Moxifloxacin (Intravenous)

Moxifloxacin injection is used to treat bacterial infections in various parts of the body. It is also used to treat and prevent plague (including pneumonic and septicemic plague).

Moxifloxacin belongs to a group of medicines called quinolone antibiotics. It works by killing bacteria or stopping their growth. However, this medicine will not work for colds, flu, or other viral infections.

This medicine should only be given by or under the direct supervision of your doctor.

It is very important for your doctor to closely monitor your progress while you are receiving this medicine to ensure it is working properly. Blood and urine tests are needed to check for any unwanted effects.

If you have low potassium levels in the blood, moxifloxacin may increase your risk of fast, slow, or irregular heartbeat, loss of consciousness, or fainting spells. If you experience these symptoms, tell your doctor right away.

Serious side effects can happen during treatment with this medicine. Sometimes serious side effects can occur without warning. Possible warning signs include: black, tarry stools, blistering, peeling, or loosening of the skin, bloody or cloudy urine, chills, decreased urination, diarrhea, fever, joint or muscle pain, red skin lesions, often with a purple center, sores, ulcers, or white spots in the mouth or on the lips, severe stomach pain, skin rash, swelling of the face, fingers, feet, or lower legs, unusual bleeding or bruising, unusual weight gain, or yellow skin or eyes. Contact your doctor immediately if you notice any of these warning signs.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you experience itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

Moxifloxacin may cause diarrhea, which can sometimes be severe. It may occur 2 months or more after you stop using this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or prolong it. If you have any questions about this or if mild diarrhea continues or worsens, consult your doctor.

Tell your doctor immediately if you start experiencing numbness, tingling, or burning pain in your hands, arms, legs, or feet. These may be symptoms of a condition called peripheral neuropathy.

Moxifloxacin may rarely cause inflammation (tendinitis) or tearing of a tendon (the cord that connects muscles to bones). This can happen while you are using the medicine or after you finish it. The risk of tendon problems may be higher if you are over 60 years old, are using steroid medicines (e.g., dexamethasone, prednisolone, prednisone, or Medrol®), have severe kidney issues, have a history of tendon problems (e.g., rheumatoid arthritis), or if you have received an organ transplant (e.g., heart, kidney, or lung). Contact your doctor immediately if you have sudden pain or swelling in a tendon after exercise (e.g., ankle, back of the knee or leg, shoulder, elbow, or wrist), bruise more easily after an injury, or are unable to bear weight or move the affected area. Avoid exercise until your doctor advises otherwise.

Notify your doctor immediately if you have any of the following symptoms while receiving this medicine: convulsions (seizures), feelings of anxiety, confusion, or depression, seeing, hearing, or feeling things that are not there, severe headache, trouble sleeping, or unusual thoughts or behaviors.

Moxifloxacin may cause some people to feel dizzy, lightheaded, drowsy, or less alert than usual. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. If these effects are especially bothersome, consult your doctor.

Some individuals receiving moxifloxacin may become more sensitive to sunlight than normal. Even brief exposure to sunlight may cause severe sunburn, or skin rash, redness, itching, or discoloration. When you start receiving this medicine:

• Stay out of direct sunlight, especially between the hours of 10 AM and 3 PM, if possible.
• Wear protective clothing, including a hat and sunglasses.
• Use a sunblock product with a sun protection factor (SPF) of at least 15. Some people may need a product with a higher SPF number, especially if they have a fair complexion. If you have questions about this, contact your doctor.
• Do not use a sunlamp or tanning bed or booth.

If you have a severe reaction to the sun, consult your doctor.

For diabetic patients: This medicine may affect your blood sugar levels. If you notice a change in your blood or urine sugar test results or if you have any questions, consult your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a drug, the risks of using the medicine must be weighed against the beneficial it will do. This is a decision you and your clinician will make. For this drug, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Additionally inform your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of moxifloxacin injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific issues that would limit the usefulness of moxifloxacin injection in the elderly. Nevertheless, elderly patients are more likely to have age-related heart or kidney problems, or develop serious tendon issues (such as tendon rupture), which may require caution in patients receiving moxifloxacin injection.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medicine while breastfeeding.

