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Norfloxacin (Oral route)

Pronunciation:

nor-FLOX-a-sin

Brand Names:

  • Noroxin

Dosage Forms:

  • Tablet

Warnings:

Oral route(Tablet)

Fluoroquinolones, including norfloxacin, are associated with an increased risk of tendinitis and tendon rupture in all ages. Risk further increases with age over 60 years, concomitant steroid therapy, and kidney, heart, or lung transplants. Fluoroquinolones, including norfloxacin, may exacerbate muscle weakness in persons with myasthenia gravis. Avoid in patients with known history of myasthenia gravis .

Classifications:

Therapeutic—

Antibiotic

Chemical—

Fluoroquinolone

Uses of This Medicine:

Norfloxacin is used to treat certain bacterial infections in many different parts of the body. Norfloxacin may mask or delay the symptoms of syphilis. It is not effective against syphilis infections.

Norfloxacin belongs to the class of medicines known as quinolone antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, 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. Also tell 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.

Children—

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

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of norfloxacin in the elderly. However, elderly patients are more likely to have age-related heart or kidney problems, or develop severe tendon problems (including tendon rupture), which may require caution and an adjustment in the dose for patients receiving norfloxacin.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

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 medication while breastfeeding.

Other medicines—

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 doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking 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 medicine 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 medicines you take.

  • Amifampridine
  • Cisapride
  • Dronedarone
  • Mesoridazine
  • Pimozide
  • Piperaquine
  • Sparfloxacin
  • Thioridazine

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

  • Acarbose
  • Acecainide
  • Acetohexamide
  • Alfuzosin
  • Alosetron
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Apomorphine
  • Arsenic Trioxide
  • Asenapine
  • Astemizole
  • Azimilide
  • Azithromycin
  • Benfluorex
  • Bretylium
  • Chloroquine
  • Chlorpromazine
  • Chlorpropamide
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Crizotinib
  • Cyclobenzaprine
  • Dasatinib
  • Desipramine
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Droperidol
  • Erythromycin
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Gatifloxacin
  • Gemifloxacin
  • Gliclazide
  • Glimepiride
  • Glipizide
  • Gliquidone
  • Glyburide
  • Granisetron
  • Guar Gum
  • Halofantrine
  • Haloperidol
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Insulin
  • Insulin Aspart, Recombinant
  • Insulin Glulisine
  • Insulin Lispro, Recombinant
  • Ivabradine
  • Lapatinib
  • Levofloxacin
  • Lopinavir
  • Lumefantrine
  • Mefloquine
  • Metformin
  • Methadone
  • Mifepristone
  • Miglitol
  • Moricizine
  • Moxifloxacin
  • Mycophenolate Mofetil
  • Nilotinib
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Ondansetron
  • Paliperidone
  • Pazopanib
  • Perflutren Lipid Microsphere
  • Posaconazole
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Salmeterol
  • Saquinavir
  • Sematilide
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sunitinib
  • Tedisamil
  • Telavancin
  • Telithromycin
  • Terfenadine
  • Tetrabenazine
  • Tizanidine
  • Tolazamide
  • Tolbutamide
  • Toremifene
  • Trazodone
  • Trifluoperazine
  • Trimipramine
  • Troglitazone
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Vinflunine
  • Voriconazole
  • Warfarin
  • Ziprasidone

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

  • Aluminum Carbonate, Basic
  • Aluminum Hydroxide
  • Aluminum Phosphate
  • Betamethasone
  • Calcium
  • Corticotropin
  • Cortisone
  • Cosyntropin
  • Cyclosporine
  • Deflazacort
  • Dexamethasone
  • Didanosine
  • Dihydroxyaluminum Aminoacetate
  • Dihydroxyaluminum Sodium Carbonate
  • Fludrocortisone
  • Fluocortolone
  • Hydrocortisone
  • Iron
  • Magaldrate
  • Magnesium Carbonate
  • Magnesium Hydroxide
  • Magnesium Oxide
  • Magnesium Trisilicate
  • Methylprednisolone
  • Paramethasone
  • Prednisolone
  • Prednisone
  • Probenecid
  • Sucralfate
  • Triamcinolone

