Nobac
Generic Name
Norfloxacin
Manufacturer
Eskayef Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nobac 400 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Norfloxacin is a synthetic broad-spectrum fluoroquinolone antibacterial agent used for the treatment of various bacterial infections, particularly those affecting the urinary tract.
Uses & Indications
Dosage
Adults
Uncomplicated UTIs: 400 mg twice daily for 3-10 days. Complicated UTIs/Prostatitis: 400 mg twice daily for 10-21 days. Gonorrhea: 800 mg as a single dose. Gastroenteritis: 400 mg twice daily for 5 days.
Elderly
Dosage adjustment may be necessary based on renal function; monitor closely.
Renal_impairment
Creatinine clearance 10-30 mL/min: 400 mg once daily. Creatinine clearance <10 mL/min: 400 mg once every 24-48 hours, or as directed by physician.
How to Take
Take orally with a full glass of water, at least one hour before or two hours after meals or milk products. Do not crush or chew the tablet.
Mechanism of Action
Norfloxacin inhibits bacterial DNA gyrase and topoisomerase IV, enzymes necessary for bacterial DNA replication, transcription, repair, and recombination. This leads to disruption of bacterial DNA and cell death.
Pharmacokinetics
Onset
Clinical effects typically begin within 1-2 hours of administration.
Excretion
Primarily excreted via the kidneys (approximately 30-40% as unchanged drug) and faeces. Both glomerular filtration and tubular secretion are involved.
Half life
Approximately 3-4 hours, potentially longer in patients with impaired renal function.
Absorption
Rapidly absorbed from the gastrointestinal tract; bioavailability is approximately 30-40%. Peak plasma concentrations are achieved 1-2 hours after an oral dose.
Metabolism
Undergoes limited hepatic metabolism to less active metabolites.
Side Effects
Contraindications
- Hypersensitivity to norfloxacin or any other quinolone antibacterial agent.
- History of tendinitis or tendon rupture associated with quinolone use.
- Children and adolescents under 18 years of age (due to potential for cartilage damage).
Drug Interactions
Caffeine
May reduce the clearance of caffeine, leading to increased levels and potential side effects.
Warfarin
May enhance the anticoagulant effect of warfarin, requiring close INR monitoring.
Theophylline
May increase plasma concentrations of theophylline and the risk of toxicity. Adjust theophylline dose if necessary.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Concurrent use may increase the risk of CNS stimulation and convulsive seizures.
Antacids/Multivitamins (containing Mg, Al, Ca, Zn, Fe)
Reduce absorption of norfloxacin. Administer norfloxacin 2 hours before or 4 hours after these agents.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, diarrhea, and in severe cases, seizures. Treatment involves gastric lavage, supportive care, and ensuring adequate hydration. Hemodialysis is not effective.
Pregnancy & Lactation
Not recommended during pregnancy due to potential for cartilage damage in the fetus, unless the benefits outweigh the risks. Norfloxacin is excreted in breast milk and should not be used during breastfeeding due to potential serious adverse reactions in the infant. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to norfloxacin or any other quinolone antibacterial agent.
- History of tendinitis or tendon rupture associated with quinolone use.
- Children and adolescents under 18 years of age (due to potential for cartilage damage).
Drug Interactions
Caffeine
May reduce the clearance of caffeine, leading to increased levels and potential side effects.
Warfarin
May enhance the anticoagulant effect of warfarin, requiring close INR monitoring.
Theophylline
May increase plasma concentrations of theophylline and the risk of toxicity. Adjust theophylline dose if necessary.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Concurrent use may increase the risk of CNS stimulation and convulsive seizures.
Antacids/Multivitamins (containing Mg, Al, Ca, Zn, Fe)
Reduce absorption of norfloxacin. Administer norfloxacin 2 hours before or 4 hours after these agents.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, diarrhea, and in severe cases, seizures. Treatment involves gastric lavage, supportive care, and ensuring adequate hydration. Hemodialysis is not effective.
Pregnancy & Lactation
Not recommended during pregnancy due to potential for cartilage damage in the fetus, unless the benefits outweigh the risks. Norfloxacin is excreted in breast milk and should not be used during breastfeeding due to potential serious adverse reactions in the infant. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the manufacturing date, consult package for exact date.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
Clinical Trials
Norfloxacin has undergone extensive clinical trials since its development, demonstrating efficacy in various bacterial infections, particularly UTIs. Post-marketing surveillance continues to monitor safety and efficacy.
Lab Monitoring
- Renal function tests (blood urea nitrogen, serum creatinine) in patients with impaired renal function or elderly.
- Liver function tests (ALT, AST) if signs of hepatic dysfunction appear.
- Complete blood count (CBC) in patients on prolonged therapy or with known blood dyscrasias risk.
- INR monitoring in patients taking warfarin concurrently.
Doctor Notes
- Emphasize the black box warning for fluoroquinolones, especially regarding tendinitis, tendon rupture, and CNS effects.
- Screen patients for myasthenia gravis, as fluoroquinolones can exacerbate it.
- Counsel patients on the importance of completing the full course and avoiding dairy products/antacids.
- Monitor renal function, especially in elderly and renally impaired patients, and adjust dosage accordingly.
Patient Guidelines
- Complete the full prescribed course of medication, even if symptoms improve, to prevent recurrence and development of resistance.
- Drink plenty of fluids to maintain hydration and aid kidney function.
- Avoid excessive sun exposure and use protective clothing/sunscreen as photosensitivity may occur.
- Immediately report any pain, swelling, or tenderness in joints or tendons (especially Achilles tendon) to your doctor.
- Avoid taking with dairy products or antacids.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
This medicine may cause dizziness, lightheadedness, or visual disturbances. Patients should be cautioned about operating machinery or driving until they are reasonably certain that norfloxacin does not adversely affect their ability to perform such activities.
Lifestyle Advice
- Maintain good personal hygiene to help prevent future infections.
- Avoid alcohol consumption during treatment as it may exacerbate certain side effects, especially CNS effects.
- If you experience dizziness or lightheadedness, avoid activities requiring mental alertness.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.