Description
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Indications and Dosage Intravenous Adult: 400 mg bid via slow infusion over at least 1 hour for 14 days.
Intravenous Adult: 200 mg bid via slow infusion over at least 30 minutes.
Intravenous Adult: 200 mg bid via slow infusion over at least 30 minutes, may be increased according to severity to 400 mg bid infused over at least 1 hour. Treatment duration: 2-4 weeks (acute); 4-8 weeks (chronic).
Intravenous Adult: 200 mg bid via slow infusion over at least 30 minutes, may be increased according to severity to 400 mg bid infused over at least 1 hour. Treatment duration: 7-10 days, up to 14 days as necessary.
Intravenous Adult: 400 mg bid via slow infusion over at least 1 hour.
Intravenous Adult: 200 mg bid via slow infusion over at least 30 minutes, may be increased according to severity to 400 mg bid infused over at least 1 hour. Treatment duration: 7-21 days.
Intravenous Adult: 200 mg bid via slow infusion over at least 30 minutes, may be increased according to severity to 400 mg bid infused over at least 1 hour. Treatment duration: 14 days.
Intravenous Adult: 200 mg bid via infusion over at least 30 minutes, may be increased according to severity to 400 mg bid infused over at least 1 hour.
Ophthalmic Adult: As 0.3% eye drop solution: Instill 1-2 drops into the affected eye(s) 2-4 hourly for days 1 and 2, then instill 1-2 drops 4 times daily for days 3-7. Max treatment duration: 10 days.
Ophthalmic Adult: As 0.3% eye drop solution: Instill 1-2 drops into the affected eye(s) every 30 minutes while awake and 4-6 hourly after retiring for days 1 and 2. Starting on day 3, instill 1-2 drops hourly while awake for 4-6 additional days; thereafter, 1-2 drops 4 times daily until clinical cure is achieved.
Oral Adult: 200 mg 12 hourly for 3-7 days.
Oral Adult: 400 mg 12 hourly for 10 days.
Oral Adult: 400 mg 12 hourly for 10-14 days.
Oral Adult: 200 mg bid, may be increased to 400 mg bid according to severity. Treatment duration: 2-4 weeks (acute); 4-8 weeks (chronic). Alternatively, 300 mg 12 hourly for 6 weeks.
Oral Adult: 400 mg bid.
Oral Adult: 400 mg daily as single or in divided doses. Alternatively, 300 mg 12 hourly. Treatment duration: 7 days.
Oral Adult: 200 mg 12 hourly for 10 days. Alternatively, 200 mg bid, may be increased to 400 mg bid according to severity for 7-21 days.
Oral Adult: 400 mg as a single dose.
Oral Adult: 400 mg daily, increased to 400 mg bid if necessary.
Otic/Aural Adult: Chronic suppurative cases with perforated tympanic membranes: As 0.3% otic solution: Instill 10 drops (1.5 mg) into the canal of the affected ear(s) bid for 14 days.
Otic/Aural Child: With tympanostomy tubes: 1-12 years As 0.3% otic solution: Instill 5 drops (0.75 mg) into the canal of the affected ear(s) bid for 10 days.