Other interactions—

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 medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Dairy Food

Other medical problems—

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

  • Bradycardia (slow heartbeat) or
  • Diabetes or
  • Diarrhea or
  • Heart disease or
  • Heart rhythm problems (eg, prolonged QT interval), or family history of or
  • Hypokalemia (low potassium in the blood), uncorrected or
  • Liver disease (including hepatitis) or
  • Myocardial ischemia (reduced blood supply in the heart) or
  • Seizures (epilepsy), or history of—Use with caution. May make these conditions worse.
  • Brain disease (eg, hardening of the arteries) or
  • Kidney disease or
  • Organ transplant (eg, heart, kidney, or lung), history of or
  • Tendon disorder (eg, rheumatoid arthritis), history of—Use with caution. May cause side effects to become worse.
  • G6PD deficiency (an enzyme problem)—Anemia may occur while using this medicine.
  • Myasthenia gravis (severe muscle weakness), or history of or
  • Tendinitis (inflammation of the tendon), history of or
  • Tendon rupture, history of—Should not be used in patients with these conditions.

Proper Use of This Medicine:

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

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

Swallow the tablet with a glass (8 ounces) of water. Drink plenty of fluids while you are being treated with this medicine. Drinking extra water will help to prevent some unwanted effects of norfloxacin.

Norfloxacin should be taken at least 1 hour before or 2 hours after a meal, milk, or other dairy products.

If you are taking aluminum or magnesium-containing antacids, iron supplements, multivitamins, Didanosine (Videx®), sucralfate (Carafate®), or zinc, do not take them at the same time that you take this medicine. It is best to take these medicines at least 2 hours before or 2 hours after taking norfloxacin. These medicines may keep norfloxacin from working properly.

Avoid caffeine-containing products (eg, coffee, soda, or chocolate) while you are using this medicine. Norfloxacin may cause caffeine to stay in your body longer than usual.

Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For infections:
      • Adults—400 milligrams (mg) every twelve hours for 3 to 21 days, depending on the medical problem being treated. Prostatitis is usually treated for 28 days. Gonorrhea is usually treated with a single oral dose of 800 mg.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress while you are using this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

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 have a rash, itching, hives, hoarseness, trouble with breathing, trouble with swallowing, or any swelling of your hands, face, or mouth after you receive this medicine.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine.

Check with your doctor right away if you have dark urine, clay-colored stools, abdominal or stomach pain, or yellow eyes or skin. These maybe symptoms of a serious liver problem.

Norfloxacin may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert. If these reactions are especially bothersome, check with your doctor.

Norfloxacin may cause diarrhea, and in some cases it can 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 make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

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

Norfloxacin may rarely cause inflammation or even tearing of a tendon (the cord that attaches muscles to bones). The risk of having tendon problems may be increased if you are over 60 years of age, using steroid medicines (eg, dexamethasone, prednisolone, prednisone, or Medrol®), if you have severe kidney problems, a history of tendon problems (eg, rheumatoid arthritis), or if you have received an organ (eg, heart, kidney, or lung) transplant. If you get sudden pain or swelling in a tendon after exercise (eg, in the ankle, back of the knee or leg, shoulder, elbow, or wrist), stop using this medicine and check with your doctor right away. Refrain from exercise until your doctor says otherwise.

Some people who take norfloxacin may become more sensitive to sunlight than they are normally. Exposure to sunlight, even for brief periods of time, may cause severe sunburn, or skin rash, redness, itching, or discoloration. When you begin using this medicine:

  • Stay out of direct sunlight, especially between the hours of 10:00 AM and 3:00 PM, if possible.
  • Wear protective clothing, including a hat and sunglasses.
  • Apply a sun block product that has a sun protection factor (SPF) of at least 15. Some people may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor.
  • Do not use a sunlamp or tanning bed or booth.

