Fluoroquinolones (Systemic)
Before Using This MedicineIn deciding to use a medicine,
the risks of taking the medicine must be weighed against the good it will
do. This is a decision you and your doctor will make. For the fluoroquinolones,
the following should be considered:
Allergies - Tell your doctor if you have ever had any unusual or
allergic reaction to any of the fluoroquinolones or to any related medicines
such as cinoxacin (e.g., Cinobac) or nalidixic acid (e.g., NegGram). Also
tell your health care professional if you are allergic to any other substances,
such as foods, preservatives, or dyes.
Pregnancy - Studies have not been done in humans. However, use
is not recommended during pregnancy since fluoroquinolones have been reported
to cause bone development problems in young animals.
Breast-feeding - Some of the fluoroquinolones are known to pass
into human breast milk. Since fluoroquinolones have been reported to cause
bone development problems in young animals, breast-feeding is not recommended
during treatment with these medicines.
Children - Use is not recommended for infants or children since
fluoroquinolones have been shown to cause bone development problems in young
animals. However, your doctor may choose to use one of these medicines if
other medicines cannot be used.
Adolescents - Use is not recommended for teenagers younger than
18 years of age since fluoroquinolones have been shown to cause bone development
problems in young animals. However, your doctor may choose to use one of these
medicines if other medicines cannot be used.
Older adults - These medicines have been tested and, in effective
doses, have not been shown to cause different side effects or problems in
older people than they do in younger adults.
Other medicines - Although
certain medicines should not be used together at all, in other cases two different
medicines may be used together even if an interaction might occur. In these
cases, your doctor may want to change the dose, or other precautions may be
necessary. When you are taking a fluoroquinolone, it is especially important
that your health care professional know if you are taking any of the following:
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Aminophylline or
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Oxtriphylline (e.g., Choledyl) or
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Theophylline (e.g., Elixophyllin, Theo-Dur) - Ciprofloxacin,
enoxacin, and norfloxacin may increase the chance of side effects of aminophylline,
oxtriphylline, or theophylline
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Amiodarone (e.g., Cordarone) or
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Astemizole (e.g., Hismanal) or
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Bepridil (e.g., Vascor) or
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Cisapride (e.g., Propulsid) or
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Disopyramide (e.g., Norpace) or
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Erythromycin (e.g., E-Mycin) or
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Pentamidine (e.g., NebuPent) or
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Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g.,
Ormazine, Thorazine Spansule, Thor-Prom], fluphenazine [e.g., Permitil, Prolixin],
mesoridazine [e.g., Serentil], methotrimeprazine [e.g., Nozinan], pericyazine
[e.g., Neuleptil], perphenazine [e.g., Trilafon], prochlorperazine [e.g.,
Compazine], promazine [e.g., Primazine, Sparine], thioridazine [e.g., Mellaril],
trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin]) or
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Procainamide (e.g., Pronestyl) or
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Quinidine (e.g., Quinidex) or
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Sotalol (e.g., Sotacor) or
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Terfenadine (e.g., Seldane) or
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Tricyclic antidepressants (amitriptyline [e.g., Elavil, Endep], amoxapine
[e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Norpramin],
doxepin [e.g., Sinequan], imipramine [e.g., Norfranil, Tipramine, Tofranil],
nortriptyline [e.g., Aventyl, Pamelor], protriptyline [e.g., Vivactil], trimipramine
[e.g., Surmontil]) - Use of these medicines with gatifloxacin, levofloxacin,
moxifloxacin or sparfloxacin may cause heart problems, such as an irregular
heartbeat
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Antacids, aluminum-, calcium-, and/or magnesium-containing, or
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Didanosine (e.g., Videx, ddI) or
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Iron supplements or
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Sucralfate (e.g., Carafate) - Antacids, didanosine, iron, or
sucralfate may keep any of the fluoroquinolones from working properly. Ciprofloxacin
may be taken 2 hours before or 6 hours after these medicines. Moxifloxacin
may be taken 4 hours before or 8 hours after these medicines.
-
Caffeine - Ciprofloxacin, enoxacin, and norfloxacin may increase
the chance of side effects of caffeine; caffeine should not
be taken during treatment with enoxacin
-
Phenytoin (e.g., Dilantin) - Ciprofloxacin may keep phenytoin
from working properly
-
Warfarin (e.g., Coumadin) - Ciprofloxacin and norfloxacin may
increase the effect of warfarin, increasing the chance of bleeding
Other medical problems - The presence of other medical problems may affect the use of fluoroquinolones.
Make sure you tell your doctor if you have any other medical problems, especially:
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Brain or spinal cord disease, including hardening of the arteries
in the brain or epilepsy or other seizures - Fluoroquinolones may cause
nervous system side effects
-
Diabetes mellitus (sugar diabetes) - Levofloxacin may cause changes
in blood sugar, which could lead to problems in controlling blood sugar
-
Heart disease - Gatifloxacin, moxifloxacin or sparfloxacin may
make this problem worse
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Kidney disease or
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Liver disease - Patients with kidney disease or liver disease
may have an increased chance of side effects with any of the fluoroquinolones
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Sensitivity of the skin to sunlight (previous) - Patients taking
sparfloxacin or any of the other fluoroquinolones may have an increased risk
of severe reactions to sunlight
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Tendinitis (previous) - Fluoroquinolones may increase the risk
of tendon injury
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