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Norflohexal

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Generic Name: Norfloxacin
Product Name: Norflohexal

Indication

Used for the treatment of infections caused by micro-organisms susceptible to Norfloxacin. Including:

  • Urinary tract infections (uncomplicated and complicated)
  • Gastrointestinal infections (e.g. shigellosis, traveller’s diarrhoea).

Norfloxacin is contraindicated in pregnant patients, children, and patients with known hypersensitivity to this drug or any of the related quinolone antibacterials.

Action

Microbiology

Norfloxacin is a broad spectrum, synthetic fluoroquinolone antibiotic. It is bacteriostatic and bactericidal. Norfloxacin shows in vitro activity against the following organisms:

Urinary tract infection pathogens: Aerobic bacteria. Gram positive bacteria including S.faecalis, S.aureus, S.epidermidis, S.saprophyticus. Gram negative bacteria including E.coli, E.cloacae, K.oxytoca, K.pneumoniae, P.mirabilis, P.aeruginosa, C.diversus, C.freundii.

Gastrointestinal tract infection pathogens: Shigella, E.coli, S.typhi. Others: N.gonorrhoea. The development of resistance during therapy is uncommon, those pathogens most likely to develop resistance include: P.aeruginosa, K.pneumoniae, Acinetobacter sp., enterococci.

Cross resistance between norfloxacin and other classes of antibacterials is uncommon, meaning norfloxacin is often active against indicated organisms resistant to the aminoglycosides, penicillins, cephalosporins, tetracyclines, macrolides, sulfonamides (including cotrimoxazole).

Pharmacokinetics

In healthy, fasting volunteers, 30-40% of the dose is absorbed (food may decrease absorption). Peak plasma concentrations are achieved close to one hour after dosing, steady state concentrations are attained after about 2 days. Effective half life is 3-4 hours. Excretion of the absorbed drug is predominantly renal. Unabsorbed drug (and a small component of absorbed drug after biliary excretion) is recovered in the faeces.

Dose advice

Urinary tract infection

Normal renal function: 400 mg, twice daily, for 7-10 days. (Uncomplicated infection may be treated for 3 days. Suppression of chronic infection may necessitate treatment for 4-12 weeks).

Impaired renal function: Creatinine clearance < 30 mL/min: 400 mg, once daily. (Duration as above)

Use in the elderly

Doses for elderly patients should be guided by their renal function, as above.

Gastrointestinal infection

400 mg, twice daily, for 5 days. Maximum daily dose should not exceed 800 mg per day.

Schedule

S4

Common side effects

  • Nausea
  • Headache
  • Dizziness
  • Abnormal haematological and hepatic & renal biochemistry laboratory values (e.g. eosinophilia,

Uncommon side effects

For further information talk to your doctor.

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Dates

Posted On: 22 July, 2003
Modified On: 1 January, 1970

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