Ofloxacin

Aka: Ofloxacin, Floxin

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II. Indications

  1. See Second Generation Fluoroquinolone
  2. Complicated Urinary Tract Infections
  3. Specific types of Bacterial Gastroenteritis
  4. Prostatitis
  5. Sexually Transmitted Disease
  6. Avoid in Community Acquired Pneumonia
    1. Risk of pneumococcal bacteremia and Meningitis

III. Contraindications

  1. See Fluoroquinolone
  2. Myasthenia Gravis (exacerbates motor weakness)

IV. Mechanism

  1. See Fluoroquinolone
  2. Similar activity to Ciprofloxacin (but without Pseudomonas coverage)

V. Dosing

  1. Complicated Urinary Tract Infection
    1. Take 200 mg orally twice daily for 10 days
  2. Chronic Bacterial Prostatitis or Epididymitis (non-STI, not FDA approved)
    1. Take 300 mg orally twice daily for up to 6 weeks
  3. Traveler's Diarrhea
    1. Take 300 mg orally twice daily for 1 to 3 days
  4. Renal Dosing
    1. eGFR 20 to 50 ml/min: Take typical dose every 24 hours
    2. eGFR <20 ml/min: Take 50% of typical dose every 24 hours

VI. Adverse Effects

  1. See Fluoroquinolone
  2. Fluoroquinolones have several serious warnings (e.g. tendon rupture, Neuropathy, Aortic Dissection)
  3. QTc Prolongation
  4. Hypersensitivity
  5. Gastrointestinal symptoms (Vomiting, Anorexia)
  6. Pruritus
  7. Dysgeusia
  8. Other uncommon effects
    1. Vasculitis (rare)
    2. Increased serum transaminases
    3. White cell findings (lymphocytopenia, Eosinophilia)
    4. Urine changes (glucosuria, Proteinuria, Hematuria, pyuria)

VII. Safety

  1. Avoided in pregnancy (despite pregnancy Category C)
    1. Cartilage damage risk
  2. Considered safe in Lactation
    1. However, risk of pediatric Arthropathy

VIII. Pharmacokinetics

  1. Bioavailability 98%
  2. Peaks 1 to 2 hours after oral dose
  3. Serum Half-Life: 5 to 8 hours (twice as long as Ciprofloxacin)
  4. Renal excretion (70 to 80% unchanged, remainder to minor, relatively inactive metabolites)
  5. Protein binding 30%
  6. Broad Distribution

IX. Drug Interactions

  1. Warfarin
    1. Ofloxacin potentiates Anticoagulant activity
  2. Drugs that interfere with Ofloxacin absorption (give at least 2 hours before or after Ofloxacin)
    1. Antacids containing Calcium, aluminum or Magnesium
    2. Sucralfate
    3. Iron
    4. Zinc
  3. Opiate urine screening
    1. False Positive

X. Resources

  1. Ofloxacin Tablet (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee1bf431-97fa-4aba-9cc3-0cfcea779ca2

XI. References

  1. (1991) Med Lett Drugs Ther 33(849): 71-3
  2. King (2000) Am Fam Physician 61(9):2741-8 [PubMed]
  3. O'Donnell (2000) Infect Dis Clin North Am 14(2):489-513 [PubMed]
  4. Oliphant (2002) Am Fam Physician 65(3):455-64 [PubMed]
  5. Owens (2000) Med Clin North Am 84(6):1447-69 [PubMed]

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Related Studies

Cost: Medications

ofloxacin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
OFLOXACIN 0.3% EAR DROPS Generic $1.89 per ml
OFLOXACIN 0.3% EYE DROPS Generic $1.69 per ml
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

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