Moxquin
Generic Name
Moxifloxacin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| moxquin 400 mg injection | ৳ 350.00 | N/A |
Description
Overview of the medicine
Moxifloxacin is a fourth-generation fluoroquinolone antibiotic used to treat a variety of severe bacterial infections, including those affecting the respiratory tract, skin, and abdomen. It is administered intravenously for rapid systemic effect.
Uses & Indications
Dosage
Adults
400 mg administered once daily by intravenous (IV) infusion over 60 minutes. The duration of treatment depends on the infection type and severity, typically 5-21 days.
Elderly
No specific dose adjustment is required for elderly patients based on age alone.
Renal_impairment
No dose adjustment is required for patients with renal impairment, including those on hemodialysis or continuous ambulatory peritoneal dialysis (CAPD).
How to Take
Moxquin 400 mg Injection should be administered by slow intravenous infusion over 60 minutes. It must not be administered by rapid or bolus injection. It can be infused into a peripheral or central vein and may be diluted with compatible intravenous solutions.
Mechanism of Action
Moxifloxacin inhibits bacterial DNA gyrase and topoisomerase IV, essential enzymes involved in bacterial DNA replication, transcription, repair, and recombination. This leads to the disruption of bacterial DNA and ultimately bacterial cell death, exhibiting broad-spectrum bactericidal activity.
Pharmacokinetics
Onset
Rapid, typically within 1 hour of intravenous administration, with antibacterial effects starting promptly.
Excretion
Excreted in urine (approx. 20% as unchanged drug) and feces (approx. 25% as unchanged drug), as well as metabolites. Renal and hepatic impairment do not generally require dose adjustment.
Half life
Approximately 12 to 15 hours, allowing for once-daily dosing.
Absorption
Rapid and complete absorption after intravenous administration, resulting in 100% bioavailability. Peak plasma concentrations are reached shortly after the end of a 60-minute infusion.
Metabolism
Undergoes hepatic metabolism primarily through glucuronide and sulfate conjugation. It is not significantly metabolized by the cytochrome P450 system.
Side Effects
Contraindications
- Hypersensitivity to moxifloxacin, other quinolones, or any component of the formulation
- History of tendon disorders or rupture associated with fluoroquinolone use
- Known QTc prolongation, uncorrected hypokalemia, or concomitant use of Class IA or Class III antiarrhythmics due to increased risk of arrhythmias
- Severe hepatic impairment (Child-Pugh Class C)
Drug Interactions
Warfarin
Potential for increased anticoagulant effect, requiring close INR monitoring.
Corticosteroids
Concomitant use increases the risk of tendinitis and tendon rupture.
Antacids, sucralfate, iron, zinc-containing products
May reduce the oral absorption of moxifloxacin (less relevant for IV, but caution if switching to oral).
Drugs that prolong the QT interval (e.g., antipsychotics, tricyclic antidepressants)
Additive effect on QTc prolongation.
Class IA antiarrhythmics (e.g., quinidine, procainamide) and Class III antiarrhythmics (e.g., amiodarone, sotalol)
Increased risk of QTc prolongation and arrhythmias.
Storage
Store at 20°C to 25°C (68°F to 77°F), with excursions permitted to 15°C to 30°C (59°F to 86°F). Protect from freezing. Do not refrigerate. Protect from light.
Overdose
In the event of an overdose, no specific antidote exists. Management should be supportive, including general symptomatic and supportive measures, and close monitoring of ECG for QTc prolongation. Hemodialysis or peritoneal dialysis may be helpful in removing some drug from the body, but specific data are limited.
Pregnancy & Lactation
Pregnancy Category C. Moxifloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human breast milk and should be avoided during lactation to prevent potential harm to the nursing infant.
Side Effects
Contraindications
- Hypersensitivity to moxifloxacin, other quinolones, or any component of the formulation
- History of tendon disorders or rupture associated with fluoroquinolone use
- Known QTc prolongation, uncorrected hypokalemia, or concomitant use of Class IA or Class III antiarrhythmics due to increased risk of arrhythmias
- Severe hepatic impairment (Child-Pugh Class C)
Drug Interactions
Warfarin
Potential for increased anticoagulant effect, requiring close INR monitoring.
Corticosteroids
Concomitant use increases the risk of tendinitis and tendon rupture.
Antacids, sucralfate, iron, zinc-containing products
May reduce the oral absorption of moxifloxacin (less relevant for IV, but caution if switching to oral).
Drugs that prolong the QT interval (e.g., antipsychotics, tricyclic antidepressants)
Additive effect on QTc prolongation.
Class IA antiarrhythmics (e.g., quinidine, procainamide) and Class III antiarrhythmics (e.g., amiodarone, sotalol)
Increased risk of QTc prolongation and arrhythmias.
Storage
Store at 20°C to 25°C (68°F to 77°F), with excursions permitted to 15°C to 30°C (59°F to 86°F). Protect from freezing. Do not refrigerate. Protect from light.
Overdose
In the event of an overdose, no specific antidote exists. Management should be supportive, including general symptomatic and supportive measures, and close monitoring of ECG for QTc prolongation. Hemodialysis or peritoneal dialysis may be helpful in removing some drug from the body, but specific data are limited.
Pregnancy & Lactation
Pregnancy Category C. Moxifloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human breast milk and should be avoided during lactation to prevent potential harm to the nursing infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture when stored under recommended conditions.
Availability
Hospitals, Pharmacies
Approval Status
Approved by regulatory authorities
Patent Status
Patent expired for generic formulation
WHO Essential Medicine
YesClinical Trials
Moxifloxacin has been evaluated in numerous clinical trials demonstrating its efficacy and safety in various bacterial infections compared to other antibiotics. Post-marketing surveillance programs continue to gather real-world data on its long-term safety profile.
Lab Monitoring
- Electrolyte levels (especially potassium and magnesium) should be monitored in patients at risk for QTc prolongation.
- ECG monitoring is recommended for patients with existing cardiac conditions or those receiving QTc-prolonging drugs.
- Liver function tests (LFTs) should be monitored periodically, especially in patients with pre-existing hepatic impairment or during prolonged treatment.
- Blood glucose levels should be monitored in diabetic patients.
Doctor Notes
- Always consider susceptibility testing results before initiating or continuing treatment with moxifloxacin to guide appropriate antibiotic selection.
- Thoroughly assess patients for risk factors for QTc prolongation, including electrolyte imbalances and concomitant medications, before administration.
- Educate patients about the black box warnings associated with fluoroquinolones, particularly regarding tendon issues and neurological adverse events, and advise immediate reporting of such symptoms.
Patient Guidelines
- Patients should be advised to report any pain, swelling, or inflammation of a tendon (especially Achilles tendon) immediately.
- Report any symptoms of peripheral neuropathy such as pain, burning, tingling, numbness, or weakness immediately.
- Do not stop the medication early, even if symptoms improve, to ensure complete eradication of the infection.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
Missed Dose Advice
If a dose of Moxquin 400 mg Injection is missed, it should be administered as soon as possible. However, if it is almost time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. Do not administer a double dose to make up for a missed one.
Driving Precautions
Moxifloxacin may cause dizziness, lightheadedness, or vision disturbances. Patients should be advised not to drive or operate machinery until they are reasonably certain that moxifloxacin does not adversely affect their ability to perform such tasks.
Lifestyle Advice
- Avoid excessive sunlight exposure or artificial UV light, as fluoroquinolones can increase photosensitivity. Use sunscreen and wear protective clothing.
- Maintain good hydration by drinking plenty of fluids during treatment.
- Avoid strenuous physical activity if tendon issues or discomfort are experienced.
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