Inoflox (ofloxacin tablet and solution, antibiotic)

Inoflox is the brand name of the drug ofloxacin. It is a quinolone antibiotic, specifically a fluoroquinolone. These work by inhibiting the enzyme DNA gyrase, which is essential for bacterial DNA replication. Inhibition of normal replication, repair, and other processes results in bacterial cell death.

All antibiotics are only available with a prescription. They are not effective against viral infections.

Uses

What is Inoflox used for?

It is mainly indicated to treat the following bacterial infections:

• Acute bacterial exacerbations of chronic bronchitis
• Community-acquired pneumonia (CAP)
• Uncomplicated dermal infections
• Non-gonococcal urethritis and cervicitis
• Acute pelvic inflammatory disease
• Uncomplicated cystitis
• Acute uncomplicated pyelonephritis
• Complicated urinary tract infections (UTI)
• Prostatitis
• Enteric infections (including typhoid fever and shigellosis)

The antimicrobial spectrum of activity of ofloxacin includes:

Aerobic Gram-positive bacteria

• Staphylococcus aureus
• Streptococcus pneumoniae
• Streptococcus pyogenes

Aerobic Gram-negative

• Citrobacter koseri
• Enterobacter aerogenes
• Escherichia coli
• Haemophilus influenzae
• Klebsiella pneumoniae
• Neisseria gonorrhoeae
• Proteus mirabilis
• Pseudomonas aeruginosa
• Shigella spp.
• Salmonella typhi
• Yersinia enterocolitica

Other microorganisms

• Chlamydia trachomatis
• Mycobacterium tuberculosis

How should I take Inoflox?

This drug is available as a vial with a solution for IV infusion and oral tablet. The IV solution is typically administered by a licensed health professional in a clinical setting. It should only be administered via slow IV infusion over a period of 30-60 minutes.

The oral tablets should be taken by mouth without chewing or crushing them. The tablets can be taken with or without food, followed by a glass of water. Avoid drinking milk, taking antacids that contain magnesium or aluminum, or taking supplements that contain iron or zinc 2 hours before or after taking ofloxacin.

When receiving either dosage form of this drug, it is important to stay well-hydrated to prevent the formation of highly concentrated urine.

How do I store Inoflox?

This drug should be stored at room temperature (<30°C) and be protected from light. Do not allow this product to freeze. Always check the label before using this product. For safety, keep out of the reach of children and pets.

Do not use if the printed expiration date has passed, the product seal has been broken, or the product has changed in color, odor, or consistency.

Do not dispose of this product by pouring it down the drain, toilet, or into the environment. Ask your pharmacist regarding the proper way and location of disposal.

Precautions & warnings

What should I know before using Inoflox?

Fluoroquinolones, including ofloxacin, are associated with an increased risk of tendinitis and tendon rupture in all ages. Elderly patients (>60 years), those taking corticosteroid drugs, and those with kidney, heart, or lung transplants have an increased risk.

Fluoroquinolones, including ofloxacin, may exacerbate muscle weakness in persons with myasthenia gravis. Avoid ofloxacin in patients with a known history of myasthenia gravis.

Before using this medication, inform your doctor if you are/have:

• Ever had an allergic reaction to ofloxacin or other fluoroquinolones
• A history of allergy to other medications, food, or other substances
• Taking other medications
• Underlying health conditions

Is it safe during pregnancy or breastfeeding?

This drug is a pregnancy category C drug. There are no adequate and well-controlled studies using ofloxacin in pregnant women. However, animal studies on fluoroquinolones showed that it causes arthropathy (joint disease) in fetuses. Therefore, only take this medication if instructed by your doctor.

This drug is excreted in breastmilk and may affect a nursing child. So, talk to your doctor or OB-GYN about breastfeeding while taking this medication.

Side effects

What side effects can occur when using Inoflox?

All drugs have the potential to elicit side effects even with normal use. Side effects are often dose-dependent, so lowering the dose or ending treatment usually reduces these effects.

