norfloxacin

Norfloxacin is a fluoroquinolone antibiotic. Other fluoroquinolones include ciprofloxacin (Cipro), levofloxacin (Levaquin), and ofloxacin (Floxin).

Norfloxacin works by blocking DNA gyrase enzyme, which is responsible for production and repair of bacterial DNA. Blocking of DNA gyrase leads to bacteria death and prevents worsening of infection.

Norfloxacin treats infections caused by gram-positive and gram-negative bacteria like Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus agalactiae, Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Klebsiella pneumonia, Neisseria gonorrhoeae, Proteus mirabilis, Proteus vulgaris, Pseudomonas aeruginosa, and Serratia marcescens.

The FDA approved the brand name norfloxacin (Noroxin) in October 1986.

Side effects of norfloxacin are

• nausea,
• stomach cramps,
• dizziness,
• headache,
• abdominal pain,
• diarrhea,
• abnormal heartbeats, and
• photosensitivity (sun sensitivity).

Norfloxacin as well as other antibiotics in the fluoroquinolone class of antibiotics, has been associated with tendinitis and even rupture of tendons, particularly the Achilles tendon.

Many antibiotics, including norfloxacin, can alter the normal bacteria in the colon and encourage the overgrowth of a bacterium responsible for the development of inflammation of the colon, (C. difficile caused pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting norfloxacin (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.

Fluoroquinolones have neuromuscular blocking activity and can worsen muscles weakness in individuals with myasthenia gravis. They also worsen low blood glucose levels when combined with sulfonylureas (for example, glyburide [Micronase, Diabeta, Glynase, Prestab]).

• Uncomplicated urinary tract infectionTake 1 tablet (400 mg) by mouth every 12 hours for 3 days
• Complicated urinary tract infection Take 1 tablet (400 mg) by mouth every 12 hours for 10 to 21 days.
• For infections caused by E. coli, K. pneumoniae, or P. mirabilis only. Take 1 tablet (400 mg) by mouth every 12 hours for 7 to 10 days, for infections caused by any other bacteria.
• ProstatitisTake 1 tablet (400 mg) by mouth every 12 hours for 28 to 42 days.
• Gonorrhea Take 2 tablets (800 mg) by mouth as one single dose.

Safe and effective use of norfloxacin is not established in patients under the age of 18 years.

Note that some organisms are resistant to norfloxacin; organisms should be tested for susceptibility to this drug.

• Norfloxacin should be used with caution with medications like caffeine, clozapine (Clozaril), ropinorole (Requip), cyclosporine (Neoral, Sandimmune, Gengraf), theophylline (Theo-24), and tizanidine (Zanaflex) because norfloxacin can slow down breakdown of these medications in and increase their levels in the body.
• Norfloxacin should be separated from aluminum and magnesium containing antacids, sucralfate (Carafate), and multivitamins because they can lower absorption of norfloxacin and reduce its effectiveness. They should be administered 2 hours before norfloxacin.
• Norfloxacin should be used with caution with warfarin (Coumadin) because norfloxacin can increase the risks of bleeding and bruising.
• Norfloxacin should be used with caution with medications used for treating abnormal heartbeats because it can affect heart rhythm.

• It is not known whether norfloxacin enters breast milk; therefore, it is best to be cautious before using it in nursing mothers.

What preparations of norfloxacin are available?

• Tablets: 400 mg

How should I keep norfloxacin stored?

• Store norfloxacin tablets between temperatures of 15 C - 30 C (59 F - 86 F), in a tightly closed container.