Ofloxacin
FLOXIN
What it isDNA-gyrase-inhibiting fluoroquinolone; mainly topical treatment of bacterial conjunctivitis and otitis externa.
Why this oneOtic drops are safe with a perforated tympanic membrane and deliver high local exposure without systemic treatment.
What limits itSystemic use can cause tendon rupture, neuropathy and CNS effects and can worsen myasthenia gravis; topical overuse selects resistance.
FDA-approved for
- bacterial conjunctivitis and otitis externa
- various systemic bacterial infections
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Acute bacterial exacerbation of chronic bronchitis | Adult | 400 mg BID ×10 days | 800 mg/day | |
| Community-acquired pneumonia | Adult | 400 mg BID ×10 days | 800 mg/day | |
| Uncomplicated skin/skin structure infection | Adult | 400 mg BID ×10 days | 800 mg/day | |
| Acute uncomplicated urethral/cervical gonorrhea | Adult | 400 mg single dose | 400 mg | |
| Nongonococcal cervicitis/urethritis (C. trachomatis) | Adult | 300 mg BID ×7 days | 600 mg/day | |
| Mixed urethral/cervical infection (C. trachomatis + N. gonorrhoeae) | Adult | 300 mg BID ×7 days | 600 mg/day | |
| Acute pelvic inflammatory disease | Adult | 400 mg BID ×10–14 days | 800 mg/day | |
| Uncomplicated cystitis (E. coli / K. pneumoniae) | Adult | 200 mg BID ×3 days | 400 mg/day | |
| Uncomplicated cystitis (other approved pathogens) | Adult | 200 mg BID ×7 days | 400 mg/day | |
| Complicated UTI | Adult | 200 mg BID ×10 days | 400 mg/day | |
| Prostatitis (E. coli) | Adult | 300 mg BID ×6 weeks | 600 mg/day |
Renal After a normal initial dose: CrCl 20–50 mL/min give usual unit dose q24h; CrCl <20 mL/min give ½ usual unit dose q24h
Hepatic Severe hepatic impairment (cirrhosis): do not exceed 400 mg/day
Instructions
- Reserve use for patients with no alternative options (per boxed warning) for ABECB and uncomplicated cystitis
- Discontinue immediately if tendon, neuropathic, or CNS reactions occur
Contraindications
- History of hypersensitivity to ofloxacin or any quinolone antimicrobial
Cautions
- Tendinitis/tendon rupture; peripheral neuropathy; CNS effects
- Avoid in known myasthenia gravis (may worsen weakness)
- QT prolongation, hypersensitivity, C. difficile, photosensitivity, dysglycemia
Adverse reactions
- Nausea, insomnia, headache
- Dizziness, diarrhea, vomiting
- Rash, pruritus
- Vaginitis, external genital pruritus
- Dysgeusia
Pregnancy Category C; use only if potential benefit justifies risk to fetus.
Lactation Undefined
⚠ BOXED WARNINGS
- Tendinitis and tendon rupture, peripheral neuropathy, CNS effects
- Exacerbation of myasthenia gravis
Cost, est. cash$5–$150/month
Generic entry2002
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: Ofloxacin ballicule
