NORFLOXACIN

Norfloxacin penetrates into the bacterial cells much more readily than nalidixic acid and exerts a potent bactericidal effect by inhibition of the A subunit of bacterial DNA gyrase an essential enzyme involved in DNA replication, precipitating a sequence of events leading to lysis of the bacteria. Its oral bioavailability is 40% Excretion occurs both in urine as well as in faeces.

Indications

Uro-genital infections, Typhoid fever. Acute bacterial gastroenteritis. Gonorrhoea. Prophylaxis of sepsis in neutropenic patients

Dosage

Typhoid fever 400 mg twice daily for 14 days UTI: 400 mg twice daily for 3 days to 12 weeks Gonorrhoea: 800mg as single dose. Acute bacterial gastroenteritis: 400mg 2-3 times daily for 5 days . Prophylaxis of sepsis in neutropenic patients 400 mg 2-3 times daily upto 8 weeks.

Contra-Indications

Hypersensitivity to any quinolone. Pregnancy. Not recommended for use in children.

Special Precautions

History of convulsions. Ensure hydration and urinary output. In moderate renal insufficiency, reduce the dose. To be used with caution in patients predisposed to seizures. Donot exceed recommended dose. Paediatrics: Not recommended. Pregnancy: Contraindicated. Lactation: Use only, if clearly indicated. Elderly: Safe.

Side Effects

Headache, dizziness, rash, heart burn abdominal cramps, diarrhoea, Anorexia, sleep disturbances, anxiety, irritability.

Drug Interactions

Raises theophylline and cyclosporine levels. Effects of warfarin potentiated. Probenecid reduces urinary excretion of norfloxacin. Others: Nitrofurantoin, oral anticoagulants, theophylline, cyclosporin. Antacids reduce absorption from GIT.