Potential side effects while using this drug include:

• Nausea
• Insomnia
• Headaches
• Dizziness
• Diarrhea
• Vomiting
• Rash and pruritus
• External genital pruritus (in women)
• Vaginitis
• Altered sense of taste
• Hypersensitivity reactions

Seek medical attention immediately if you experience any of these serious drug reactions:

• Severe hypersensitivity reaction
  • Fever
  • Toxic epidermal necrolysis (TEN) or Stevens-Johnson Syndrome (SJS)
  • Vasculitis
  • Serum sickness
• Tendon pain (tendinitis)
• Muscle pain (myalgia)
• Joint pain (arthralgia)
• Hepatitis
• Hematologic abnormalities
  • Anemia
  • Thrombocytopenia
  • Leukopenia
  • Agranulocytosis
  • Pancytopenia

You may experience some, none, or other side effects not mentioned above. If you have any concerns about a side effect or it becomes bothersome, consult your doctor or pharmacist.

Interactions

What drugs may interact with Inoflox?

This drug may interact with other medications. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Known drugs and their interactions with ofloxacin include:

• Metal cations
• Antacids
• Didanosine
• Multivitamins
• Antidiabetic medications
• Aminoglycosides
• Antituberculosis medications
• Β-lactam antibiotics
• Corticosteroids
• Antiarrhythmic agents (class IA & III)
• Macrolides
• Antipsychotics
• Tricyclic antidepressants
• Furosemide
• Methotrexate
• NSAIDs
• Probenecid
• Theophylline
• Warfarin

If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Your dose may need to be adjusted, substituted with another drug, or discontinue using the drug.

Does food or alcohol interact with Inoflox?

The oral form of this drug should be taken on an empty stomach for optimal absorption. However, the absorption rate is only slightly decreased with food so it can be taken with meals if desired. There are no notable interactions with alcohol with this drug.

Inform your doctor or pharmacist if you have any concerns regarding food-drug interactions.

What health conditions may interact with Inoflox?

This drug should be taken with caution if you have any of the following conditions or risk factors:

• Myasthenia gravis
• Adolescents under 18 years
• Adults over 60 years
• Conditions that require corticosteroid therapy
• History of organ transplantation

Inform your doctor or pharmacist if you have any concerns regarding specific health conditions.

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

For respiratory and uncomplicated skin infections

• Oral/IV: administer 400 mg every 12 hours for 10 days.

For cervicitis or urethritis due to Chlamydia trachomatis

• Oral/IV: administer 300 mg every 12 hours for 7 days.

For acute pelvic inflammatory disease

• Oral/IV: administer 400 mg every 12 hours for 10 to 14 days

For uncomplicated urinary tract infections

• Cystitis due to coli or K. pneumoniae: administer 200 mg every 12 hours for 3 days
• Cystitis due to other susceptible bacteria: 200 mg every 12 hours for 7 days
• Acute pyelonephritis: administer 400 mg every 12 hours for 14 days
• UTI: administer 200 mg every 12 hours for 14 days

For prostatitis

• Oral/IV: administer 300 mg every 12 hours for 6 weeks

For typhoid fever

• Oral/IV: administer 15 mg/kg/day in 2 divided doses (maximum daily dose: 800 mg) every 12 hours for 5 to 14 days

For shigellosis

• Oral/IV: administer 200 mg every 8 hours for one day, or;
• Oral/IV: administer 400 mg as a single dose

Dose adjustments for patients with renal impairment

• CrCl 20-50 mL/min: no change to the dose, change frequency to once a day
• CrCl <20 mL/min: reduce the dose by half and change the frequency to once a day

What is the dose for a child?

Children should not take fluoroquinolones, including ofloxacin. It may cause bone, joint, and tissue damage in children under 18 years old. Consult with a doctor or pharmacist for alternatives and more information.

How is Inoflox available?

This drug is available in the following dosage forms and strengths:

• Oral tablets 200 mg, 400 mg
• Solution for infusion 200 mg/100 mL

What should I do in case of an emergency or overdose?

Clinical features of acute overdose of ofloxacin may include CNS symptoms such as confusion, dizziness, impairment of consciousness, and convulsive seizures, as well as GI reactions such as nausea and mucosal erosions.

In the event of overdose, symptomatic treatment should be implemented. The patient should be observed, and proper hydration maintained. ECG monitoring should be undertaken because of the possibility of QT interval prolongation.

Gastric lavage or induction of emesis may be used to empty the stomach. Elimination of ofloxacin may be increased by forced diuresis.

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of this drug, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.