Moxifloxacin

BRAND NAMES

Moxeza: Moxeza includes the active components of moxifloxacin. It is marketed as a 0.5% ophthalmic solution, which is used to treat bacterial conjunctivitis.

Avelox: Avelox contains moxifloxacin's active components. It is available as tablets and is used to treat a variety of bacterial diseases.

MECHANISM OF ACTION

DNA gyrase is a necessary enzyme that aids in the replication, transcription, and repair of bacteria's DNA. Topoisomerase IV is an enzyme that plays an important role in the partitioning of chromosomal DNA during bacterial cell division. Moxifloxacin's bactericidal activity is caused by inhibition of the topoisomerases II and IV.

PHARMACOKINETICS

ABSORPTION

The average oral bioavailability is about 90%. It passes easily through the digestive system. Food has minimal influence on absorption.

DISTRIBUTION

The estimated average volume of distribution for moxifloxacin is 1.7 to 2.7 L/kg.

METABOLISM

Moxifloxacin undergoes limited hepatic metabolism, largely by glucuronidation, and creates inert metabolites. Notably, the metabolism of moxifloxacin is barely impacted by the P450 enzyme.

EXCRETION

The primary mode of elimination for moxifloxacin and its metabolites is unaltered excretion in urine. Approximately 45% to 48% of the administered dose is excreted in the urine, mostly in its unaltered form, with the remainder removed via feces.

PHARMACODYNAMICS

Moxifloxacin is antibacterial, and its mode of action is based on inhibiting bacterial DNA replication by binding to an enzyme known as DNA gyrase, which facilitates the untwisting required to reproduce one double helix into two. Moxifloxacin is a broad-spectrum antibiotic that works on both gram-positive and gram-negative bacteria.

DOSAGE AND ADMINISTRATION

Moxifloxacin is available in tablet form for oral use. It is typically administered once daily, with or without food, for 5 to 21 days. The length of treatment is determined by the type of infection being treated. It is also accessible as an ophthalmic solution. Moxifloxacin is available in the following strengths: 

Injectable solutions: 400 mg/250 ml.

DRUG INTERACTIONS

The drug interaction of moxifloxacin may include 

• Antacids: sucralfate
• Anti-HIV drugs: didanosine
• Minerals include iron, zinc, and magnesium.
• Antibiotics: azithromycin
• Anti-depressants- escitalopram
• Schizophrenic drugs: risperidone
• Blood thinner—Warfarin

CONTRAINDICATION

Individuals who have had known hypersensitivity or adverse responses to moxifloxacin or other fluoroquinolone antibiotics should not take it.

SIDE EFFECTS

Moxifloxacin may cause side effects; it may include

• Nausea
• Vomiting
• Stomach pain
• Diarrhea
• Constipation
• Heartburn

Experience symptoms of moxifloxacin after administration

• Severe diarrhea
• Rash
• Hives
• Itching
• Peeling of the skin
• Fever
• Swelling of the eye
• Hoarseness of throat
• Difficulty breathing
• Yellowing of the skin or eyes
• Extreme hunger
• Decreased urination
• Sudden pain in the chest

OVERDOSE

Symptoms of overdose include CNS and gastrointestinal effects such as

• Somnolence
• Tremor
• Convulsions
• Vomiting
• diarrhea

TOXICITY

Moxifloxacin has been connected to rare, severe, and sometimes deadly episodes of acute liver damage. The onset is usually rapid, and the symptoms include nausea, exhaustion, strange discomfort, and jaundice. These anomalies are usually modest, asymptomatic, and resolve quickly, even with continued medication.