If you have a severe reaction from the sun, check with 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.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare
Chest pain or discomfort
chills
diarrhea
discouragement
fast, irregular, pounding, or racing heartbeat or pulse
feeling sad or empty
fever
flushing or redness of the skin
hives or welts
increased sweating
irritability
irritation or soreness of the mouth
itching of the rectal area
itching skin
lack of appetite
loss of interest or pleasure
nausea
pain and inflammation at the joints
pain or discomfort in the arms, jaw, back, or neck
redness of the skin
shortness of breath
skin rash
sweating
swelling of the foot or hand
swelling of the stomach
tingling of the fingers
tiredness
trouble with concentrating
trouble with sleeping
unusually warm skin
vomiting
Incidence not known
Abdominal or stomach cramps or tenderness
anxiety
back, leg, or stomach pains
black, tarry stools
bleeding gums
blistering, peeling, or loosening of the skin
bloating
blood in the urine or stools
blurred vision
bone pain
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
clay-colored stools
cold sweats
constipation
cool, pale skin
cough or hoarseness
cracks in the skin
dark-colored urine
decreased frequency or amount of urine
diarrhea, watery and severe, which may also be bloody
difficulty with breathing, chewing, swallowing, or talking
difficulty with moving
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
double vision
drooping eyelids
dry mouth
dry skin
false sense of well-being
fever with or without chills
fruit-like breath odor
general body swelling
general feeling of tiredness or weakness
greatly decreased frequency of urination or amount of urine
headache
inability to move the arms and legs
increased blood pressure
increased hunger
increased sensitivity of the skin to sunlight
increased thirst
increased urination
indigestion
irregular or slow heart rate
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
light-colored stools
loss of heat from the body
lower back or side pain
mood or mental changes
mood swings
muscle aching or cramping
muscle pain or stiffness
muscle weakness
nervousness
nightmares
nosebleeds
numbness or tingling in the hands, feet, or lips
pain or burning while urinating
pain, inflammation, or swelling in the calves, shoulders, or hands
pain, swelling, or redness in the joints
painful or difficult urination
pains in the stomach, side, or abdomen, possibly radiating to the back
personality changes
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
red, swollen skin
scaly skin
seizures
severe sunburn
severe tiredness
shakiness and unsteady walk
skin rash
slurred speech
sore throat
sores, ulcers, or white spots on the lips or in the mouth
sores, welting, or blisters
stomach pain, continuing
sudden decrease in the amount of urine
sudden numbness and weakness in the arms and legs
swelling of the face, fingers, or lower legs
swelling or inflammation of the mouth
swollen glands
tightness in the chest
unexplained weight loss
unpleasant breath odor
unsteadiness, awkwardness, trembling, or other problems with muscle control or coordination
unusual behavior, such as disorientation to time or place, failure to recognize people, hyperactivity, or restlessness
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight loss
vomiting of blood
weakness in the arms, hands, legs, or feet
weight gain
wheezing
yellowing of the eyes or skin

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

Less common
Lack or loss of strength
Rare
Acid or sour stomach
belching
bitter taste
cramps
excess air or gas in the stomach or intestines
full feeling
heartburn
heavy bleeding
pain
passing gas
sleepiness or unusual drowsiness
sleeplessness
stomach discomfort, upset, or pain
unable to sleep
weight loss
Incidence not known
Change in taste
continuing ringing or buzzing or other unexplained noise in the ears
hearing loss
itching of the vagina or outside genitals
loss of taste
pain during sexual intercourse
seeing double
thick, white curd-like vaginal discharge without odor or with mild odor
uncontrolled eye movements

Other side effects not listed may also occur in some patients. If you notice any other effects, check with 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.


Last Updated: 4/4/2014

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