-marketing use of anagrelide.
A cardiovascular examination, including an ECG, should be obtained in all patients prior to initiating anagrelide therapy.
Monitor patients during anagrelide therapy for cardiovascular effects and evaluate as necessary. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with anagrelide include ofloxacin.
Moderate Some quinolones, including ofloxacin, have been associated with QT prolongation and infrequent cases of arrhythmia.
Major QT prolongation has occurred during therapeutic use of aripiprazole and following overdose. Aripiprazole should be used cautiously and with close monitoring with ofloxacin. Major Concurrent use of arsenic trioxide and ofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes TdP.
If possible, ofloxacin should be discontinued prior to initiating arsenic trioxide therapy. QT prolongation should be expected with the administration of arsenic trioxide. TdP and complete atrioventricular block have been reported. Major Concurrent use of artemether; lumefantrine and ofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes TdP.
Consider ECG monitoring if ofloxacin must be used with or after artemether; lumefantrine treatment. The administration of artemether; lumefantrine is associated with prolongation of the QT interval. Major Concurrent use of asenapine and ofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes TdP. Asenapine has been associated with QT prolongation. Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose.
Atomoxetine is considered a drug with a possible risk of torsade de pointes TdP. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with atomoxetine include ofloxacin. Major Administer oral products that contain zinc at least 2 hours before or 2 hours after ofloxacin. Examples of compounds that may interfere with quinolone bioavailability include multivitamins that contain zinc. Moderate Quinolones have been associated with an increased risk of tendon rupture requiring surgical repair or resulting in prolonged disability; this risk is further increased in those receiving concomitant corticosteroids.
Discontinue quinolone therapy at the first sign of tendon inflammation or tendon pain, as these are symptoms that may precede rupture of the tendon. Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering ofloxacin with azithromycin.
Post-marketing surveillance for ofloxacin has identified very rare cases of TdP. Cases of QT prolongation and TdP have also been reported with the post-marketing use of azithromycin. Major Urinary concentrations of ofloxacin could interfere with the therapeutic effectiveness of BCG. Postpone instillation of BCG if the patient is receiving antibiotics. Major Coadministration of bedaquiline with other QT prolonging drugs, such as ofloxacin, may result in additive or synergistic prolongation of the QT interval.
Prior to initiating bedaquiline, obtain serum electrolyte concentrations and a baseline ECG. An ECG should also be performed at least 2, 12, and 24 weeks after starting bedaquiline therapy. Major Bepridil administration is associated with a well-established risk of QT prolongation and torsades de pointes.
Patients receiving other drugs which have the potential for QT prolongation, such as ofloxacin, have an increased risk of developing proarrhythmias during bepridil therapy.
Bismuth Subcitrate Potassium; Metronidazole; Tetracycline: Major Potential QT prolongation has been reported in limited case reports with metronidazole. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with metronidazole include ofloxacin.
Bismuth Subsalicylate; Metronidazole; Tetracycline: Major Buprenorphine should be used cautiously and with close monitoring with ofloxacin. Buprenorphine has been associated with QT prolongation and has a possible risk of torsade de pointes TdP. FDA-approved labeling for some buprenorphine products recommend avoiding use with Class 1A and Class III antiarrhythmic medications while other labels recommend avoiding use with any drug that has the potential to prolong the QT interval.
Major Administer oral products that contain calcium at least 2 hours before or 2 hours after ofloxacin. Examples of compounds that may interfere with quinolone bioavailability include antacids and multivitamins that contain calcium. Calcium Carbonate; Magnesium Hydroxide: Moderate The concomitant administration of quinolones and nonsteroidal antiinflammatory drugs has been reported to increase the risk of CNS stimulation and convulsive seizures. Patients with CNS disorders or other risk factors that may predispose them to seizure development or patients taking drugs that lower the seizure threshold may not be appropriate candidates for NSAID usage if they are also taking a quinolone.
