No

Antibiotic, Quinolone

Lower respiratory infections, acute bacterial exacerbation of chronic bronchitis, skin infections, sexually transmitted diseases, and urinary tract infections caused by E. coli, K. pneumoniae, P. mirabilis, P. aeruginosa; also has gram-positive activity including S. pneumoniae and some staphylococci

C

Hypersensitivity to lomefloxacin or other members of the quinolone group such as nalidixic acid, oxolinic acid, cinoxacin, norfloxacin, and ciprofloxacin; avoid use in children <18 years of age due to association of other quinolones with transient arthropathies

Use with caution in patients with epilepsy or other CNS diseases which could predispose them to seizures.

1% to 10%:

Central nervous system: Headache, dizziness

Dermatologic: Photosensitivity

Gastrointestinal: Nausea

<1%: Flushing, chest pain, hypotension, hypertension, edema, syncope, tachycardia, bradycardia, arrhythmia, extrasystoles, cyanosis, cardiac failure, angina pectoris, myocardial infarction, facial edema, fatigue, malaise, chills, convulsions, vertigo, coma, purpura, rash, gout, hypoglycemia, abdominal pain, vomiting, flatulence, constipation, xerostomia, discoloration of tongue, abnormal taste, urinary disorders, dysuria, thrombocytopenia, increased fibrinolysis, back pain, hyperkinesia, tremor, paresthesias, leg cramps, myalgia, weakness, earache, hematuria, anuria, dyspnea, cough, epistaxis, diaphoresis (increased), allergic reaction, flu-like symptoms, decreased heat tolerance, thirst

Symptoms of overdose include acute renal failure, seizures

GI decontamination and supportive care; diazepam for seizures; not removed by peritoneal or hemodialysis

Decreased effect: Decreased absorption with antacids containing aluminum, magnesium, and/or calcium (by up to 98% if given at the same time), sucralfate, didanosine, divalent and trivalent cations.

Increased toxicity/serum levels: Quinolones cause increased levels of caffeine, warfarin, cyclosporine, and theophylline; cimetidine, probenecid increase quinolone levels

Inhibits DNA-gyrase in susceptible organisms thereby inhibits relaxation of supercoiled DNA and promotes breakage of DNA strands. DNA gyrase (topoisomerase II), is an essential bacterial enzyme that maintains the superhelical structure of DNA and is required for DNA replication and transcription, DNA repair, recombination, and transposition.

Absorption: Well absorbed

Distribution: V_d: 2.4-3.5 L/kg; distributed well into bronchus, prostatic tissue, and urine

Protein binding: 20%

Half-life, elimination: 5-7.5 hours

Elimination: Primarily unchanged in urine

Lower respiratory and urinary tract infections (UTI): Adults: Oral: 400 mg once daily for 10-14 days

Urinary tract infection (UTI) due to susceptible organisms:

Uncomplicated cystitis caused by Escherichia coli: Adult female: Oral: 400 mg once daily for 3 successive days

Uncomplicated cystitis caused by Klebsiella pneumoniae, Proteus mirabilis, or Staphylococcus saprophyticus: Adult female: 400 mg once daily for 10 successive days

Complicated UTI caused by Escherichia coli, Klebsiella penumoniae, Proteus mirabilis, or Pseudomonas aeruginosa: Adults: Oral: 400 mg once daily for 14 successive days

Surgical prophylaxis: 400 mg 2-6 hours before surgery

Uncomplicated gonorrhea: 400 mg as a single dose

No dosage adjustment is needed for elderly patients with normal renal function

Dosing adjustment in renal impairment:

Cl_cr 11-39 mL/minute: Loading dose: 400 mg; then 200 mg every day

Hemodialysis: Same as above

May be taken without regard to meals

Dizziness is common; may cause sedation; quinolones reported to cause restlessness, confusion, depression, paranoia, euphoria, panic, and hallucinations

Inhibits CYP1A2 isoenzyme; use caution with clozapine and other psychotropics; monitor for adverse effects

No information available to require special precautions

No effects or complications reported

Take as directed, preferably on an empty stomach 1 hour before or 2 hours after meals. Complete entire prescription even if feeling better. Maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake). You may experience dizziness or drowsiness; use caution when driving or engaging in tasks that require alertness until response to drug is known. You may experience photosensitivity (use sunscreen, wear protective clothing and eyewear, and avoid direct sunlight). Can take in the evening to reduce risk of photosensitivity. Report any signs of opportunistic infection (eg, fever, chills, vaginal itching or foul-smelling vaginal discharge, oral thrush, easy bruising). Report immediately any signs of allergic reaction (eg, rash, itching or tingling of skin); join pain; difficulty breathing; CNS changes (excitability, seizures); pain, inflammation, or rupture of tendon; or abdominal cramping or pain. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Do not breast-feed.

Monitor signs and symptoms of infection, urinalysis, appropriate cultures, and sensitivities; patients receiving warfarin concurrent therapy should have protimes/INR monitored

Tablet, as hydrochloride: 400 mg

Hoogkamp-Korstanje JA, " In vitro Activities of Ciprofloxacin, Levofloxacin, Lomefloxacin, Ofloxacin, Pefloxacin, Sparfloxacin, and Trovafloxacin Against Gram-Positive and Gram-Negative Pathogens From Respiratory Tract Infections," J Antimicrob Chemother, 1997, 40(3):427-31.

Hooper DC and Wolfson JS, "Fluoroquinolone Antimicrobial Agents," N Engl J Med, 1991, 324(6):384-94.

Kovarik JM, Hoepelman AI, Smit JM, et al, "Steady-State Pharmacokinetics and Sputum Penetration of Lomefloxacin in Patients With Chronic Obstructive Pulmonary Disease and Acute Respiratory Tract Infections," Antimicrob Agents Chemother, 1992, 36(11):2458-61.

Lomaestro BM and Bailie GR, "Quinolone-Cation Interactions: A Review," DICP, 1991, 25(11):1249-58.

Stein GE, "The 4-Quinolone Antibiotics: Past, Present, and Future," Pharmacotherapy, 1988, 8(6):301-14.

Walker RC and Wright AJ, "The Fluoroquinolones," Mayo Clin Proc, 1991, 66(12):1249-59.