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Third Generation Fluoroquinolone
Aka: Third Generation Fluoroquinolone, Third Generation Quinolone, Levofloxacin, Levaquin, Sparfloxacin, Zagam, Gatifloxacin, Tequin, Moxifloxacin, Avelox- See Also
- Precautions
- QT Prolongation with Levofloxacin (Levaquin)
- Three fold increased risk of Sudden Cardiac Death while on Levofloxacin
- This appears to be a class effect with most Fluoroquinolones except Ciprofloxacin
- Ray (2013) N Engl J Med 366(20): 1881-90 [PubMed]
- QT Prolongation with Levofloxacin (Levaquin)
- Activity Spectrum
- Gram Negative Rod coverage (see other Fluoroquinolones)
- Atypical Bacteria
- Moderate Gram Positive activity
- Indications
- Community Acquired Pneumonia
- Refractory acute Bacterial Sinusitis (third line agent)
- Preparations
- Levofloxacin (Levaquin)
- Moxifloxacin (Avelox)
- Low urine concentrations (avoid in UTI)
- No pseudomonas coverage
- Highest risk Quinolone for QT Prolongation
- Sparfloxacin (Zagam)
- Low urine concentrations (avoid in UTI)
- Gatifloxacin (Tequin)
- Removed from U.S. market in 2006 due to fatalities (Hypoglycemia related)
- Adverse Effects
- See Fluoroquinolone
- Hypoglycemia with Gatifloxacin (Tequin)
- Has occurred in non-diabetics
- Contraindicated in Diabetes Mellitus
- References
| Medication Costs | ||
|---|---|---|
| levofloxacin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
| LEVOFLOXACIN 0.5% EYE DROPS | Generic | $5.69 per ml |
| LEVOFLOXACIN 25 MG/ML SOLUTION | Generic | $0.94 per ml |
| LEVOFLOXACIN 250 MG TABLET | Generic | $0.18 each |
| LEVOFLOXACIN 500 MG TABLET | Generic | $0.20 each |
| LEVOFLOXACIN 750 MG TABLET | Generic | $0.43 each |
| gatifloxacin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
| GATIFLOXACIN 0.5% EYE DROPS | Generic | $28.53 per ml |
| moxifloxacin (on 5/17/2017 at Medicaid.Gov Pharmacy Drug pricing) | ||
| MOXIFLOXACIN HCL 400 MG TABLET | Generic | $5.53 each |
| avelox (on 10/12/2016 at Medicaid.Gov Pharmacy Drug pricing) | ||
| AVELOX 400 MG TABLET | Generic | $5.53 each |
| 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. | ||
sparfloxacin (C0052585) |
|
|---|---|
| Definition (NCI) | A fluoroquinolone antibiotic that inhibits bacterial DNA gyrase, thereby inhibiting DNA replication and transcription. Sparfloxacin was withdrawn from the U.S. market due to a high incidence of phototoxicity. |
| Concepts | Antibiotic (T195) , Organic Chemical (T109) |
| MSH | C061363 |
| SnomedCT | 387554008, 96090000 |
| LNC | LP17280-6, MTHU009179 |
| English | sparfloxacin, sparfloxacin (medication), sparfloxacin [Chemical/Ingredient], 5-amino-1-cyclopropyl-7-[(3R,5S)3,5-dimethylpiperazin-1-yl]-6,8-difluoro-4-oxo-quinoline-3-carboxylic acid, 5-amino-1-cyclopropyl-7-(cis-3,5-dimethyl-1-piperazinyl)- 6,8-difluoro-1,4-dihydro-4-oxo-3-quinolinecarboxylic acid, Sparfloxacin, Sparfloxacin (product), Sparfloxacin (substance), SPARFLOXACIN |
| Spanish | esparfloxacino, esparfloxacina (producto), esparfloxacino (producto), esparfloxacina, esparfloxacino (sustancia), esparfloxacina (sustancia) |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Levofloxacin (C0282386) |
|
|---|---|
| Definition (MSH) | The L-isomer of Ofloxacin. |
| Definition (NCI) | A broad-spectrum, third-generation fluoroquinolone antibiotic and optically active L-isomer of ofloxacin with antibacterial activity. Levofloxacin diffuses through the bacterial cell wall and acts by inhibiting DNA gyrase (bacterial topoisomerase II), an enzyme required for DNA replication, RNA transcription, and repair of bacterial DNA. Inhibition of DNA gyrase activity leads to blockage of bacterial cell growth. |
| Definition (NCI_NCI-GLOSS) | A substance used to treat bacterial infections. It belongs to the family of drugs called quinolone antibiotics. |
| Definition (PDQ) | A broad-spectrum, third-generation fluoroquinolone antibiotic and optically active L-isomer of ofloxacin with antibacterial activity. Levofloxacin diffuses through the bacterial cell wall and acts by inhibiting DNA gyrase (bacterial topoisomerase II), an enzyme required for DNA replication, RNA transcription, and repair of bacterial DNA. Inhibition of DNA gyrase activity leads to blockage of bacterial cell growth. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37941&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37941&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1586" NCI Thesaurus) |
