norfloxacin, Noroxin

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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What is norfloxacin-oral, and how does it work (mechanism of action)?

Norfloxacin is a fluoroquinolone antibiotic. Other fluoroquinolones include ciprofloxacin (Cipro), levofloxacin (Levaquin), and ofloxacin (Floxin). Norfloxacin works by blocking DNA gyrase enzyme, which is responsible for production and repair of bacterial DNA. Blocking of DNA gyrase leads to bacteria death and prevents worsening of infection. Norfloxacin treats infections caused by gram-positive and gram-negative bacteria like Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Streptococcus agalactiae, Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Klebsiella pneumonia, Neisseria gonorrhoeae, Proteus mirabilis, Proteus vulgaris, Pseudomonas aeruginosa, and Serratia marcescens. FDA approved the brand name norfloxacin (Noroxin) in October 1986.

What brand names are available for norfloxacin-oral?

Noroxin

Is norfloxacin-oral available as a generic drug?

GENERIC AVAILABLE: Not in US, in Canada

Do I need a prescription for norfloxacin-oral?

Yes

What are the side effects of norfloxacin-oral?

Side effects of norfloxacin are nausea, stomach cramps, dizziness, headache, abdominal pain, diarrhea, abnormal heart beats, and photosensitivity (sun sensitivity).

Norfloxacin as well as other antibiotics in the fluoroquinolone class of antibiotics, has been associated with tendinitis and even rupture of tendons, particularly the Achilles tendon. Many antibiotics, including norfloxacin, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon, (C. difficile caused pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting norfloxacin (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.

Fluoroquinolones have neuromuscular blocking activity and can worsen muscles weakness in individuals with myasthenia gravis. They also worsen low blood glucose levels when combined with sulfonylureas (for example, glyburide [Micronase, Diabeta, Glynase, Prestab]).

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What is the dosage for norfloxacin-oral?

  • Uncomplicated urinary tract infectionTake 1 tablet (400 mg) by mouth every 12 hours for 3 days
  • Complicated urinary tract infection Take 1 tablet (400 mg) by mouth every 12 hours for 10 to 21 days.
  • For infections caused by E. coli, K. pneumoniae, or P. mirabilis only. Take 1 tablet (400 mg) by mouth every 12 hours for 7 to 10 days, for infections caused by any other bacteria.
  • ProstatitisTake 1 tablet (400 mg) by mouth every 12 hours for 28 to 42 days.
  • Gonorrhea Take 2 tablets (800 mg) by mouth as one single dose.

Safe and effective use of norfloxacin is not established in patients under the age of 18 years.

Note that some organisms are resistant to norfloxacin; organisms should be tested for susceptibility to this drug.

Which drugs or supplements interact with norfloxacin-oral?

: Norfloxacin should be used with caution with medications like caffeine, clozapine (Clozaril), ropinorole (Requip), cyclosporine (Neoral, Sandimmune, Gengraf), theophylline (Theo-24), and tizanidine (Zanaflex) because norfloxacin can slow down breakdown of these medications in and increase their levels in the body.

Norfloxacin should be separated from aluminum and magnesium containing antacids, sucralfate (Carafate), and multivitamins because they can lower absorption of norfloxacin and reduce its effectiveness. They should be administered 2 hours before norfloxacin.

Norfloxacin should be used with caution with warfarin (Coumadin) because norfloxacin can increase the risks of bleeding and bruising.

Norfloxacin should be used with caution with medications used for treating abnormal heart beats because it can affect heart rhythm.

Is norfloxacin-oral safe to take if I'm pregnant or breastfeeding?

It is not known whether norfloxacin enters breast milk; therefore, it is best to be cautious before using it in nursing mothers.

What else should I know about norfloxacin-oral?

What preparations of norfloxacin-oral are available?

Tablets: 400 mg

How should I keep norfloxacin-oral stored?

Store norfloxacin tablets between temperatures of 15 C - 30 C (59 F - 86 F), in a tightly closed container.

REFERENCE: FDA Prescribing Information.

Last Editorial Review: 10/24/2014

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Reviewed on 10/24/2014
References
REFERENCE: FDA Prescribing Information.

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