Fluoroquinolones (Systemic)

Precautions While Using This Medicine

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

If you are taking aluminum- or magnesium-containing antacids, or sucralfate, do not take them at the same time that you take this medicine . It is best to take these medicines at least 6 hours before or 2 hours after taking ciprofloxacin; at least 8 hours before or 2 hours after taking enoxacin; at least 4 hours after taking gatifloxacin; at least 4 hours before or 4 hours after taking sparfloxacin; at least 2 hours before or 2 hours after taking levofloxacin, norfloxacin, or ofloxacin; at least 4 hours before or 2 hours after taking lomefloxacin, and at least 8 hours before and 4 hours after taking moxifloxacin. These medicines may keep fluoroquinolones from working properly.

If you are taking metal cations such as iron, and multivitamin preparations with zinc, or didanosine (Videx[reg ]) chewable/buffered tablets or the pediatric powder for oral solution take moxifloxacin at least 4 hours before or 8 hours after and take ciprofloxacin at least 2 hours before or 6 hours after taking these medicines.

If you are taking levofloxacin, you should not take certain medications which correct a fast, slow or irregular heartbeat. Check with your physician to determine whether you are taking one of these medications.

If you are taking enoxacin, you should not take any caffeine-containing products (e.g., coffee, tea, chocolate, certain carbonated beverages) . Taking any of these caffeine-containing products while you are taking enoxacin may increase the effects of caffeine.

Some people who take fluoroquinolones, especially sparfloxacin, may become more sensitive to sunlight than they are normally. Exposure to sunlight, even for brief periods of time, may cause severe sunburn, or skin rash, redness, itching, or discoloration. When you begin taking this medicine:

• Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.
• Wear protective clothing, including a hat and sunglasses.
• Apply a sun block product that has a skin protection factor (SPF) of at least 15. Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your health care professional.
• Do not use a sunlamp or tanning bed or booth.

Stay out of direct sunlight and artificial light (e.g., sunlamp, tanning bed or booth) for the next 5 days or until the reaction has stopped.

If you get a skin rash or other signs of an allergic reaction, stop taking the fluoroquinolone and check with your doctor .

Fluoroquinolones may also cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that can be dangerous if you are dizzy or are not alert . If these reactions are especially bothersome, check with your doctor.

Fluoroquinolones may rarely cause inflammation or even tearing of a tendon (the cord that attaches muscles to bones). If you get sudden pain in a tendon after exercise (for example, in your ankle, back of the knee or leg, shoulder, elbow, or wrist), stop taking the fluoroquinolone and check with your doctor . Rest and do not exercise until the doctor has made sure that you have not injured or torn the tendon.

For patients with diabetes taking insulin or diabetes medicine by mouth: Levofloxacin may cause hypoglycemia (low blood sugar) in some patients. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out) . Different people may feel different symptoms of low blood sugar. If you experience symptoms of low blood sugar, stop taking levofloxacin and check with your doctor right away:

• Symptoms of low blood sugar can include: Anxious feeling, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty in concentrating, drowsiness, excessive hunger, headache, nausea, nervousness, rapid heartbeat, shakiness, unusual tiredness or weakness.

For patients with low potassium levels: levofloxacin may increase your risk of experiencing a fast, slow or irregular heartbeat.