Interactions with Drugs

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your physician may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are using any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medication with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other drugs you take.

• Bepridil
• Cisapride
• Dronedarone
• Levoketoconazole
• Mesoridazine
• Pimozide
• Piperaquine
• Sparfloxacin
• Terfenadine
• Thioridazine
• Ziprasidone

Using this medicine with any of the following medications is usually not advised, but may be required in some cases. If both medications are prescribed together, your clinician may change the dose or how often you use one or both of the medicines.

• Acarbose
• Adagrasib
• Albiglutide
• Alfuzosin
• Alogliptin
• Amiodarone
• Amisulpride
• Amitriptyline
• Anagrelide
• Apomorphine
• Aripiprazole
• Aripiprazole Lauroxil
• Arsenic Trioxide
• Asenapine
• Astemizole
• Atazanavir
• Azithromycin
• Bedaquiline
• Betamethasone
• Budesonide
• Buprenorphine
• Bupropion
• Buserelin
• Canagliflozin
• Ceritinib
• Chloroquine
• Chlorpromazine
• Chlorpropamide
• Cholera Vaccine, Live
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clofazimine
• Clomipramine
• Clothiapine
• Clozapine
• Corticotropin
• Cortisone
• Cosyntropin
• Crizotinib
• Cyclobenzaprine
• Dabrafenib
• Dapagliflozin
• Dasatinib
• Deflazacort
• Degarelix
• Delamanid
• Desipramine
• Deslorelin
• Deutetrabenazine
• Dexamethasone
• Dexmedetomidine
• Disopyramide
• Dofetilide
• Dolasetron
• Domperidone
• Donepezil
• Doxepin
• Droperidol
• Dulaglutide
• Ebastine
• Efavirenz
• Empagliflozin
• Encorafenib
• Entrectinib
• Eribulin
• Ertugliflozin
• Erythromycin
• Escitalopram
• Etrasimod
• Exenatide
• Famotidine
• Felbamate
• Fexinidazole
• Fingolimod
• Flecainide
• Fluconazole
• Fludrocortisone
• Fluocortolone
• Fluoxetine
• Formoterol
• Foscarnet
• Fosphenytoin
• Fostemsavir
• Galantamine
• Gatifloxacin
• Gemifloxacin
• Gepirone
• Glasdegib
• Glimepiride
• Glipizide
• Glyburide
• Gonadorelin
• Goserelin
• Granisetron
• Halofantrine
• Haloperidol
• Histrelin
• Hydrocortisone
• Hydroquinidine
• Hydroxychloroquine
• Hydroxyzine
• Ibutilide
• Iloperidone
• Imipramine
• Inotuzumab Ozogamicin
• Insulin
• Insulin Aspart, Recombinant
• Insulin Bovine
• Insulin Degludec
• Insulin Detemir
• Insulin Glulisine
• Insulin Lispro, Recombinant
• Itraconazole
• Ivabradine
• Ivosidenib
• Ketoconazole
• Lapatinib
• Lefamulin
• Lenvatinib
• Leuprolide
• Levofloxacin
• Linagliptin
• Liraglutide
• Lixisenatide
• Lofexidine
• Lumefantrine
• Macimorelin
• Magnesium Sulfate
• Mefloquine
• Metformin
• Methadone
• Methotrexate
• Methylprednisolone
• Metronidazole
• Mifepristone
• Miglitol
• Mirtazapine
• Mizolastine
• Mobocertinib
• Nafarelin
• Nateglinide
• Nelfinavir
• Nilotinib
• Norfloxacin
• Octreotide
• Ofloxacin
• Olanzapine
• Ondansetron
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Ozanimod
• Pacritinib
• Paliperidone
• Panobinostat
• Paroxetine
• Pasireotide
• Pazopanib
• Pentamidine
• Perphenazine
• Phenobarbital
• Pimavanserin
• Pioglitazone
• Pipamperone
• Pitolisant
• Ponesimod
• Porfimer
• Posaconazole
• Pramlintide
• Prednisolone
• Prednisone
• Primidone
• Probucol
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Protriptyline
• Quetiapine
• Quinidine
• Quinine
• Quizartinib
• Ranolazine
• Rasagiline
• Relugolix
• Repaglinide
• Ribociclib
• Rilpivirine
• Risperidone
• Ritonavir
• Rosiglitazone
• Saxagliptin
• Selpercatinib
• Semaglutide
• Sertindole
• Sertraline
• Sevoflurane
• Siponimod
• Sitagliptin
• Sodium Phosphate
• Sodium Phosphate, Dibasic
• Sodium Phosphate, Monobasic
• Solifenacin
• Sorafenib
• Sotalol
• Sulpiride
• Sunitinib
• Tacrolimus
• Tamoxifen
• Telaprevir
• Telavancin
• Telithromycin
• Tetrabenazine
• Tolazamide
• Tolbutamide
• Tolterodine
• Toremifene
• Trazodone
• Triamcinolone
• Triclabendazole
• Trimipramine
• Triptorelin
• Vandetanib
• Vardenafil
• Vemurafenib
• Venlafaxine
• Vilanterol
• Vinflunine
• Voclosporin
• Voglibose
• Voriconazole
• Vorinostat
• Warfarin
• Zuclopenthixol

