me FLOKS a
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
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
<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
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: Vd: 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
Dosing adjustment in renal impairment:
Clcr 11-39 mL/minute: Loading dose: 400 mg; then 200 mg every day
Hemodialysis: Same as above
May be taken without regard to meals
|Mental Health: Effects
on Mental Status|
Dizziness is common; may cause sedation; quinolones reported to cause
restlessness, confusion, depression, paranoia, euphoria, panic, and
Effects on Psychiatric
Inhibits CYP1A2 isoenzyme; use caution with clozapine and other
psychotropics; monitor for adverse effects
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
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
Monitor signs and symptoms of infection, urinalysis, appropriate cultures,
and sensitivities; patients receiving warfarin concurrent therapy should have
Tablet, as hydrochloride: 400 mg
" 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,
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