Moxifloxacin Hydrochloride, Oral/Injection

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KEY POINTS

• This medicine is taken by mouth or given by injection to treat infections caused by bacteria. Take it exactly as directed.
• If you develop severe diarrhea or diarrhea that lasts more than 2 or 3 days while taking this medicine, or for several weeks after you stop taking this medicine, contact your healthcare provider right away.
• You may develop a different infection while you are taking this medicine.
• This medicine may cause severe nerve problems, worsening of myasthenia gravis, severe tendon problems, or other side effects that may be life threatening. It may cause other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: fluoroquinolone antibiotic

Generic and brand names: moxifloxacin hydrochloride, oral; moxifloxacin hydrochloride, injection; Avelox; Avelox IV

What is this medicine used for?

This medicine is an antibiotic used to treat various infections in the body. This medicine will not cure viral infections such as colds or flu.

This medicine may be taken by mouth, or given by injection.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A kidney, lung or heart transplant
• Cardiomyopathy
• Diabetes
• G6PD deficiency
• Heart rhythm problems
• Kidney disease
• Liver disease
• Long QT syndrome (problems with electrical activity in the heart muscle) or if you have a close relative who has long QT syndrome.
• Too little potassium or magnesium in your blood
• Myasthenia gravis
• Peripheral neuropathy (numbness, tingling, pain, or burning feelings in your feet or hands)
• Rheumatoid arthritis
• Seizures

Tell your healthcare provider if you have recently had a heart attack or stroke.

Females of childbearing age: This medicine is not usually given during pregnancy. Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

Treatment with this medicine may be given an IV infusion (slow drip through a needle into a large vein). You may also take this medicine by mouth.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Take it regularly for as long as prescribed, even if you start to feel better. The infection may return if you stop taking the medicine too soon.

Check with your healthcare provider before using this medicine in children under age 18.

Take the medicine at the same time each day to help you remember to take it. Take each dose with a full glass of water. Drink plenty of fluids while you are taking this medicine.

Take this medicine 4 hours before or 8 hours after medicines, vitamins, or supplements that contain calcium, iron, or zinc; antacids that contain aluminum or magnesium; sucralfate (Carafate); or didanosine (Videx). Do not take antacids (for example, Maalox or Mylanta) within 2 hours of taking as this medicine.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: restlessness, seizures, tremors, vomiting, diarrhea, irregular heartbeat.

What should I watch out for?

This medicine may cause serious side effects that could be life-threatening. If you have these side effects, stop taking the medicine and contact your healthcare provider right away.

• Swelling or rupture of the Achilles tendon or other tendons. Symptoms include pain or swelling in the back of your knee or ankle, in your shoulder or elbow, or in your hand or wrist; hearing or feeling a snap in a tendon area; not being able to move part of your body or bear weight.
• Severe nerve problems (peripheral neuropathy). Symptoms include pain, burning, tingling, numbness, or weakness in your hands, feet, arms or legs; not being able to feel the difference between touching something hot or cold.
• Nervous system effects. Symptoms include seizures; unusual nervousness or anxiety; hallucinations (seeing or hearing things that aren’t there); thoughts of suicide.
• Worsening of myasthenia gravis. Symptoms include worsening muscle weakness or breathing problems.

These symptoms can start soon after you start taking the medicine and problems may be permanent. Your provider may need to prescribe a different medicine.

This medicine may cause or worsen diarrhea. If you develop severe diarrhea or diarrhea that lasts more than 2 or 3 days while taking this medicine, or for several weeks after you stop taking this medicine, contact your healthcare provider right away. Do not take medicine to treat diarrhea without your provider's approval.

Adults over the age of 65 may be at greater risk for side effects.

If you are a diabetic using insulin or taking diabetes medicine by mouth and you have symptoms of low blood sugar, contact your healthcare provider right away. Symptoms of low blood sugar include shaking, anxiety, cold sweats, irritability, fast heartbeat, feeling faint, strong hunger, vision problems, headache, nausea, slurred speech, confusion, unusual mood changes, tingling in the lips or tongue, and weakness.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

This medicine may make your skin more sensitive to the sun, and to indirect light through glass, even when you use sunscreen lotions. This may lead to painful sunburns. While you are taking this medicine and for 5 days after you stop taking it, avoid long exposure to the sun. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. Do not use a sunlamp. If you get a severe sunburn, contact your healthcare provider right away.

This medicine may cause joint pain or damage if given to people under 18 years of age. Talk with your healthcare provider about this.

You may develop a different infection while you are taking this medicine. Report any signs of infection to your healthcare provider.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Continuous or severe bloody diarrhea; fast or pounding heartbeat; seizures; tremors; hallucinations (seeing or hearing things that are not there); blurred vision or double vision; buzzing in the ears; depression or thoughts of suicide; fainting; severe pain or swelling in your ankle or tendons; chest pain; yellowing of your skin or eyes; pain, burning, numbness, weakness, tingling, or a change in sense of touch in your arms, hands, legs, or feet; skin rash with fever.

Other: Nausea, vomiting, mild diarrhea, stomach pain, dry mouth, change in sense of taste, headache, dizziness, drowsiness, sensitivity to the sun, restlessness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antacids that contain aluminum, calcium, or magnesium, such as Gaviscon, Maalox, Mylanta, Phillips' Chewable Tablets, Rolaids, or TUMS (Take antacids at least 4 hours before or 4 hours after you take this medicine.)
• Antiarrhythmic medicines (to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), mexiletine, procainamide, propafenone (Rythmol), quinidine, and sotalol (Betapace, Sorine)
• Antibiotics such as azithromycin (Zithromax, Zmax), clarithromycin (Biaxin), and erythromycin (E.E.S., Ery-Tab, Erythrocin)
• Antidepressants such as amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), duloxetine (Cymbalta), fluoxetine (Prozac), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline, trazodone, and trimipramine (Surmontil)
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Antipsychotic medicines such as chlorpromazine, clozapine (Clozaril, FazaClo), fluphenazine, perphenazine, pimozide (Orap), prochlorperazine (Compro), quetiapine (Seroquel), thioridazine, thiothixene (Navane), trifluoperazine, and ziprasidone (Geodon)
• Calcium acetate (Phos-Lo)
• Corticosteroids such as cortisone, dexamethasone, methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), and prednisone (Prednisone Intensol)
• Diabetes medicines such as acarbose (Precose), glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Glynase), insulin, metformin (Fortamet, Glucophage, Riomet), miglitol (Glyset), nateglinide (Starlix), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia), tolazamide, and tolbutamide
• Doxepin (Silenor)
• HIV medicines such as didanosine (Videx), ritonavir (Norvir), saquinavir (Invirase)
• Iron supplements or multivitamins that contain iron, and iron medicines such as ferric carboxymaltose (Injectafer), ferric gluconate (Ferrlecit), ferumoxytol (Feraheme), and iron sucrose (Venofer)
• Natural remedies such as dong quai and St. John's wort
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as celecoxib (Celebrex), diclofenac (Cambia, Voltaren, Zipsor), diflunisal, etodolac, ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Quinapril (Accupril)
• Ropinirole (Requip)
• Sevelamer (Renagel, Renvela)
• Sucralfate (Carafate)
• Supplements or multivitamins that contain calcium, iron, magnesium, or zinc (Take several hours before or after you take this medicine.)
• Warfarin (Coumadin)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.