Using this medicine with any of the following medications may cause an increased chance of certain adverse effects, but using both drugs may be the best therapy for you. If both medications are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aminolevulinic Acid
• Lanthanum Carbonate
• Rifampin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medications may also cause interactions to occur. Discuss with your healthcare professional the use of your medication with food, alcohol, or tobacco.

Other Medical Issues

The presence of other medical problems may affect the use of this medication. Make sure you tell your doctor if you have any other medical issues, especially:

• Bradycardia (slow heartbeat) or
• Diabetes or
• Diarrhea or
• Heart disease or
• Heart rhythm issues (eg, prolonged QT interval), or family history of or
• Hypoglycemia (low blood sugar) or
• Hypokalemia (low potassium in the blood) or
• Mental illness, history of or
• Seizures (epilepsy), history of—Use with caution. May make these conditions worse.

• Brain disease (eg, hardening of the arteries) or
• Kidney disease or
• Liver disease (including cirrhosis) or
• Organ transplant (eg, heart, kidney, or lung), history of or
• Tendon disorder (eg, rheumatoid arthritis), history of—Use with caution. May cause adverse effects to become worse.

• Myasthenia gravis (serious muscle weakness), or history of—Should not be used in patients with this condition.

Along with its intended effects, this medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they might require medical attention.

Contact your doctor or nurse right away if you experience any of the following side effects:

