Moxifloxacin review

Moxifloxacin belongs to a family of third generation flouoroquinolone chemotherapeutic drugs. The use of moxifloxacin has been limited as it is considered as a last resort when all other options for bacterial infection treatment fail.

Bayer AG markets Moxifloxacin as an oral drug with the names Avelox, Avalox, and Avelon. Vigamox is a moxifloxacin variant available as an ophthalmic solution. Moxifloxacin is indicated for the treatment of bacterial infections in adults such as acute bacterial sinusitis, chronic bronchitis, and community acquired pneumonia. Moxifloxacin is also used to treat both complicated and uncomplicated skin infections, intra-abdominal infections.

Moxifloxacin may be administered orally or via intravenous route. The usual recommended dosage of moxifloxacin is 400 mg once every 24 hours. The length of time of the therapy depends on the type and severity of the infection of the patient. Switching from oral to intravenous route requires no adjustment in the dosage. Oral moxifloxacin should be given 4 hours before or eight hours after a patient takes in certain antacids that contains magnesium or aluminum.

General side effects of moxifloxacin use include gastrointestinal pain (abdominal pain, diarrhea, flatulence), dehydration, allergic reactions in the injection site, headaches, and nausea.

The use of moxifloxacin may result in heart problems such as tachycardia, arrhythmia, palpitations, and vasodilation. Abnormal liver functioning, dyspepsia, dry mouth, constipation and vomiting may also be experienced upon the use of the drug as its side effects.

Other serious side effects that the drug may bring about include leucopenia, thrombocythemia, and increase in lactic dehydrogenase and amylase. Myalgia, insomnia, vertigo, tremors and anxiety may also occur.

Moxifloxacin is contraindicated in patients with a known hypersensitivity to the drug or its known components. It is also contraindicated in patients with hypersensitivity to any family of quinolones or anti-microbial agents.

Antacids containing metal cations such as magnesium and aluminum may be found to interfere with the body’s absorption of quinolones. Hence, there should be a period of time before consuming the drug.

Although the interaction of moxifloxacin and non-steroidal anti-inflammatory drugs were not established in clinical studies, the concomitant use of both should be given caution as NSAIDs used with other quinolone may increase the risks of the stimulation of the central nervous system and may cause convulsions.

Moxifloxacin is not recommended for the use in patients with known heart diseases, liver and kidney impairment as it may cause serious to fatal side effects. Clostridium difficile associated diarrhea was reported with the use of all antibacterial agents, including moxifloxacin. Once CDAD is suspected, antibacterial agents not intended for the infection must be stopped. Fluid and electrolyte management must be initiated, along with protein supplementation and antibacterial treatment for CDAD must be initiated.

The use of the drug in pregnant women must be consulted with their physician. The potential benefit that the drug may bring must be weighed against the risk it may pose to the mother and unborn. Women who are nursing or plan to breastfeed must consult their physician prior to use of the drug.

Although no clinical studies prove ill effects on children, the use of the drug in patients less than 18 years must always be exercised with caution. Care must be given to administering the drug in geriatric patients, as they are more prone to rupture in the tendons, as well as the interactions of quinolones with NSAIDs.

Moxifloxacin has the following structural formula:

Chemical structure of moxifloxacin

• Molecular formula of moxifloxacin is C21H24FN3O4
• Chemical IUPAC Name is 1-cyclopropyl-7-[(1S,6S)-2,8-diazabicyclo[4.3.0]non-8-yl]-6- fluoro-8-methoxy-4-oxo-quinoline-3-carboxylic acid
• Molecular weight is 401.431 g/mol

Brand name(s): Avelox, Moxifloxacin HCl, Vigamox

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