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Moxifloxacin

Pronunciation

Generic Name: moxifloxacin (MOX-i-FLOX-a-sin)
Brand Name: Avelox

Moxifloxacin is associated with an increased risk of tendon problems. These include pain, swelling, inflammation, and possible breakage of tendons. The risk of tendon problems is greater in patients who are older than 60 years old, patients who take corticosteroids (eg, prednisone), or in those who have received kidney, heart, or lung transplants. The Achilles tendon in the back of the foot/ankle area is most often affected. However, problems may also occur in other tendons (eg, in the shoulder, arm, or hand). Problems may occur while you use moxifloxacin or up to several months after you stop using it.

Signs of tendon problems may include pain, soreness, redness, or swelling of a tendon or joint; bruising right after an injury in a tendon area; hearing or feeling a snap or pop in a joint or tendon area; or inability to move or bear weight on a joint or tendon area. Tell your doctor right away if you experience any of these symptoms while you use moxifloxacin or within several months after you stop using it.

Moxifloxacin may worsen muscle weakness and breathing problems in patients with myasthenia gravis. Do not use moxifloxacin if you have a history of myasthenia gravis.


Moxifloxacin is used for:

Treating infections caused by certain bacteria.

Moxifloxacin is a fluoroquinolone. It works by killing sensitive bacteria.

Do NOT use moxifloxacin if:

  • you are allergic to any ingredient in moxifloxacin or to any other fluoroquinolone antibiotic (eg, levofloxacin)
  • you have a certain type of irregular heartbeat (eg, QT prolongation) or uncorrected low blood potassium levels
  • you have a history of myasthenia gravis
  • you are taking certain antiarrhythmics (eg, amiodarone, dronedarone, procainamide, quinidine, sotalol), asenapine, citalopram, nilotinib, pentamidine, or tetrabenazine

Contact your doctor or health care provider right away if any of these apply to you.

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Before using moxifloxacin:

Some medical conditions may interact with moxifloxacin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a stomach infection, liver problems, brain or nervous system problems, increased pressure in the brain, Alzheimer disease, brain blood vessel problems, or a history of seizures
  • if you have a history of severe or persistent diarrhea, skin sensitivity to the sun, low blood potassium levels, irregular heartbeat (eg, QT prolongation) or other heart problems (eg, fast or slow heartbeat, angina, heart failure), or heart attack, or if you have a family member with a history of irregular heartbeat (QT prolongation)
  • if you have a history of joint or tendon problems; rheumatoid arthritis; kidney problems or decreased kidney function; or a heart, kidney, or lung transplant
  • if you participate in strenuous physical work or exercise
  • if you take any medicine that may increase the risk of a certain type of irregular heartbeat (prolonged QT interval). Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat

Some MEDICINES MAY INTERACT with moxifloxacin. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Corticosteroids (eg, prednisone) because the risk of tendon problems may be increased
  • Antiarrhythmics (eg, amiodarone, dofetilide, dronedarone, procainamide, quinidine, sotalol), arsenic, asenapine, bepridil, chloroquine, cisapride, citalopram, clozapine, crizotinib, diuretics (eg, furosemide, hydrochlorothiazide), dolasetron, domperidone, droperidol, fluconazole, halofantrine, haloperidol, iloperidone, macrolide antibiotics (eg, erythromycin), maprotiline, methadone, ondansetron, paliperidone, pentamidine, phenothiazines (eg, thioridazine), pimozide, quetiapine, romidepsin, tacrolimus, telithromycin, tetrabenazine, toremifene, tricyclic antidepressants (eg, amitriptyline), tyrosine kinase inhibitors (eg, dasatinib, nilotinib), vandetanib, or ziprasidone because the risk of severe and possibly fatal irregular heartbeat may be increased
  • Warfarin because the risk of bleeding may be increased by moxifloxacin
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, ketorolac) because they may increase the risk of moxifloxacin's side effects

This may not be a complete list of all interactions that may occur. Ask your health care provider if moxifloxacin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use moxifloxacin:

Use moxifloxacin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Moxifloxacin comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get moxifloxacin refilled.
  • Moxifloxacin is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using moxifloxacin at home, a health care provider will teach you how to use it. Be sure you understand how to use moxifloxacin. Follow the procedures you are taught when you use a dose. Contact a health care provider if you have any questions.
  • Do not use moxifloxacin if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • Use moxifloxacin on a regular schedule to get the most benefit from it.
  • Drink plenty of liquids while you are using moxifloxacin.
  • Moxifloxacin should not be mixed with other injectable medications. Ask your doctor any questions that you may have about moxifloxacin or giving injections.
  • To clear up your infection completely, use moxifloxacin for the full course of treatment. Keep using it even if you feel better in a few days.
  • Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of moxifloxacin, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take more than 1 dose in the same day.

