MOXOFT 400 400MG TABLETS

Indications

• Community-acquired pneumonia
• Acute exacerbation of chronic bronchitis
• Sinusitis
• Skin and soft tissue infections
• Intra-abdominal infections
• Complicated urinary tract infections

Dosage

Children: Refer to the BNF for Children for appropriate paediatric dosing recommendations.

Adults: Refer to the BNF for specific dosing guidelines based on the indication and severity of the infection.

Mechanism of action

Moxifloxacin exerts its antibacterial effects primarily through inhibition of bacterial DNA gyrase and topoisomerase IV. By binding to these enzymes, moxifloxacin prevents the supercoiling of DNA, which is necessary for DNA replication, transcription, and repair, ultimately leading to bacterial cell death.

Pharmacodynamics

Moxifloxacin demonstrates concentration-dependent bactericidal activity. Its efficacy is primarily attributed to its ability to achieve high intracellular concentrations and prolonged post-antibiotic effects. The drug is effective against a wide array of pathogens, including Streptococcus pneumoniae, Haemophilus influenzae, and certain atypical pathogens such as Mycoplasma pneumoniae and Chlamydia pneumoniae.

Pharmacokinetics

Moxifloxacin is well absorbed after oral administration, with bioavailability exceeding 90%. It has a large volume of distribution, indicating extensive tissue penetration. The drug is primarily metabolized in the liver via glucuronidation and oxidation, with a half-life of approximately 12 hours. Excretion occurs mainly through the kidneys, with about 50-70% of the dose eliminated in urine as unchanged drug and metabolites.

Contra-indications

• Hypersensitivity to moxifloxacin or other quinolones
• History of tendon disorders related to fluoroquinolone use
• Severe hepatic impairment
• Concomitant use with tizanidine

Adverse effects

• Nausea
• Diarrhea
• Headache
• Dizziness
• Rash
• Tendon rupture
• QT interval prolongation
• Hepatotoxicity

Interactions

• Antacids containing aluminum or magnesium may reduce absorption
• Iron and zinc supplements may decrease bioavailability
• Concurrent use with anticoagulants may increase bleeding risk
• Caution with concurrent use of drugs that prolong the QT interval

Precautions

• Use with caution in patients with a history of seizures
• Monitor for signs of tendon injury, particularly in older patients
• Assess renal function prior to use, as dose adjustment may be necessary
• Caution in patients with myasthenia gravis due to potential exacerbation

Pregnancy

Moxifloxacin should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Animal studies have shown reproductive toxicity.

Breast-feeding

Moxifloxacin is excreted in breast milk. Caution is advised when administering to nursing mothers.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Tablets: 400 mg
• Intravenous infusion: 400 mg/250 mL