Norfloxacin

A to Z Drug Facts

Norfloxacin

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(nor-FLOX-uh-SIN)

Chibroxin, Noroxin, Noroxin Ophthalmic

Class: Antibiotic/Fluoroquinolone

Action Interferes with microbial DNA synthesis.

Indications Oral treatment of urinary tract infections (UTIs) caused by susceptible organisms; treatment of STDs caused by Neisseria gonorrhoeae; ocular solution for treatment of superficial ocular infections due to strains of susceptible organisms; prostatitis caused by E. coli.

Contraindications Hypersensitivity to fluoroquinolones, quinolones, or any component; tendonitis or tendon rupture associated with quinolone use. Ophthalmic use: Epithelial herpes simplex keratitis; fungal disease of ocular structure; mycobacterial infections of eye; vaccinia; varicella.

Route/Dosage

UTIs

ADULTS: PO 400 mg q 12 hr for 3 to 21 days.

STDs

ADULTS: PO 800 mg as single dose.

Ocular Infections

ADULTS and CHILDREN: Topical Acute infection: 1 to 2 gtt q 15 to 30 min; moderate infection: 1 to 2 gtt 4 to 6 times daily.

Prostatitis Caused By E. coli

ADULTS: PO 400 mg q 12 h for 28 days.

Interactions

Antacids, iron salts, zinc salts, sucralfate, didanosine: May decrease oral absorption of norfloxacin. Antineoplastic agents: Serum norfloxacin levels may be decreased. Cyclosporine: Elevated serum cyclosporine levels. Theophylline: Decreased clearance and increased plasma levels of theophylline may result in toxicity.

Lab Test Interferences None well documented.

Adverse Reactions

CNS: Headache; dizziness; fatigue; drowsiness. DERM: Rash. EENT: Conjunctival hyperemia, chemosis, photophobia, transient burning, itching, or stinging. GI: Diarrhea; nausea; vomiting; abdominal pain/discomfort. GU: Increased serum creatinine and BUN. HEMA: Eosinophilia; leukopenia; neutropenia. HEPA: Increased ALT, AST, LDH.

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established (oral form). Convulsions: CNS stimulation can occur; use drug with caution in patients with known or suspected CNS disorders. Photosensitivity: Moderate-to-severe reactions have occurred; avoid excessive sunlight and ultraviolet light. Pseudomembranous colitis: Consider possibility in patients who develop diarrhea. Renal impairment: Reduced clearance may occur; adjust dose accordingly. Superinfection: Use of antibiotics may result in bacterial or fungal overgrowth.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Ophthalmic

Store at room temperature in original container.

Tablets

Store at room temperature.
Give 1 hr before or 2 hr after meals with full glass of water.
Do not administer antacids within 2 hr of dose.

Assessment/Interventions

Obtain patient history, including drug history and any known allergies.
Assess baseline CBC, taste alterations, conjunctivitis, or mycobacterial infections.
Review baseline BUN, creatinine, ALT, AST, and LDH.
Monitor vital signs, elimination patterns, food intolerance, sedation, and sleep patterns.
Monitor conjunctival color and edema if using eyedrop preparation.
Encourage fluid intake; take full glass with each dose and full glass between each dose if not medically contraindicated.
Notify physician of any nausea, rashes, diarrhea, shortness of breath, dizziness, extreme headache, or lethargy.

OVERDOSAGE: SIGNS & SYMPTOMS
	Nausea, headache, dizziness, crystalluria, vomiting, drowsiness, seizures

Patient/Family Education

For ophthalmic use, demonstrate and observe return demonstration of correct technique for instillation of drops.
Advise patient to take medication on empty stomach with full glass of water.
Caution patient to avoid exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.
Advise patient not to double dose if one dose is missed and to notify physician if > 1 dose is missed.
Advise patient to notify physician of any nausea, rashes, diarrhea, shortness of breath, dizziness, unusual headache, or lethargy.
Instruct patient to maintain increased fluid intake (if not contraindicated) while taking this medication.
Advise patient to use caution when driving or performing tasks that require mental alertness until effects of medication are determined.
Remind patient to complete full course of therapy, even if symptoms of urinary tract or eye infection have resolved.
Instruct patient to stop treatment and inform physician if experiencing pain, inflammation, or rupture of tendon, and to rest or refrain from exercise until diagnosis of tendonitis or tendon rupture is excluded.