Otic/Aural Adult: As 0.3% otic solution: Instill 10 drops (1.5 mg) into the canal of the affected ear(s) once daily for 7 days. |
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Renal Impairment Oral:
Intravenous:
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Hepatic Impairment Oral/Intravenous: |
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Administration May be taken with or without food. Avoid antacids or supplements containing Fe or Zn w/in 2 hr before or after ofloxacin. Ensure adequate hydration. |
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Incompatibility IV: Heparin. |
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Contraindications Hypersensitivity to ofloxacin or to other quinolone antibacterials. History of tendon disorders associated with quinolone use, epilepsy or lowered seizure threshold. |
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Special Precautions Patient with known/suspected CNS disorders (e.g. epilepsy, severe cerebral arteriosclerosis) or risk factors that may predispose to seizures or lower the seizure threshold; myasthenia gravis, rheumatoid arthritis, latent or diagnosed G6PD deficiency, risk factors for QT interval prolongation (e.g. congenital long QT syndrome, uncorrected hypokalaemia or hypomagnesaemia, heart failure, MI, bradycardia), history of aneurysm disease, pre-existing aortic aneurysm/dissection or its predisposing conditions (e.g. Marfan syndrome, vascular Ehlers-Danlos syndrome, Takayasu/giant cell arteritis, Behcet’s disease); psychiatric disease, history of psychotic disorder or risk factor for depression; diabetes. Organ transplant recipients. Not indicated for the treatment of syphilis as it may mask symptoms (oral). Renal and hepatic impairment. Children and elderly. Pregnancy and lactation. |
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Adverse Reactions Significant: Tendon rupture or tendinitis, aortic aneurysm ruptures or dissection, CNS effects (e.g. seizures, tremors, dizziness, lightheadedness, increased intracranial pressure), hyperglycaemia, psychiatric reactions (e.g. hallucinations, toxic psychosis), phototoxicity. Rarely, peripheral neuropathy, QT interval prolongation, torsades de pointes, haemolytic reactions (G6PD deficient patients). |
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PO: C (Caution especially in 1st trimester); Ophth/Otic: C |
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Patient Counseling Information This drug may cause drowsiness, dizziness and visual disturbances; if affected, do not drive or operate machinery. Avoid excessive exposure to sunlight or artificial UV light. Do not wear contact lenses during treatment of ophthalmic infections. |
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MonitoringParameters Monitor CBC, hepatic and renal function periodically (prolonged therapy). Perform culture and sensitivity tests and consult local recommendations before treatment initiation due to antibiotic resistance risks; test for syphilis at the time of gonorrheal diagnosis and 3 months later. Assess for signs and symptoms of glucose disturbances, CNS effects, and tendon problems. Monitor ofloxacin serum concentration for patient with severe renal impairment and on dialysis (IV). |
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Overdosage Symptoms: Dizziness, confusion, impaired consciousness, increased QT interval, convulsive seizures, nausea, mucosal erosions. Management: Symptomatic treatment. May employ gastric lavage or administer adsorbents and Na sulfate during the 1st 30 minutes to remove any unabsorbed drug. Antacids may be given for protection of gastric mucosa. Elimination may be increased by forced diuresis. Monitor ECG. |
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Drug Interactions Increased risk of tendon rupture or inflammation with concomitant use of corticosteroids. Increased risk of QT interval prolongation with Class IA and III anti-arrhythmics, TCAs, macrolides, antipsychotics. May increase the risk of bleeding when given with vitamin K antagonists (e.g. warfarin). Reduced absorption with Mg-, Ca- or Al-containing antacids, Zn or Fe preparations, sucralfate and didanosine chewable or buffered tab. Decreased clearance with drugs that affect the renal tubular secretion (e.g. probenecid, furosemide, cimetidine, methotrexate). May slightly increase plasma levels of glibenclamide. Theophylline and NSAIDs may cause pronounced lowering of cerebral seizure threshold. |
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Food Interaction May enhance CNS effects with alcohol. |
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Lab Interference May cause false-positive results in the determination of opiates or porphyrin levels in urine. |
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Action Description: Ofloxacin is a fluoroquinolone antibacterial which inhibits bacterial topoisomerase IV and DNA gyrase enzymes required for DNA replication, transcription, repair, transposition and recombination. |
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Chemical Structure
Ofloxacin Source: National Center for Biotechnology Information. PubChem Database. Ofloxacin, CID=4583, https://pubchem.ncbi.nlm.nih.gov/compound/Ofloxacin (accessed on Jan. 22, 2020) |
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Storage Tab: Store between 20-25°C. IV solution/otic solution: Store between 20-25°C. Protect from light. Ophthalmic solution: Store between 15-25°C. Protect from light and excessive heat. |
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MIMS Class Ear Anti-Infectives & Antiseptics / Quinolones / Eye Anti-Infectives & Antiseptics |
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ATC Classification S01AE01 – ofloxacin ; Belongs to the class of quinolone antiinfectives. Used in the treatment of eye infections. |
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References |