Ask your health care provider any questions you may have about how to use moxifloxacin.

Important safety information:

  • Moxifloxacin may cause dizziness, drowsiness, light-headedness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use moxifloxacin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Be sure to use moxifloxacin for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
  • Moxifloxacin may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to moxifloxacin. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.
  • Nerve problems in the arms, hands, legs, or feet can happen in people taking moxifloxacin. These nerve problems can happen soon after moxifloxacin is started and may be permanent. Call your doctor right away if you have symptoms or nerve problems (eg, not able to handle heat or cold; decreased sensation of touch; unusual burning, numbness, tingling, pain, or weakness of the arms, hands, legs, or feet).
  • Moxifloxacin only works against bacteria; it does not treat viral infections (eg, the common cold).
  • Do not receive certain live vaccines (oral typhoid vaccine, bacille Calmette-Guérin [BCG] vaccine) while you are taking moxifloxacin. Talk with your doctor before you receive any vaccine.
  • Long-term or repeated use of moxifloxacin may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
  • Moxifloxacin has infrequently caused tendon problems, including tendon rupture. If you experience any unusual pain or swelling in your joints (eg, shoulder, elbow, hand, hip, knee, ankle, foot), contact your doctor immediately. Rest and avoid exercise or other physically stressful activity until your doctor tells you otherwise.
  • Use moxifloxacin with caution in the ELDERLY; they may be more sensitive to its effects (eg, tendon problems), especially if they take corticosteroids (eg, prednisone). They may also be more sensitive to other effects (eg, irregular heartbeat).
  • Moxifloxacin should be used with extreme caution in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed. They may also be more sensitive to the effects of moxifloxacin, including bone and joint problems.
  • PREGNANCY and BREAST-FEEDING: It is not known if moxifloxacin can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using moxifloxacin while you are pregnant. It is not known if moxifloxacin is found in breast milk. Do not breast-feed while using moxifloxacin.

Possible side effects of moxifloxacin:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; headache; nausea.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest or throat; swelling of the mouth, face, lips, or tongue; unusual hoarseness); bloody or tarry stools; chest pain; decreased urination; fainting; fast, slow, or irregular heartbeat; fever, chills, unusual cough, or persistent sore throat; hallucinations; hearing loss or other hearing changes; inability to move or bear weight on a joint or tendon area; moderate to severe sunburn; mood or mental changes (eg, new or worsening anxiety, agitation, confusion, depression, nervousness, paranoia, restlessness); muscle pain or weakness; nightmares; pain, soreness, redness, swelling, weakness, or bruising of a tendon or joint area; red, swollen, blistered, or peeling skin; seizures; severe or persistent diarrhea; severe or persistent dizziness, headache, or light-headedness; shortness of breath or trouble breathing; stomach pain or cramps; suicidal thoughts or actions; symptoms of liver problems (eg, dark urine; loss of appetite; pale stools; yellowing of the skin or eyes); tremor; trouble sleeping; trouble walking or unusual gait; unusual bruising or bleeding; unusual swelling or weight gain; unusual tiredness or weakness; unusual vaginal discharge, itching, or odor; vision changes (eg, blurred vision, vision loss); white patches in the mouth.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include irregular heartbeat.

Proper storage of moxifloxacin:

Moxifloxacin is usually handled and stored by a health care provider. If you are using moxifloxacin at home, store moxifloxacin as directed by your pharmacist or health care provider. Keep moxifloxacin out of the reach of children and away from pets.

General information:

  • If you have any questions about moxifloxacin, please talk with your doctor, pharmacist, or other health care provider.
  • Moxifloxacin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take moxifloxacin or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about moxifloxacin. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to moxifloxacin. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using moxifloxacin.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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