Major Periodically monitor electrolytes and ECGs in patients receiving concomitant treatment with ceritinib and ofloxacin; an interruption of ceritinib therapy, dose reduction, or discontinuation of therapy may be necessary if QT prolongation occurs. Ceritinib causes concentration-dependent prolongation of the QT interval. Quinolones have been associated with a risk of QT prolongation and torsade de pointes TdP. Although extremely rare, TdP has been reported during postmarketing surveillance of ofloxacin; these reports generally involved patients with concurrent medical conditions or concomitant medications that may have been contributory.
Major Due to the cardiotoxic potential of all local anesthetics, they should be used with caution with other agents that can prolong the QT interval, such as ofloxacin. Major Concurrent use of chloroquine and ofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes TdP. The need to coadminister these drugs should be done with a careful assessment of risks versus benefits. Chloroquine administration is associated with an increased risk of QT prolongation and TdP.
Major Concurrent use of chlorpromazine and ofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes TdP. The risk is generally higher at elevated drugs concentrations of phenothiazines. Chlorpromazine is specifically associated with an established risk of QT prolongation and TdP; case reports have included patients receiving therapeutic doses of chlorpromazine. Choline Salicylate; Magnesium Salicylate: Major Both ciprofloxacin and ofloxacin are quinolone antibiotics and coadministration would represent duplicate therapy.
Additionally, coadministration may also increase the risk for QT prolongation and torsade de pointes TdP. Ciprofloxacin is associated with a possible risk for QT prolongation and TdP. Ofloxacin has also been associated with QT prolongation and infrequent cases of arrhythmia.
Severe Some quinolones, including ofloxacin, have been associated with QT prolongation and infrequent cases of arrhythmia. Postmarketing surveillance for ofloxacin has identified very rare cases of torsades de pointes TdP. Because of the potential for TdP, use of cisapride with ofloxacin is contraindicated. Major Concurrent use of citalopram and ofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes TdP.
If concurrent therapy is considered essential, ECG monitoring is recommended. Citalopram causes dose-dependent QT interval prolongation. Major Class IA antiarrhythmics such as disopyramide, quinidine, and procainamide should be used cautiously and with close monitoring with ofloxacin. Class IA antiarrhythmics such as disopyramide, quinidine, and procainamide are associated with QT prolongation and torsades de pointes TdP. Moderate Use tretinoin with caution in patients who are also taking drugs known to be photosensitizers, such as ofloxacin, as concomitant use may augment phototoxicity.
Patients should take care and use proper techniques to limit sunlight and UV exposure of treated areas. Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering clozapine with ofloxacin. Treatment with clozapine has been associated with QT prolongation, TdP, cardiac arrest, and sudden death.
Moderate Promethazine carries a possible risk of QT prolongation. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with promethazine include ofloxacin. Major Monitor ECGs for QT prolongation and monitor electrolytes in patients receiving crizotinib concomitantly with ofloxacin. An interruption of therapy, dose reduction, or discontinuation of therapy may be necessary for crizotinib patients if QT prolongation occurs.
Crizotinib has been associated with concentration-dependent QT prolongation. Quinolones have also been associated with a risk of QT prolongation as well as torsade de pointes TdP. Although extremely rare, TdP has been reported during postmarketing surveillance of ofloxacin. These reports generally involved patients with concurrent medical conditions or concomitant medications that may have been contributory. Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering cyclobenzaprine with ofloxacin.
Cyclobenzaprine is structurally similar to tricyclic antidepressants. Tricyclic antidepressants have been reported to prolong the QT interval, especially when given in excessive doses or in overdosage settings. Cyclobenzaprine is associated with a possible risk of QT prolongation and TdP, particularly in the event of acute overdose. Additionally, postmarketing surveillance for ofloxacin has identified very rare cases of TdP. Moderate Careful monitoring of blood glucose is recommended when quinolones and antidiabetic agents, including saxagliptin, are coadministered.
Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir: Major Concomitant use of ritonavir with ofloxacin may theoretically increase the risk for QT prolongation. Fluoroquinolones, including ofloxacin, have been associated with QT prolongation and cases of torsade de pointes TdP.
Ritonavir has been associated with dose-related QT prolongation. Caution and close monitoring is advised if these drugs are administered together. Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering dasatinib with ofloxacin.