| Concepts | Organic Chemical (T109) , Antibiotic (T195) |
| MSH | D064704 |
| SnomedCT | 387552007, 96087006 |
| LNC | LP17276-4, MTHU009097 |
| English | levofloxacin, levofloxacin (medication), LEVOFLOXACIN, Levofloxacin [Chemical/Ingredient], Levofloxacin, Ofloxacin, (S)-Isomer, Levofloxacin (product), Levofloxacin (substance) |
| Spanish | levofloxacino (producto), levofloxacina, levofloxacino, levofloxacino (sustancia), levofloxacina (producto), levofloxacina (sustancia) |
| Czech | levofloxacin |
| French | Lévofloxacine |
| German | Levofloxacin |
| Italian | Levofloxacina |
| Russian | ЛЕВОФЛОКСАЦИН, ОФЛОКСАЦИН, (S)-ИЗОМЕР, OFLOKSATSIN, (S)-IZOMER, QUIXIN, LEVOFLOKSATSIN |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
moxifloxacin (C0536495) |
|
|---|---|
| Definition (NCI) | A fluoroquinolone antibiotic with antibacterial activity. Moxifloxacin binds to and inhibits the bacterial enzymes DNA gyrase (topoisomerase II) and topoisomerase IV, resulting in inhibition of DNA replication and repair and cell death in sensitive bacterial species. |
| Definition (NCI_NCI-GLOSS) | A drug used to treat bacterial infections. It is a type of fluoroquinolone. |
| Concepts | Organic Chemical (T109) , Antibiotic (T195) |
| MSH | C104727 |
| SnomedCT | 371296007, 408008008, 412439003 |
| LNC | LP28720-8, MTHU014635 |
| English | 1-cyclopropyl--7-(2,8-diazabicyclo(4.3.0)non-8-yl)-6-fluoro-8-methoxy-1,4-dihydro-4-oxo-3-quinolinecarboxylic acid, moxifloxacin, moxifloxacin [Chemical/Ingredient], Moxifloxacin (product), MOXIFLOXACIN, Moxifloxacin product (product), Moxifloxacin product, MOXI, Moxifloxacin, Moxifloxacin (substance) |
| Spanish | moxifloxacina, producto (producto), moxifloxacina, producto, moxifloxacina (producto), moxifloxacino (sustancia), moxifloxacino, moxifloxacina, moxifloxacina (sustancia), moxifloxacino (producto) |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Levaquin (C0721336) |
|
|---|---|
| Definition (CHV) | brand name levofloxacin |
| Definition (CHV) | brand name levofloxacin |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D064704 |
| English | levaquin, levaquin [brand name], Levaquin |
| Czech | Levaquin |
| Italian | Levaquin |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Zagam (C0724448) |
|
|---|---|
| Concepts | Antibiotic (T195) , Organic Chemical (T109) |
| MSH | C061363 |
| English | Zagam, sparfloxacin (Zagam), Aventis Behring brand of sparfloxacin, Bertek brand of sparfloxacin |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
gatifloxacin (C0753645) |
|
|---|---|
| Definition (NCI) | A synthetic 8-methoxyfluoroquinolone with antibacterial activity against a wide range of gram-negative and gram-positive microorganisms. Gatifloxacin exerts its effect through inhibition of DNA gyrase, an enzyme involved in DNA replication, transcription and repair, and inhibition of topoisomerase IV, an enzyme involved in partitioning of chromosomal DNA during bacterial cell division. |
| Concepts | Antibiotic (T195) , Organic Chemical (T109) |
| MSH | C078049 |
| SnomedCT | 371238005, 116349004 |
| LNC | LP28719-0, MTHU014634 |
| English | 1-cyclopropyl-1,4-dihydro-6-fluoro-8-methoxy-7-(3-methyl-1-piperazinyl)-4-oxo-3-quinolinecarboxylic acid, 3-Quinolinecarboxylic acid, 1-cyclopropyl-6-fluoro-1,4-dihydro-8-methoxy-7-(3-methyl-1-piperazinyl)-4-oxo-, 1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-quinoline-3-carboxylic acid, Gatifloxacin product, gatifloxacin (medication), gatifloxacin, gatifloxacin [Chemical/Ingredient], GATIFLOXACIN, Gatifloxacin (product), Gatifloxacin (substance), Gatifloxacin, Gatifloxacin product (product) |
| Spanish | gatifloxacina (producto), gatifloxacina (sustancia), gatifloxacino (sustancia), gatifloxacina, gatifloxacino, gatifloxacino (producto) |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Avelox (C0875968) |
|
|---|---|
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C104727 |
| English | Avelox, avelox, Avalox, Bayer brand of moxifloxacin hydrochloride, Izilox, Actira |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
Tequin (C0876180) |
|
|---|---|
| Concepts | Antibiotic (T195) , Organic Chemical (T109) |
| MSH | C078049 |
| English | Tequin, tequin |
| Sources |
Derived from the NIH UMLS (Unified Medical Language System) |
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