'''''For patient information of Ofloxacin injection, click <u>[[Ofloxacin injection (patient information)|here]]</u>'''''.
'''''For patient information of Ofloxacin ophthalmic, click <u>[[Ofloxacin ophthalmic (patient information)|here]]</u>'''''.
'''''For patient information of Ofloxacin oral, click <u>[[Ofloxacin oral (patient information)|here]]</u>'''''.
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'''''For patient information of Ofloxacin otic, click <u>[[Ofloxacin otic (patient information)|here]]</u>'''''.
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{{CMG}}; {{AE}} {{SS}}
==Overview==
'''Ofloxacin''' (sold under the brand name '''Floxin®''' in the [[United States]], '''Tarivid®''' in Europe and some other countries) is a[[fluoroquinolone]] [[antibiotic]]. Ofloxacin is the [[racemate|racemic]] mixture of the [[Chirality (chemistry)|chiral]] compound. The biologically active [[enantiomer]] is sold separately under the name of [[levofloxacin]]. It is used as a treatment for [[Gonorrhoea#Treatment|gonorrhoea]] and is an alternative treatment to [[ciprofloxacin]] for [[anthrax]].
'''| [[Ofloxacin dosage and administration|Dosage and Administration]]'''
'''| [[Ofloxacin how supplied|How Supplied]]'''
'''| [[Ofloxacin labels and packages|Labels and Packages]]'''
==Mechanism of Action==
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==Mode of action==
Ofloxacin is a [[broad-spectrum antibiotic]] that is active against both
[[Gram-positive]] and [[Gram-negative]] bacteria. It functions by inhibiting [[DNA gyrase]], a type II [[topoisomerase]], and topoisomerase IV,<ref>{{cite journal |author=Drlica K, Zhao X |title=DNA gyrase, topoisomerase IV, and the 4-quinolones |journal=Microbiol Mol Biol Rev. |volume=61 |issue=3 |pages=377–92 |date=1 September 1997|pmid=9293187 |pmc=232616 |url=http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=9293187 }}</ref> which is an enzyme necessary to separate (mostly in prokaryotes, in bacteria in particular) replicated DNA, thereby inhibiting bacterial cell division.
The fluoroquinolones interfere with DNA replication by inhibiting an enzyme complex called DNA gyrase. This can also affect mammalian cell replication. In particular, some [[Congener (chemistry)|congeners]] of this drug family display high activity not only against bacterial topoisomerases, but also against eukaryotic topoisomerases and are toxic to cultured mammalian cells and ''[[in vivo]]'' tumor models. Although the quinolone is highly toxic to mammalian cells in culture, its mechanism of [[cytotoxic]] action is not known. Quinolone induced DNA damage was first reported in 1986.<ref>{{cite journal |author=Hussy P, Maass G, Tümmler B, Grosse F, Schomburg U |title=Effect of 4-quinolones and novobiocin on calf thymus DNA polymerase alpha primase complex, topoisomerases I and II, and growth of mammalian lymphoblasts |journal=Antimicrob. Agents Chemother. |volume=29 |issue=6 |pages=1073–8 |year=1986 |month=June |pmid=3015015 |pmc=180502 |doi= 10.1128/AAC.29.6.1073|url=http://aac.asm.org/cgi/reprint/29/6/1073.pdf}}</ref>
Recent studies have demonstrated a correlation between mammalian cell cytotoxicity of the quinolones and the induction of [[micronuclei]].<ref>Hosomi JA. Maeda Y. Oomori T. Irikura and T. Yokota (1988). "Mutagenicity of norfloxacin and AM-833 in bacteria and mammalian cells". Rev. Infect. Dis 10 (Suppl. 1): S148–S149.</ref><ref>{{cite journal |author=Forsgren A, Bredberg A, Pardee AB, Schlossman SF, Tedder TF |title=Effects of ciprofloxacin on eucaryotic pyrimidine nucleotide biosynthesis and cell growth |journal=Antimicrob. Agents Chemother. |volume=31 |issue=5 |pages=774–9 |year=1987 |month=May |pmid=3606077 |pmc=174831 |doi= 10.1128/AAC.31.5.774|url=http://aac.asm.org/cgi/reprint/31/5/774.pdf |format=PDF |first1=A |first2=A |first3=AB |first4=SF |first5=TF |issn=0066-4804}}</ref><ref>{{cite journal |author=Gootz TD, Barrett JF, Sutcliffe JA |title=Inhibitory effects of quinolone antibacterial agents on eucaryotic topoisomerases and related test systems |journal=Antimicrob. Agents Chemother. |volume=34 |issue=1 |pages=8–12 |year=1990 |month=January |pmid=2158274 |pmc=171510 |doi= 10.1128/AAC.34.1.8|first1=TD |first2=JF |first3=JA |issn=0066-4804}}</ref>
|indication=
As such some fluoroquinolones may cause injury to the chromosome of eukaryotic cells.<ref>{{cite journal |author=Elsea SH, Osheroff N, Nitiss JL |title=Cytotoxicity of quinolones toward eukaryotic cells. Identification of topoisomerase II as the primary cellular target for the quinolone CP-115,953 in yeast |journal=J. Biol. Chem. |volume=267 |issue=19 |pages=13150–3 |year=1992 |month=July |pmid=1320012 |doi= |url=http://www.jbc.org/cgi/reprint/267/19/13150 |first1=SH |first2=N |first3=JL |issn=0021-9258}}</ref><ref>{{cite journal |author=Enzmann H, Wiemann C, Ahr HJ, Schlüter G |title=Damage to mitochondrial DNA induced by the quinolone Bay y 3118 in embryonic turkey liver |journal=Mutat. Res. |volume=425 |issue=2 |pages=213–24 |year=1999 |month=April |pmid=10216214 |doi= 10.1016/S0027-5107(99)00044-5|url= |first1=H |first2=C |first3=HJ |first4=G |issn=0027-5107}}</ref><ref>{{cite journal |author=Kashida Y, Sasaki YF, Ohsawa K |title=Mechanistic study on flumequine hepatocarcinogenicity focusing on DNA damage in mice |journal=Toxicol. Sci. |volume=69 |issue=2 |pages=317–21 |year=2002 |month=October |pmid=12377980 |doi= 10.1093/toxsci/69.2.317|url=http://toxsci.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=12377980 |first1=Y |first2=YF |first3=K |first4=N |first5=A |first6=T |first7=K |issn=1096-6080}}</ref><ref>{{cite journal |author=Thomas A, Tocher J, Edwards DI |title=Electrochemical characteristics of five quinolone drugs and their effect on DNA damage and repair in Escherichia coli |journal=[[J. Antimicrob. Chemother.]] |volume=25 |issue=5 |pages=733–44 |year=1990 |month=May |pmid=2165050 |doi= 10.1093/jac/25.5.733|url=http://jac.oxfordjournals.org/cgi/reprint/25/5/733 |first1=A |first2=J |first3=DI |issn=0305-7453}}</ref><ref>{{cite web | url = http://www.academy.org.uk/pharmacy/fluoroq.htm| title = Fluoroquinolones and Quinolones| accessdate = January 29, 2009| publisher = The American Academy of Optometry (British Chapter) }}</ref>
