CrCl > 80: 400 mg po/iv q d.
CrCl 80-50: 400 mg po/iv q d.
CrCl 50-10: 400 mg po/iv q d.
CrCl < 10: 400 mg po/iv q d.
Hemodialysis: no mention in PDR.
Peritoneal dialysis: no mention in PDR.
Important side effects
Diarrhea, nausea, dizziness, headache, peripheral neuropathy, qt interval prolongation (rare), severe hypersensitivity reactions (rare), tendon rupture (rare). Diplopia (PubMed).
Liver disease in the elderly (about 6 in 100,000) (PubMed).
Can double the risk of acute kidney injury (PubMed).
Arrhythmias: "Gatifloxacin use was associated with the highest rate (RR = 7.38; 95% CI, 2.30-23.70); moxifloxacin and ciprofloxacin were also associated with elevated rates of serious arrhythmia (RR = 3.30; 95% CI, 1.47-7.37 and RR = 2.15; 95% CI, 1.34-3.46, respectively)" (PubMed). Not so much with levofloxicin.
Important drug interactions
Antacids, antidiabetic agents, cisapride, class ia antiarrhythmic agents, class iii antiarrhythmic agents, corticosteroids, didanosine, erythromycin, erythromycin/sulfisoxazole, iron, mesoridazine, phenothiazines, sucralfate, thioridazine, tricyclic antidepressants, zinc, ziprasidone.
Rants and Screeds
As with all quinolones, antacids bind the drug to prevent absorbtion.
Treatment of choice
Don't use for
UTI, it is not excreted in the urine.