
Moxifloxacin
1-cyclopropyl-7-[(1S,6S)-2,8-diazabicyclo
[4.3.0]non-8-yl]-6-fluoro-8-methoxy-4-oxo- quinoline-3-carboxylic acid
Moxifloxacin 會干擾DNA之形成,透過抑制協助DNA 複製、修復與轉錄之酵素topoisomerase 群中的topoisomerase II 及IV ,產生殺菌作用。
治療下列微生物具感受性的菌株所引起的細菌性結膜炎。
好氧性革蘭氏陽性菌:Corynebacterium species*、Micrococcus luteus*、Staphylococcus aureus、Staphylococcus epidermidis、Staphylococcus haemolyticus、Staphylococcus hominis、Staphylococcus warneri*、Streptococcus pneumoniae、Streptococcus viridans group
好氧性革蘭氏陰性菌:Acinetobacter Iwoffii*、Haemophilus influenzae、Haemophilus parainfluenzae*
每次點一滴於患眼,每天三次,連續點藥七天。
最常見的眼部副作用為結膜炎、視覺敏銳度降低、眼睛乾澀、角膜炎、眼部不適、眼部充血、眼部疼痛、眼部搔癢、結膜下出血及流淚。這些問題的發生率約為1-6%。
非眼部副作用發生率介於1-4%,有:發燒、咳嗽增加、感染、中耳炎、咽炎、皮疹及鼻炎。
Absorption
Bioavailability is approximately 90%; AUC is approximately 48 mcg•h/mL; mean C max is 4.5 mcg/mL (multiple 400 mg oral doses).
Distribution
Protein binding is approximately 30% to 50%; Vd is 1.7 to 2.7 L/kg.
Metabolism
Metabolized via glucuronide (approximately 14%) and sulfate (approximately 38%) conjugation in the liver.
Elimination
Moxifloxacin is eliminated in urine (approximately 20% unchanged) and feces (approximately 25%), sulfate conjugate is excreted in feces, and glucuronide conjugate is excreted in urine. The half-life is approximately 12 h; mean apparent total Cl is approximately 12 L/h; renal Cl is approximately 2.6 L/h.
Special Populations
Renal Function Impairment
No dosage adjustment is necessary in patients with renal function impairment, including those requiring hemodialysis or continuous ambulatory peritoneal dialysis.
Hepatic Function Impairment
No dosage adjustment is recommended for mild or moderate hepatic insufficiency. Severe hepatic insufficiency has not been studied.
Elderly
No dosage adjustment is necessary based on age.
Gender
No differences in pharmacokinetics between men and women.
Race
Pharmacokinetics are similar between Japanese men and white men.
Antacids containing aluminum, calcium, or magnesium; drug formulations containing divalent or trivalent cations (eg, some didanosine formulations); metal cations (eg, iron); multivitamins containing iron or zinc; sucralfate
May decrease the absorption of moxifloxacin. Take moxifloxacin at least 4 h before or 8 h after these agents.
Azole antifungal agents; cisapride; class IA antiarrhythmic agents (eg, procainamide, quinidine); class III antiarrhythmic agents (eg, amiodarone, sotalol); erythromycin; methadone; pentamidine; phenothiazines; tricyclic antidepressants; ziprasidone; any other drug known to prolong the QTc interval
Increased risk of torsades de pointes or other ventricular arrhythmias.
Warfarin
Anticoagulant effect may be increased.
1.不可作為注射劑使用。
2.不可於結膜下注射Vigamox?,也不可直接注入眼睛前房。
曾有報告指出,接受全身性quinolone 類藥品(包括moxifloxacin)治療的患者,發生嚴重的、有時甚至是致死性的過敏(無防禦性)反應,其中有些是在第一次給藥後發生。有些反應伴隨著心血管衰弱、喪失意識、血管水腫(包括喉部、咽部及臉部水腫、氣道阻塞、呼吸困難、蕁麻疹及癢。假如對moxifloxacin 發生過敏反應,請停用本藥品。嚴重的急性過敏反應可能需要立即進行急救治療,並應視臨床狀況使用氧氣及施行氣道處理。
1. 一般:和其他抗菌製劑一樣,長期使用可能導致非敏感性微生物(包括黴菌)過度生長。若發生重複感染時,應停藥並採取適當的替代治療方式。當臨床判定有需要時,患者需接受利用放大倍率的輔助工具所進行的檢查,如隙燈活體組織顯微鏡或螢光染色檢查。
2. 應告知患者:若發生感染細菌性結膜炎的症狀時,不要配戴隱形眼鏡。
3.患者須知:避免甁口與眼睛、手指及其他地方接觸,以免遭到污染。
4. 全身投予quinolone 類藥品(包括moxifloxacin)可能造成過敏反應,甚至是在第一次給藥後就發生。一出現皮疹或過敏反應的徵狀時,請立即停用並求醫。
藥品應置於攝氏 15 ~ 25 度乾燥處所;如發生變質或過期,不可再使用。
眼藥水第一次開瓶使用,4星期後,如未用完,剩下的應拋棄。