There is debate as to whether or not this DNA damage is to be considered one of the mechanisms of action concerning the severe and non abating adverse reactions experienced by some patients following fluoroquinolone therapy.<ref>{{cite journal |title=A new class of dihaloquinolones bearing N'-aldehydoglycosylhydrazides, mercapto-1,2,4-triazole, oxadiazoline and a-amino ester precursors: synthesis and antimicrobial activity |journal=J. Braz. Chem. Soc |volume=14 |issue=5 |pages= 790|year=2003 |doi=10.1590/S0103-50532003000500014 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-50532003000500014&lng=es&nrm=iso&tlng=es |quote=Nevertheless, some quinolones cause injury to the chromosome of eukaryotic cells.21,22 These findings prompted us to optimize the substituent at C-3, by... |author1=Al-soud, Yaseen A |author2=Al-masoudi, Najim A |last1=Al-Soud |first1=Yaseen A.}}</ref><ref>{{cite journal |author=Yaseen A. Al-Soud a and Najim A. Al-Masoudi |title=A New Class of Dihaloquinolones Bearing N'-Aldehydoglycosylhydrazides, Mercapto-1,2,4-triazole, Oxadiazoline and α-Amino Ester Precursors: Synthesis and Antimicrobial Activity |journal=J. Braz. Chem. Soc |volume=14 |issue=5 |pages=790–796 |year=2003 |url=http://jbcs.sbq.org.br/jbcs/2003/v14_n5/13-048-02.pdf |quote=Although the current quinolones are not considered to be potent inhibitors of eucaryotic topoisomerases, some effects on these and other enzymes involved with DNA replication have been observed |doi=10.1590/S0103-50532003000500014}}</ref><ref name="pmid14529452">{{cite journal |author=Sissi C, Palumbo M |title=The quinolone family: from antibacterial to anticancer agents |journal=Curr Med Chem Anticancer Agents |volume=3 |issue=6 |pages=439–50 |year=2003 |month=November |pmid=14529452 |doi= 10.2174/1568011033482279|url=http://openurl.ingenta.com/content/nlm?genre=article&issn=1568-0118&volume=3&issue=6&spage=439&aulast=Sissi |quote=The present review focuses on the structural modifications responsible for the transformation of an antibacterial into an anticancer agent. Indeed, a distinctive feature of drugs based on the quinolone structure is their remarkable ability to target different type II topoisomerase enzymes. In particular, some congeners of this drug family display high activity not only against bacterial topoisomerases, but also against eukaryotic topoisomerases and are toxic to cultured mammalian cells and in vivo tumor models. |first1=C |first2=M |issn=1568-0118}}</ref>
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Black Box Warning
Title
See full prescribing information for complete Boxed Warning.
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Content
Overview
Ofloxacin (oral) is a that is FDA approved for the {{{indicationType}}} of . There is a Black Box Warning for this drug as shown here. Common adverse reactions include .
Adult Indications and Dosage
FDA-Labeled Indications and Dosage (Adult)
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Off-Label Use and Dosage (Adult)
Guideline-Supported Use
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There is limited information regarding Off-Label Guideline-Supported Use of Ofloxacin (oral) in adult patients.
Non–Guideline-Supported Use
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There is limited information regarding Off-Label Non–Guideline-Supported Use of Ofloxacin (oral) in adult patients.
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
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There is limited information regarding FDA-Labeled Use of Ofloxacin (oral) in pediatric patients.
Off-Label Use and Dosage (Pediatric)
Guideline-Supported Use
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There is limited information regarding Off-Label Guideline-Supported Use of Ofloxacin (oral) in pediatric patients.
Non–Guideline-Supported Use
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There is limited information regarding Off-Label Non–Guideline-Supported Use of Ofloxacin (oral) in pediatric patients.
Contraindications
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Adverse Reactions
Clinical Trials Experience
There is limited information regarding Clinical Trial Experience of Ofloxacin (oral) in the drug label.
Body as a Whole
Cardiovascular
Digestive
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Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
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Skin and Hypersensitivy Reactions
Special Senses
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Postmarketing Experience
There is limited information regarding Postmarketing Experience of Ofloxacin (oral) in the drug label.