II. Indications
- Conditions
- Community Acquired Pneumonia (including Penicillin-resistant pneumococcus)
- Refractory acute Bacterial Sinusitis (third line agent)
- Skin and Soft Tissue Infections
- Avoid in UTI (Bladder concentrations too low)
- Activity Spectrum
- Moderate to good Gram Positive activity (includes Streptococcus Pneumoniae)
- Aerobic Gram Negative Rod coverage (see other Fluoroquinolones)
- Less activity than other Fluoroquinolones
- Enterobacteriaceae
- Does not cover Pseudomonas
- Atypical Bacteria
- Anaerobic Coverage
- Only Fluoroquinolone to have anaerobic coverage
III. Contraindications
- See Fluoroquinolone
- Myasthenia Gravis (exacerbates motor weakness)
- Ziprasidone use
IV. Mechanism
- See Fluoroquinolone
- Low urine concentrations (avoid in UTI)
- No Pseudomonas coverage
V. Dosing
- Take 400 mg orally or IV daily
VI. Pharmacokinetics
- Excellent oral Bioavailability (similar to Levofloxacin)
- Oral and Intravenous dosing are the same
VII. Adverse Effects
- See Fluoroquinolone
- Fluoroquinolones have several serious warnings (e.g. tendon rupture, Neuropathy, Aortic Dissection)
-
QT Prolongation
- Moxifloxacin is the highest risk Quinolone for QT Prolongation
- Avoid in known Prolonged QT, Hypokalemia or in combination of Class 1 or Class 3 Antiarrhythmics
VIII. Safety
- Pregnancy Category X in first trimester (unknown safety in other trimesters)
- Unknown safety in Lactation
- Risk of pediatric Arthropathy
IX. Drug Interactions
-
Sulfonylureas and other antidiabetic medications
- Hypoglycemia risk
-
Ziprasidone
- Do not use with Moxifloxacin
-
Drug-Induced QTc Prolongation
- Avoid combining with agents that prolong QT Interval
- Drugs that interfere with absorption (give dose at least 4 hours before or 8 hours after)
X. Resources
- Moxifloxacin Injection Solution (DailyMed)
- Moxifloxacin Tablet (DailyMed)
XI. References
- (2019) Comparison Table: Some Systemic Fluoroquinolones, Med Lett Drugs Ther, p. e57
- King (2000) Am Fam Physician 61(9):2741-8 [PubMed]
- O'Donnell (2000) Infect Dis Clin North Am 14(2):489-513 [PubMed]
- Oliphant (2002) Am Fam Physician 65(3):455-64 [PubMed]
- Owens (2000) Med Clin North Am 84(6):1447-69 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| moxifloxacin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| MOXIFLOXACIN 0.5% EYE DROPS | Generic | $3.48 per ml |
| MOXIFLOXACIN HCL 400 MG TABLET | Generic | $1.38 each |