In vitro studies have shown that dasatinib has the potential to prolong cardiac ventricular repolarization prolong QT interval. Major Some quinolones, including ofloxacin, have been associated with QT prolongation and infrequent cases of arrhythmia. CDAD must be considered in all patients who present with diarrhea following antibiotic use.
Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. Ofloxacin has not been shown to be effective in the treatment of syphilis. Antimicrobial agents used in high doses for short periods of time to treat gonorrhea may mask or delay the symptoms of incubating syphilis.
All patients with gonorrhea should have a serologic test for syphilis at the time of diagnosis. Patients treated with ofloxacin for gonorrhea should have a follow-up serologic test for syphilis after three months and, if positive, treatment with an appropriate antimicrobial should be instituted.
Adequate hydration of patients receiving ofloxacin should be maintained to prevent the formation of a highly concentrated urine. Therefore, excessive exposure to these sources of light should be avoided. As with other quinolones, ofloxacin should be used with caution in any patient with a known or suspected CNS disorder that may predispose to seizures or lower the seizure threshold e. A possible interaction between oral hypoglycemic drugs e.
The mechanism for this interaction is not known. In patients with a Middle Ear Infection, if a dose of Ofloxacin Otic Solution is missed, it should be given as soon as possible. However, if it is almost time for the next dose, skip the missed dose and go back to the regular dosing schedule. Do not use a double dose unless the doctor has instructed you to do so.
If the infection is not improved after one week, you should consult your doctor. If you have two or more episodes of drainage within six months, it is recommended that you see your doctor for further evaluation. What activities should be avoided while using Ofloxacin Otic Solution? It is important that the infected ear s remain clean and dry. When bathing, avoid getting the infected ear s wet. Avoid swimming unless the doctor has instructed otherwise.
What are some of the possible side effects of Ofloxacin Otic Solution? Dosage[ edit ] Ofloxacin should be administered as described within the Dosage Guidelines table found within the most current package insert. Ofloxacin is eliminated primarily by renal excretion. However, the drug is also metabolized and partially cleared through the liver. Modification of the dosage is required using the table found within the package insert for those with impaired liver or kidney function Particularly for patients with severe renal dysfunction.
However, since the drug is known to be substantially excreted by the kidneys, the risk of toxic reactions to this drug may be greater in patients with impaired renal function. The duration of treatment depends upon the severity of infection and the usual duration is 7 to 14 days.
Antibiotic abuse and Antibiotic resistance Resistance to ofloxacin and other fluoroquinolones may evolve rapidly, even during a course of treatment. Numerous pathogens , including Staphylococcus aureus , enterococci , and Streptococcus pyogenes now exhibit resistance worldwide.
Vemurafenib has been associated with QT prolongation. Because of the potential for TdP, use of dofetilide with ofloxacin is contraindicated. Ten lactating women time postpartum not stated were given ofloxacin mg orally every 12 hours for 3 doses. Quinolones have been associated with a risk of QT prolongation and TdP. If the pain is severe, the medication should be stopped and you should contact your doctor, ofloxacin 1 5mg. Ofloxacin is also considered to be contraindicated within the pediatric population, pregnancyofloxacin 1 5mg, nursing mothers, patients with psychiatric illnesses and in patients with epilepsy or other seizure disorders. Minor Due to an increased risk for QT prolongation and torsade de pointes TdPcaution is advised when administering prochlorperazine with ofloxacin, ofloxacin 1 5mg. If possible, ofloxacin should be discontinued prior to initiating arsenic trioxide therapy. Some quinolones, including ofloxacin, have also been associated with QT prolongation and infrequent cases of arrhythmia. Because many foods contain divalent or trivalent cations, food interactions with quinolones are also significant. Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate: Clinicians should warn patients about all dairy products and other high calcium- and iron-containing foods. Ofloxacin Ccoadministration of efavirenz and ofloxacin may increase the risk for QT prolongation and torsade de pointes TdP. Arrhythmias, sinus bradycardia, 5mg conduction disturbances have occurred during octreotide therapy warranting more cautious monitoring during octreotide administration in ofloxacin risk patients with cardiac disease. Choline Salicylate; 5mg Salicylate: Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with sulfamethoxazole; trimethoprim include ofloxacin.
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