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Moxifloxacin Dosage

Applies to the following strength(s): 400 mg ; 400 mg/250 mL

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for Bronchitis

400 mg orally or IV every 24 hours for 5 days

Use: For the treatment of acute bacterial exacerbation of chronic bronchitis due to susceptible isolates of Streptococcus pneumoniae, Haemophilus influenzae, H parainfluenzae, Klebsiella pneumoniae, methicillin-susceptible Staphylococcus aureus, or Moraxella catarrhalis

Usual Adult Dose for Intraabdominal Infection

400 mg orally or IV every 24 hours for 5 to 14 days

Use: For the treatment of complicated intraabdominal infections including polymicrobial infections (such as abscess) due to susceptible isolates of Escherichia coli, Bacteroides fragilis, S anginosus, S constellatus, Enterococcus faecalis, Proteus mirabilis, Clostridium perfringens, B thetaiotaomicron, or Peptostreptococcus species

Usual Adult Dose for Pneumonia

400 mg orally or IV every 24 hours for 7 to 14 days

Use: For the treatment of community-acquired pneumonia due to susceptible isolates of S pneumoniae (including multi-drug resistant isolates), H influenzae, M catarrhalis, methicillin-susceptible S aureus, K pneumoniae, Mycoplasma pneumoniae, or Chlamydophila pneumoniae

Usual Adult Dose for Sinusitis

400 mg orally or IV every 24 hours for 10 days

Use: For the treatment of acute bacterial sinusitis due to susceptible isolates of S pneumoniae, H influenzae, or M catarrhalis

Usual Adult Dose for Skin or Soft Tissue Infection

400 mg orally or IV every 24 hours

Duration of therapy:
-Complicated infections: 7 to 21 days
-Uncomplicated infections: 7 days

Uses: For the treatment of uncomplicated skin and skin structure infections due to susceptible isolates of methicillin-susceptible S aureus or S pyogenes; for the treatment of complicated skin and skin structure infections due to susceptible isolates of methicillin-susceptible S aureus, E coli, K pneumoniae, or Enterobacter cloacae

Usual Adult Dose for Skin and Structure Infection

400 mg orally or IV every 24 hours

Duration of therapy:
-Complicated infections: 7 to 21 days
-Uncomplicated infections: 7 days

Uses: For the treatment of uncomplicated skin and skin structure infections due to susceptible isolates of methicillin-susceptible S aureus or S pyogenes; for the treatment of complicated skin and skin structure infections due to susceptible isolates of methicillin-susceptible S aureus, E coli, K pneumoniae, or Enterobacter cloacae

Usual Adult Dose for Inhalation Bacillus anthracis

US CDC recommendations: 400 mg orally or IV once a day

Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days

Systemic anthrax:
-With possible/confirmed meningitis: At least 2 to 3 weeks or until patient is clinically stable (whichever is longer)
-When meningitis has been excluded: 2 weeks or until patient is clinically stable (whichever is longer)
-Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness.

Cutaneous anthrax without systemic involvement:
-Bioterrorism-related cases: 60 days
-Naturally acquired cases: 7 to 10 days

Comments:
-Ciprofloxacin is preferred for pregnant women.
-Recommended as an alternative oral drug for postexposure prophylaxis and as an alternative IV drug for the treatment of systemic anthrax
-Recommended as a preferred oral drug for the treatment of cutaneous anthrax without systemic involvement
-Recommended for all strains (regardless of penicillin susceptibility or if susceptibility is unknown) when used for postexposure prophylaxis, systemic anthrax when meningitis has been excluded, or cutaneous anthrax without systemic involvement
-Recommended for use with a protein synthesis inhibitor when used for systemic anthrax; the addition of a bactericidal beta-lactam is recommended with possible/confirmed meningitis.
-Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Cutaneous Bacillus anthracis

US CDC recommendations: 400 mg orally or IV once a day

Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days

Systemic anthrax:
-With possible/confirmed meningitis: At least 2 to 3 weeks or until patient is clinically stable (whichever is longer)
-When meningitis has been excluded: 2 weeks or until patient is clinically stable (whichever is longer)
-Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness.