Rare

• Black, tarry stools
• Bleeding gums
• Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
• Blisters
• Bloating or swelling of the face, arms, hands, lower legs, or feet
• Blood in the urine or stools
• Blurred vision
• Bone pain
• Burning, crawling, itching, numbness, prickling, "pins and needles," or tingling feelings
• Chest pain
• Chills
• Clay-colored stools
• Cough
• Crying
• Dark urine
• Deep or fast breathing with dizziness
• Diarrhea, watery and severe, which may also be bloody
• Difficult or labored breathing
• Difficulty with moving
• Difficulty with swallowing
• Discouragement
• Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• Dry mouth
• Excessive muscle tone
• Fainting
• Fast, irregular, pounding, or racing heartbeat or pulse
• Feeling of unreality
• Feeling of warmth or heat
• Feeling sad or empty
• Fever
• Flushed, dry skin
• Flushing or redness of the skin, especially on the face and neck
• Fruit-like breath odor
• Headache
• Increased hunger
• Increased sensitivity of the skin to sunlight
• Increased thirst
• Increased urination
• Irregular heartbeat, recurrent
• Irritability
• Joint pain, stiffness, or swelling
• Lack of coordination
• Loss of appetite
• Loss of interest or pleasure
• Lower back, side, or stomach pain
• Mood or mental changes
• Muscle cramps, pains, stiffness, tension, or tightness
• Nausea
• Nervousness
• Noisy breathing
• Numbness of the feet, hands, and around the mouth
• Pain in the pelvis
• Pain, warmth, or burning in the fingers, toes, and legs
• Painful or difficult urination
• Painful, swollen joints
• Pale skin
• Pinpoint red spots on the skin
• Pounding in the ears
• Problems with speech or speaking
• Problems with vision or hearing
• Quick to react or overreact emotionally
• Rapid weight gain
• Rapidly changing moods
• Redness or other discoloration of the skin
• Restlessness
• Seeing, hearing, or feeling things that are not there
• Seizures
• Sensation of the skin burning
• Sense of detachment from self or body
• Severe sunburn
• Shakiness in the legs, arms, hands, or feet
• Skin rash or itching
• Sore throat
• Sores, ulcers, or white spots on the lips or in the mouth
• Stomach cramps or tenderness
• Sweating
• Swelling of the feet or lower legs
• Swelling or puffiness of the face
• Swollen glands
• Thick, white vaginal discharge with no odor or with a mild odor
• Tightness in the chest
• Tingling of the hands or feet
• Trouble concentrating
• Trouble sleeping
• Troubled breathing with exertion
• Unexplained weight loss
• Unpleasant breath odor
• Unusual bleeding or bruising
• Unusual tiredness or weakness
• Unusual weight gain or loss
• Vomiting
• Vomiting of blood
• White patches in the mouth or on the tongue
• Yellow eyes or skin

Incidence not known

• Blistering, peeling, or loosening of the skin
• Burning, numbness, tingling, or painful sensations
• Change in the ability to see colors, especially blue or yellow
• Confusion as to time, place, or person
• Difficulty with chewing or talking
• Double vision
• Drooping eyelids
• Eye pain
• General feeling of tiredness or weakness
• Hives
• Hoarseness
• Irregular or slow heart rate
• Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
• Light-colored stools
• Loss of consciousness
• Muscle weakness
• No blood pressure or pulse
• Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• Red, irritated eyes
• Red skin lesions, often with a purple center
• Severe headache
• Severe tiredness
• Stomach pain, continuing
• Stopping of the heart
• Unsteadiness or awkwardness
• Unusual excitement, nervousness, or restlessness
• Weakness in the arms, hands, legs, or feet

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adapts to the medicine. Also, your health care professional may be able to inform you about ways to prevent or lessen some of these side effects. Consult your health care professional if any of the following side effects persist, are bothersome, or if you have any questions about them:

Rare

• Bad, unusual, or unpleasant (after) taste
• Belching
• Burning feeling in the chest or stomach
• Change in sense of smell
• Change in taste
• Changes in vision
• Continuing ringing or buzzing or other unexplained noise in the ears
• Difficulty having a bowel movement
• Excess air or gas in the stomach or bowels
• Fear or nervousness
• Feeling of constant movement of self or surroundings
• Full feeling
• General feeling of discomfort or illness
• Hearing loss
• Heartburn
• Impaired vision
• Indigestion
• Itching of the vagina or genital area
• Lack or loss of strength
• Loss of memory
• Pain during sexual intercourse
• Passing of gas
• Problems with memory
• Redness, swelling, or soreness of the tongue
• Sensation of spinning
• Sleepiness or unusual drowsiness
• Sore mouth or tongue
• Stomach discomfort, upset, or pain

Other side effects not listed may also occur in some patients. If you notice any other effects, contact your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Avelox I.V.

Available Dosage Forms:

• Solution

Therapeutic Class: Antibiotic

Chemical Class: Moxifloxacin

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins. The medicine must be injected slowly, so your IV tube will need to stay in place for at least 60 minutes.

This medicine comes with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Your doctor may give you a few doses of this medicine until your condition improves, and then you may be switched to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.