Moxifloxacin Krka (Moxifloxacin)

Moxifloxacin is a fluoroquinolone antibiotic used to treat infections caused by susceptible bacteria.

• Community-acquired pneumonia: achieves bacterial clearance and clinical cure in adult patients with lower respiratory tract infection.
• Acute bacterial sinusitis: reduces sinus inflammation and eradicates causative pathogens, improving symptoms.
• Skin and soft tissue infections: provides effective treatment of cellulitis, abscesses and wound infections caused by Gram‑negative and Gram‑positive organisms.
• Complicated intra‑abdominal infections: facilitates bacterial eradication in patients with perforated viscus or postoperative intra‑abdominal sepsis.

• Moxifloxacin exerts its antibacterial activity by binding to the DNA gyrase (topoisomerase II) and topoisomerase IV enzymes of susceptible bacteria. This inhibition prevents the supercoiling and relaxation of bacterial DNA required for replication and transcription, leading to rapid bactericidal effect against a broad spectrum of Gram‑positive, Gram‑negative and atypical organisms.

Moxifloxacin may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Nausea
• Diarrhea
• Headache
• Dizziness
• Rash
• Elevated liver enzymes

Serious or Rare Side Effects

• Tendon rupture or tendinitis, especially Achilles tendon
• QT interval prolongation leading to arrhythmias
• Clostridioides difficile‑associated colitis
• Severe allergic reactions such as anaphylaxis
• Hepatic failure or severe liver injury
• Stevens‑Johnson syndrome and toxic epidermal necrolysis

When using Moxifloxacin, clinicians should observe several precautionary measures to minimize risk.

• Assess renal and hepatic function: adjust therapy in patients with impairment.
• Monitor cardiac status: watch for QT prolongation, especially in patients with electrolyte disturbances.
• Avoid use in patients with known tendon disorders: risk of tendon rupture.
• Use with caution in elderly patients: higher incidence of adverse events.
• Review concomitant medications that may prolong QT or affect metabolism: adjust as needed.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Moxifloxacin can interact with other medicines, altering its efficacy or safety.

Major Interactions (Avoid)

• Co‑administration with other QT‑prolonging agents: increased risk of cardiac arrhythmias.
• Antacids or supplements containing aluminum, magnesium, calcium, or iron: reduce oral absorption of moxifloxacin.
• Warfarin: may enhance anticoagulant effect and raise INR.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: may reduce hormonal efficacy, consider alternative contraception.
• Cyclosporine: may increase moxifloxacin plasma concentrations, monitor levels.
• Theophylline: may raise theophylline serum levels, monitor for toxicity.