Contraindications – When must not be given?
Fluoroquinolones must not be given if there are allergies or intolerances to the active ingredient or other substances contained in the drug. Even in the case of severe side effects after fluoroquinolone therapy, renewed treatment with fluoroquinolones should be avoided. For example, anyone who has experienced central nervous system side effects or visual complaints during/after fluoroquinolone therapy should be treated with other antibiotics in the future. Diseases such as epilepsy are also contraindications for treatment with fluoroquinolones. As there are not enough data available, some fluoroquinolones should not be given to children and adolescents or during pregnancy and lactation.
Dosage
The dosage of the fluoroquinolones depends on various criteria. Thus, different dosages are used in different classes of fluoroquinolones. The body weight of the treated person and the severity of the disease also play a role.
Norfloxacin is typically prescribed in a dosage of 400 mg twice daily. Ciprofloxacin can be taken in doses between 250 and 500 mg twice daily. For levofloxacin, a dosage of 500 mg per day is usually recommended, while moxifloxacin has a maximum dose of 400 mg per day. Special attention must be paid to the dosage in case of liver and kidney diseases. The dosage must usually be adjusted (reduced) based on the remaining liver or kidney function.
Price
The price of fluoroquinolones depends on the class of active ingredient, the quantity of the active ingredient and the dosage form. For persons treated with fluoroquinolones in tablet form, the prescription fee of only 5€ is usually charged. The rest of the costs is covered by the health insurance. If fluoroquinolones are administered into the vein (e.g. as part of an in-patient therapy), usually nothing has to be paid for the fluoroquinolone treatment.
Fluoroquinolones and alcohol – is it compatible?
Fluoroquinolones are mainly metabolized in the liver and then excreted via both the liver and the kidneys. Therefore, there are interactions when consuming alcohol. The alcohol must also be metabolized in the liver.
Therefore, if the substances are present in the body at the same time, they can influence each other. For example, the fluoroquinolones may have an increased level of effectiveness because the alcohol in the body slows down the breakdown of the active substance. Alcohol can also prevent the fluoroquinolones from being converted into their effective form in the liver. Thus, reduced effectiveness of antibiotics can be caused by alcohol consumption. In addition, not only a slower breakdown of fluoroquinolones but also of alcohol can occur, which is why high blood alcohol levels can be reached even with low alcohol consumption.
All articles in this series:
