Avelox Drug Interactions

Interactions with medicinal products: An additive effect on QT interval prolongation of moxifloxacin and other medicinal products that may prolong the QTc interval cannot be excluded. This might lead to an increased risk of ventricular arrhythmias, including torsade de pointes. Therefore co-administration of moxifloxacin with any of the following medicinal products is contraindicated (see also Contraindications): Anti-arrhythmics class IA (e.g. quinidine, hydroquinidine, disopyramide); Anti-arrhythmics class III (e.g. amiodarone, sotalol, dofetilide, ibutilide); Antipsychotics (e.g. phenothiazines, pimozide, sertindole, haloperidol, sultopride); Tricyclic antidepressive agents; Certain antimicrobial agents (sparfloxacin, erythromycin IV, pentamidine, antimalarials particularly halofantrine); Certain antihistamine (terfenadine, astemizole, mizolastine); Others (cisapride, vincamine IV, bepridil, diphemanil).
Antacids, Sucralfate, Multivitamins and other Products Containing Multivalent Cations: Fluoroquinolones, including AVELOX, form chelates with alkaline earth and transition metal cations. Oral administration of AVELOX with antacids containing aluminum or magnesium, with sucralfate, with metal cations such as iron, or with multivitamins containing iron or zinc, or with formulations containing divalent and trivalent cations such as didanosine buffered tablets for oral suspension or the pediatric powder for oral solution, may substantially interfere with the absorption of AVELOX, resulting in systemic concentrations considerably lower than desired. Therefore, AVELOX should be taken at least 4 hours before or 8 hours after these agents (see Dosage & Administration and Pharmacology: Pharmacokinetics under Actions).
Warfarin: Fluoroquinolones, including AVELOX, have been reported to enhance the anticoagulant effects of warfarin or its derivatives in the patient population. In addition, infectious disease and its accompanying inflammatory process, age, and general status of the patient are risk factors for increased anticoagulant activity. Therefore the prothrombin time, International Normalized Ratio (INR), or other suitable anticoagulation tests should be closely monitored if AVELOX is administered concomitantly with warfarin or its derivatives (see Adverse Reactions and Pharmacology: Pharmacokinetics under Actions).
Antidiabetic Agents: Disturbances of blood glucose, including hyperglycemia and hypoglycemia, have been reported in patients treated concomitantly with fluoroquinolones, including AVELOX, and an antidiabetic agent. Therefore, careful monitoring of blood glucose is recommended when these agents are co-administered. If a hypoglycemic reaction occurs, AVELOX should be discontinued and appropriate therapy should be initiated immediately (see Precautions and Adverse Reactions).
Nonsteroidal Anti-Inflammatory Drugs: The concomitant administration of a nonsteroidal anti-inflammatory drug (NSAID) with a fluoroquinolone, including AVELOX, may increase the risks of CNS stimulation and convulsions (see Precautions).
Drugs that Prolong QT: There is limited information available on the potential for a pharmacodynamic interaction in humans between AVELOX and other drugs that prolong the QTc interval of the electrocardiogram. Sotalol, a Class III antiarrhythmic, has been shown to further increase the QTc interval when combined with high doses of intravenous AVELOX in dogs. Therefore, AVELOX should be avoided with Class IA and Class III antiarrhythmics (see Precautions and Pharmacology: Toxicology: Non-clinical Toxicology under Actions).