Moxifloxacin dosing

The sulfate conjugate (Ml, 88) comprises approx. 36% of the dose, and is found predominantly in the feces, whereas approx. 14% of the moxifloxacin dose is excreted exclusively via the urine in the form of its glucuronide (M2, 89). The maximum plasma concentrations of the metabolites were much lower than those of moxifloxacin after oral or intravenous application. 

High-dose penicillin (12 million units/day for adults) or ceftiiaxonec or cefotaximec Levofloxaan,1 moxifloxacin,1 gemifloxacin,1 telithromyan, or vancomycin Penicillin-resistant (MIC >1.0 mcg/mL)... 

For penicillin-allergic adults, use a fluoroquinolone (ciprofloxacin 0.5-0.75 g orally every 12 hours or 0.4 g IV every 12 hours levofloxacin 0.5-0.75 g orally or IV every 24 hours or moxifloxacin 0.4 g orally or IV every 24 hours). eGentamicin or tobramycin, 2 mg/kg loading dose, then maintenance dose as determined by serum concentrations, fluoroquinolone or aztreonam 1 g IV every 6 hours may be used in place of the aminoglycoside in patients with severe renal dysfunction or other relative contraindications to aminoglycoside use. 

The long-term (more than several weeks) use of moxifloxacin in children and adolescents has not been approved because of concerns about effects on bone and cartilage growth. The optimal dose is not known. 

MOXIFLOXACIN HYDROCHLORIDE The dose of moxifloxacin is 400 mg (orally or as an IV infusion) once every 24 hours. 

Administer oral doses of moxifloxacin at least 4 hours before or 8 hours after antacids containing magnesium or aluminum, sucralfate, metal cations such as iron, multivitamin preparations with zinc, or didanosine (chewable/buffered tablets or pediatric powder for oral solution). 

Moxifloxacin - Moxifloxacin is well absorbed from the Gl tract. The C ax attained 1 to 3 hours after oral dosing. Steady state is achieved after 3 days or more. Moxifloxacin is widely distributed throughout the body. Moxifloxacin is metabolized via glucuronide and sulfate conjugation. 

In terms of pharmacokinetics, moxifloxacin has a high bioavailability, based on once-daily dosing of 400 mg, of 90% (Keating and Scott, 2004). The maximum plasma... 

Moxifloxacin Oral, TV "respiratory" fluoroquinolone once-daily dosing improved activity versus anaerobes and Mycobacterium tuberculosis hepatic clearance results in lower urinary levels so use in urinary tract infections is not recommended... 

Intravenous conivaptan had no effects on the electrocardiogram in a randomized, single-blind, placebo- and positive-controlled, parallel-group study, in which an intravenous loading dose of conivaptan of 20 mg was followed by a continuous infusion of 40 or 80 mg/day for 4 days or moxifloxacin 400 mg/day for 4 days (9). 

When administered orally, moxifloxacin is absorbed rapidly and almost completely, and has a bioavailabihty of approx. 91% and a plasma half-life of approx. 12 h, which allows once-daily dosing. In the dosage range of 50 to 800 mg, the peak plasma concentration (Cmax) and the area under the plasma concentration/... 

Scheme 14.5 Metabolism of moxifloxacin in humans after a single dose (400 mg, p.o. or i.v.).

Moxifloxacin has excellent pharmacokinetics, is well-tolerated, nonphototoxic, and penetrates rapidly into the body tissues and fluids. Its powerful bactericidal activity and rapid tissue penetration and diffusion to the site of infection produce a rapid onset of action. Due to its long plasma half-life of 12 h, a once-daily dose of400 mg is sufficient for treatment. 

Stass H, et al. Pharmacokinetics, safety, and tolerability of ascending single doses of moxifloxacin, a new 8-methoxy quinolone, administered to healthy subjects. Antimicrob. Agents Chemother., 1998, 42, 2060-2065. 

Stass H, Kubitza D, Wensing G. Pooled analysis of pharmacokinetics, safety and tolerability of single oral 400 mg moxifloxacin (MFX) doses in patients with mild and moderate liver cirrhosis (LC). In 40th Interscience Conference on Antimicrobial Agents and Chemotherapy, Abstract No. 2269. Toronto, 2000. 

Because of their broad potent bactericidal activity the fluoroquinolone antibiotics are also an appropriate topical therapy for nongonococcal hyperacute conjimc-tivitis. Topical moxifloxacin or gatifloxacin should be administered initially in a dose of two drops every hour. 

In an open, randomized, crossover study, the absolute systemic availability of a single 100 mg dose of moxifloxacin was 0.92 in 10 healthy men (mean age 29 years) (8). There was no evidence of active tubular secretion. Both the oral and intravenous formulations were well tolerated, with five reported possible or probable drug-related adverse events, including headache, nausea, and localized urticaria. 

Sinus tachycardia (120/minute) associated with moxifloxacin has been reported in a 49-year-old man about 45 minutes after he took a single 400 mg dose of moxifloxacin (17). 

Demolis JL, Kubitza D, Tenneze L, Funck-Brentano C. Effect of a single oral dose of moxifloxacin (400 mg and 800 mg) on ventricular repolarization in healthy subjects. Chn Pharmacol Ther 2000 68(6) 658-66. 

Burkhardl O, Borner K, Slass H, Beyer G, Allewell M, Nord CE, Lode H. Single- and mulliple-dose pharmaco-kinelics of oral moxifloxacin and clarilhromycin, and con-cenlralions in serum, saliva and faeces. Scand J Infecl Dis 2002 34(12) 898-903. 

Lettieri J, Vargas R, Agarwal V, Liu P. Effect of food on the pharmacokinetics of a single oral dose of moxifloxacin 400mg in healthy male volunteers. Clin Pharmacokinet 2001 40(Suppl l) 19-25. 

In a randomized, multiple-dose, period-balanced, three-way, crossover study in healthy nonsmoking male volunteers, moxifloxacin did not alter the pharmacokinetics of theophylline (77). 

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