Moxifloxacin
AVELOX
What it isFluoroquinolone inhibiting bacterial DNA gyrase; respiratory and intra-abdominal infection.
Why this oneThe broadest anaerobic and pneumococcal cover of the quinolones, once daily, with excellent tissue penetration.
What limits itPoor urinary exposure makes it the wrong quinolone for UTI. Its prominent QT signal compounds the class tendon and neuropathy risks.
FDA-approved for
- community-acquired pneumonia (1999)
- sinusitis (1999)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Community-acquired pneumonia (7–14 d) | adult | 400 mg QD | ||
| Uncomplicated skin/skin-structure infection (7 d) | adult | 400 mg QD | ||
| Complicated skin/skin-structure infection (7–21 d) | adult | 400 mg QD | ||
| Complicated intra-abdominal infection (5–14 d) | adult | 400 mg QD | ||
| Plague (10–14 d) | adult | 400 mg QD | ||
| Acute bacterial sinusitis (10 d) | adult | 400 mg QD | ||
| Acute bacterial exacerbation of chronic bronchitis (5 d) | adult | 400 mg QD |
Renal No adjustment needed (including hemodialysis or CAPD)
Hepatic No adjustment needed (Child-Pugh A–C); use caution re QT prolongation in cirrhosis
Instructions
- Take at least 4 h before or 8 h after products with magnesium, aluminum, iron, or zinc (antacids, sucralfate, multivitamins, buffered didanosine)
- May take with or without food; drink fluids liberally
- IV-to-oral switch needs no dose change
Contraindications
- Hypersensitivity to any quinolone antibacterial (class cross-reactivity)
Cautions
- QT prolongation / torsade de pointes — avoid with QT-prolonging drugs and proarrhythmic conditions
- Serious/fatal hypersensitivity and anaphylaxis
- Aortic aneurysm and dissection risk
- C. difficile-associated diarrhea
- Blood glucose disturbances
- Photosensitivity/phototoxicity
Adverse reactions
- Nausea
- Diarrhea
- Headache
- Dizziness
- Vomiting
- Insomnia
Pregnancy No human data; animal studies suggest possible fetal harm
Lactation Unknown if present in human milk; likely excreted (animal data)
⚠ BOXED WARNINGS
- Tendinitis and tendon rupture, peripheral neuropathy, CNS effects
- Exacerbation of myasthenia gravis
Cost, est. cash$10–$500/month
Generic entryBy 2023
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityTendon/aortic injury, dysglycemia and CNS effects; QT or CYP1A2 risk varies by agent.
Mechanism of action: Moxifloxacin ballicule
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Memory aids: mascots and interaction avatars
QT prolongation
