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(gat i FLOKS a sin)

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Ophthalmic:

Zymaxid: 0.5% (2.5 mL) [contains benzalkonium chloride, edetate disodium]

Generic: 0.5% (2.5 mL)

Brand Names: U.S.

  • Zymaxid

Pharmacologic Category

  • Antibiotic, Fluoroquinolone
  • Antibiotic, Ophthalmic


Gatifloxacin is a DNA gyrase inhibitor, and also inhibits topoisomerase IV. DNA gyrase (topoisomerase II) is an essential bacterial enzyme that maintains the superhelical structure of DNA. DNA gyrase is required for DNA replication and transcription, DNA repair, recombination, and transposition; inhibition is bactericidal.


Ophthalmic: Not measurable (<5 ng/mL)

Use: Labeled Indications

Conjunctivitis: Treatment of bacterial conjunctivitis caused by Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus mitis group, Streptococcus oralis, Streptococcus pneumoniae, and Haemophilus influenzae.


Hypersensitivity to gatifloxacin, other quinolones, or any component of the formulation

Dosing: Adult

Bacterial conjunctivitis: Ophthalmic:

Zymar [Canadian product]:

Days 1 and 2: Instill 1 drop into affected eye(s) every 2 hours while awake (maximum: 8 times/day).

Days 3 to 7: Instill 1 drop into affected eye(s) 4 times/day while awake.


Day 1: Instill 1 drop into affected eye(s) every 2 hours while awake (maximum: 8 times/day).

Days 2 to 7: Instill 1 drop into affected eye(s) 2 to 4 times/day while awake.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Bacterial conjunctivitis: Children ≥1 year and Adolescents: Ophthalmic: Refer to adult dosing.

Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment unlikely due to low systemic absorption.

Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer’s labeling. However, dosage adjustment unlikely due to low systemic absorption.


For topical ophthalmic use only; not for injection. Avoid touching tip of applicator to eye, fingers, or other surfaces.


Store between 15°C to 25°C (59°F to 77°F); protect from freezing.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

1% to 10%:

Cardiovascular: Edema

Dermatologic: Contact dermatitis, erythema

Gastrointestinal: Dysgeusia

Ophthalmic: Conjunctival irritation, decreased visual acuity, eye discharge, eye irritation, eye pain, increased lacrimation, keratitis, ocular edema, papillary conjunctivitis, xerophthalmia

Respiratory: Rhinorrhea

<1% (Limited to important or life-threatening): Angioedema, blepharitis (allergic), blurred vision, chemosis, conjunctival hemorrhage, corneal deposits, corneal disease, corneal opacity (subepithelial), corneal ulcer, cyst (conjunctival), dermatitis, dizziness, endophthalmitis, eye redness, iritis, keratoconjunctivitis, macular edema, nausea, oral paresthesia, photophobia, pruritus, sore throat, tinnitus, tremor, urticaria, uveitis


Concerns related to adverse effects:

• Hypersensitivity reactions: Hypersensitivity reactions, including anaphylactic reactions, angioedema (including pharyngeal, laryngeal, or facial edema), dyspnea, urticaria, and itching, have been reported (even following a single dose) with topical ophthalmic gatifloxacin. Rare cases of Stevens-Johnson syndrome were also reported. If an allergic reaction occurs, discontinue use.

• Superinfection: Prolonged use may result in fungal or bacterial superinfection. If superinfection is suspected, institute appropriate alternative therapy.

Special populations:

• Contact lens wearers: Contact lenses should not be worn during treatment of ophthalmic infections.

Dosage form specific issues:

• Appropriate use: For topical ophthalmic use only. Do not inject ophthalmic solution subconjunctivally or introduce directly into the anterior chamber of the eye (may cause corneal endothelial cell injury).

Pregnancy Considerations

Systemic concentrations of gatifloxacin following ophthalmic administration are below the limit of quantification. If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctual occlusion for 3 to 5 minutes after application to decrease potential exposure to the fetus (Samples 1988).

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience bad taste. Have patient report immediately to prescriber vision changes, eye pain, severe eye irritation, or eye or eyelid edema (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.