Moxifloxacin (Mfx)

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    Update: September 2022

     

    Forms and strengths

    • 400 mg tablet 

    • 100 mg dispersible tablet, to be dispersed in 10 ml water

    Dosage (standard dose) 

    • Child under 30 kg: 10 to 15 mg/kg once daily 

    • Child 30 kg and over and adult: 400 mg once daily 

    • Maximum dose: 400 mg daily 

     

    Weight
    (kg)

    Daily dose
    (mg)

    400 mg tablet

    100 mg

    dispersible tablet

    5

    50-75

    7 ml

    6

    60-90

    7 ml

    7

    70-105

    1 tab

    8

    80-120

    1 tab

    9

    90-135

    1 tab

    10

    100-150

    2 tab

    11

    110-165

    2 tab

    12

    120-180

    2 tab

    13

    130-195

    2 tab

    14

    140-210

    2 tab

    15

    150-225

    2 tab

    16

    160-240

    3 tab

    17

    170-255

    3 tab

    18

    180-270

    3 tab

    19

    190-285

    3 tab

    20

    200-300

    3 tab

    21

    210-315

    3 tab

    22

    220-330

    3 tab

    23

    230-345

    3 tab

    24

    240-360

    4 tab

    25

    250-375

    4 tab

    26

    260-390

    4 tab

    27

    270-405

    4 tab

    28

    280-420

    4 tab

    29

    290-435

    4 tab

     

    30-35

    400

    1 tab

    36-45

    400

    1 tab

    46-55

    400

    1 tab

    56-70

    400

    1 tab

    > 70

    400

    1 tab

     

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with hypersensitivity reaction or tendon damage during a previous treatment with a fluoroquinolone.
    • Administer with caution to patients:
      • over 60 years or on corticosteroid treatment (increased risk of tendon damage);
      • with diabetes or history of psychiatric disorders or seizures.
    • May cause:
      • tendinitis, tendon rupture, moderate QT prolongation;
      • gastrointestinal disturbances (abdominal or epigastric pain, diarrhoea);
      • nervous system or psychiatric disorders (headache, seizures, psychosis, etc.);
      • photosensitivity;
      • hypersensitvity reactions, hypo/hyperglycaemia;
      • rarely: crystalluria, peripheral neuropathy, ototoxicity.
    • For the management of adverse effects, see Appendix 17.
    • Avoid or use with caution and under close monitoring in patients taking other QT prolonging drugs (Appendix 19) or warfarin.
    • Do not administer simultaneously with antacids containing magnesium/aluminium, calcium, iron and zinc salts (administer 2 hours apart).
    • Pregnancy:
      • DR-TB: use if the benefits outweigh the risks (safety not established).  

      • DS-TB: do not use.  

    • Breastfeeding
      • DR-TB: avoid breastfeeding during treatment (no absolute contra-indication). 

      • DS-TB: avoid breastfeeding during treatment.  

    Monitoring

    • Symptomatic monitoring

    Patient instructions

    • Take 2 hours apart from milk-based product, antacids, calcium, iron and zinc salts.
    • 100 mg tablets should be dispersed in 10 ml water.
    • Maintain a good fluid intake.
    • Protect your skin from sun.

    Remarks

    • High dose moxifloxacin (Mfxh), i.e. 600 to 800 mg once daily in patients over 30 kg may be used in the presence of certain mutations conferring low level fluoroquinolone resistance. Mfxh may cause strong QT prolongation.  

    Storage

     
    – 
     
    –  Below 25 °C