Cutaneous anthrax without systemic involvement:
-Bioterrorism-related cases: 60 days
-Naturally acquired cases: 7 to 10 days

Comments:
-Ciprofloxacin is preferred for pregnant women.
-Recommended as an alternative oral drug for postexposure prophylaxis and as an alternative IV drug for the treatment of systemic anthrax
-Recommended as a preferred oral drug for the treatment of cutaneous anthrax without systemic involvement
-Recommended for all strains (regardless of penicillin susceptibility or if susceptibility is unknown) when used for postexposure prophylaxis, systemic anthrax when meningitis has been excluded, or cutaneous anthrax without systemic involvement
-Recommended for use with a protein synthesis inhibitor when used for systemic anthrax; the addition of a bactericidal beta-lactam is recommended with possible/confirmed meningitis.
-Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Anthrax Prophylaxis

US CDC recommendations: 400 mg orally or IV once a day

Duration of Therapy:
Postexposure prophylaxis for B anthracis infection: 60 days

Systemic anthrax:
-With possible/confirmed meningitis: At least 2 to 3 weeks or until patient is clinically stable (whichever is longer)
-When meningitis has been excluded: 2 weeks or until patient is clinically stable (whichever is longer)
-Patients exposed to aerosolized spores will require prophylaxis to complete an antimicrobial regimen of 60 days from onset of illness.

Cutaneous anthrax without systemic involvement:
-Bioterrorism-related cases: 60 days
-Naturally acquired cases: 7 to 10 days

Comments:
-Ciprofloxacin is preferred for pregnant women.
-Recommended as an alternative oral drug for postexposure prophylaxis and as an alternative IV drug for the treatment of systemic anthrax
-Recommended as a preferred oral drug for the treatment of cutaneous anthrax without systemic involvement
-Recommended for all strains (regardless of penicillin susceptibility or if susceptibility is unknown) when used for postexposure prophylaxis, systemic anthrax when meningitis has been excluded, or cutaneous anthrax without systemic involvement
-Recommended for use with a protein synthesis inhibitor when used for systemic anthrax; the addition of a bactericidal beta-lactam is recommended with possible/confirmed meningitis.
-Systemic anthrax includes anthrax meningitis, inhalation anthrax, injection anthrax, gastrointestinal anthrax, and cutaneous anthrax with systemic involvement, extensive edema, or lesions of the head or neck.
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Tuberculosis - Active

US CDC, Infectious Diseases Society of America, and American Thoracic Society recommendations: 400 mg orally or IV once a day

Comments:
-Recommended as a second-line drug
-Optimal duration of therapy has not been established.
-The WHO recommends susceptibility testing and a tailored regimen using second-line drugs based on test results, if testing and second-line drugs are available.
-Current guidelines should be consulted for additional information.

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

No adjustment recommended; caution is recommended.

Precautions

US BOXED WARNINGS:
-TENDON EFFECTS: This drug is associated with increased risk of tendinitis and tendon rupture in all ages. Risk is further increased in older patients usually over 60 years of age, in kidney, heart, or lung transplant recipients, and with use of concomitant corticosteroids.
-MYASTHENIA GRAVIS: This drug may exacerbate muscle weakness in patients with myasthenia gravis. This drug should be avoided in patients with known history of myasthenia gravis.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Hemodialysis and CAPD: No adjustment recommended.

Other Comments

Administration advice:
-Administer IV doses over at least 60 minutes by direct infusion or through Y-type IV infusion set; avoid rapid or bolus IV infusion. For IV infusion only
-May administer oral doses without regard to meals
-May switch from IV to oral therapy when clinically indicated at the physician's discretion; no dose adjustment needed.
-If same IV line or Y-type line used for sequential infusion of other drugs, or if "piggyback" method is used, flush the line before and after infusion of this drug with an infusion solution compatible to all drugs administered via the common line.
-Administer oral doses at least 4 hours before or 8 hours after iron-, zinc-, aluminum-, or magnesium-containing products (e.g., antacids, sucralfate, mineral supplements, buffered didanosine).

Storage requirements:
-Store at 25C (77F), excursions permitted to 15C to 30C (59F to 86F).
-IV solution: Do not refrigerate (product will precipitate).
-Oral tablets: Avoid high humidity.

IV compatibility:
-Compatible IV solutions (at ratios from 1:10 to 10:1): Sterile Water for Injection USP, 0.9% Sodium Chloride Injection USP, 1M Sodium Chloride Injection, 10% Dextrose for Injection USP, 5% Dextrose Injection USP, Lactated Ringers for Injection
-Limited data regarding compatibility with other IV products; additives or other drugs should not be added to this drug or infused concurrently through the same IV line.

General:
-Culture and susceptibility information should be considered when selecting treatment or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.
-IV solution recommended when route is beneficial to patient (e.g., oral dosing is not tolerated).
-The injection contains about 34.2 mEq (787 mg) of sodium in 250 mL.

Monitoring:
-Metabolic: Blood glucose in diabetic patients

Patient advice:
-Drink plenty of fluids.
-Avoid missing doses and complete the entire course of therapy.
-Do not drive, operate machinery, or engage in other tasks that require mental alertness or coordination until you know how the drug affects you.

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