How Ofloxacin Works
Ofloxacin inhibits two vital enzymes of bacteria: topoisomerase II (DNA gyrase) and topoisomerase IV.
The genetic material of bacteria, DNA, is a rope ladder-shaped molecule that is highly coiled and twisted in the cell nucleus for reasons of space. In order to be able to read genetic information, the twisting of the DNA must be unraveled in places. Afterwards, the DNA strand must be twisted again at this point.
For this breaking and re-twisting, bacteria need the enzymes mentioned. Ofloxacin inhibits these enzymes, however, which means that the DNA cannot be read – the cell dies.
Absorption, degradation and excretion
When taken orally (by mouth), ofloxacin is very well absorbed into the blood through the intestine. The highest blood levels are reached after 30 to 60 minutes.
When is Ofloxacin used?
Ofloxacin has numerous indications (indications for use) depending on the dosage form (tablets, drops, eye ointment).
Ofloxacin tablets help in bacterial infections of the respiratory and urinary tracts, bones, soft tissues, as well as in bacterial pancreatitis. The prerequisite is that the respective pathogens are sensitive to this antibiotic.
Ofloxacin drops are used for infections of the anterior segment of the eye, for example, conjunctivitis, corneal inflammation or chlamydial infection of the eye. There are also drops used in the treatment of certain forms of otitis media.
Ofloxacin eye ointment, like the eye drops, is suitable for the treatment of infections of the anterior segment of the eye.
How Ofloxacin is used
The dosage depends primarily on the type and severity of the disease, but also on individual factors such as the patient’s age and kidney function.
For example, adults with uncomplicated urinary tract infections are usually prescribed a daily dose of 200 milligrams (mg) divided into two individual doses. It is usually taken over three days. If the kidneys are weak, the doctor must reduce the dose. For more severe infections, the doctor prescribes a higher dose up to a maximum of 400 milligrams ofloxacin twice daily.
For eye infections, one drop is usually placed in the affected eye four times a day. When using ofloxacin as an eye ointment, patients usually need to put a one-centimeter strand of ointment in the corner of the eye three times a day. The duration of treatment is a maximum of 14 days.
What are the side effects ofloxacin?
Common side effect of the tablets is gastrointestinal discomfort (especially diarrhea). Sometimes liver dysfunction, headache, dizziness, sleep disturbances, restlessness, confusion, rapid heartbeat (tachycardia), and a temporary drop in blood pressure also develop.
Very rarely, side effects include severe liver damage, jaundice, liver or kidney inflammation, drowsiness, tremors, seizures, impaired vision, taste or smell, depression, hallucinations, nightmares, joint problems, tendon ruptures, or blood count changes.
When ofloxacin is applied locally to the eye or ear, only a fraction of the applied amount of active ingredient enters the bloodstream. Side effects are therefore mainly limited to local reactions. Nevertheless, it is conceivable that systemic side effects (affecting the body) may occur, as described after taking the tablets.
What should be considered when using ofloxacin?
Contraindications
Ofloxacin tablets must not be used in the following cases:
- hypersensitivity to the antibiotic
- epilepsy
- @ Children and adolescents in the growth phase (risk of joint cartilage damage)
Ofloxacin drops and eye ointment must not be used in:
- hypersensitivity to ofloxacin or to any of the components of the drug
Drug interactions
The antibiotic must not be taken together with medicines or food containing aluminum, magnesium, calcium, iron, or zinc because they interfere with the absorption of ofloxacin. Therefore, it is recommended to take the antibiotic with a time delay: the antibiotic should be taken at least two hours before and at least three hours after such drugs or foods.
Ofloxacin may increase the effect of coumarins (anticoagulants) and glibenclamide (anti-diabetic agent). In addition, other drug interactions are possible, such as with probenecid (gout medicine), cimetidine (for heartburn and stomach ulcer), furosemide (diuretic), and methotrexate (for cancer and autoimmune diseases).
During treatment, you should make sure you drink enough fluids, otherwise crystals may form in your urine (crystalluria).
If you notice signs of tendonitis (e.g., pain when moving the tendon), inform your treating doctor.
Age restriction
Tablets are contraindicated in children and adolescents under 18 years of age. Eye drops and eye ointment may be used in children over one year of age. Safety and effectiveness in children under one year of age have not been established.
Ear drops available in Austria are approved for use in children one year of age and older.
Pregnancy and lactation
drops and eye ointment should not be used during pregnancy to be on the safe side according to the expert information. During breastfeeding, it is decided individually whether breastfeeding should be interrupted for the duration of the application.
Experts from the Pharmacovigilance and Advisory Center for Embryonic Toxicology at Charité University Medical Center conclude that observations to date speak against a toxic effect for the fetus (fetotoxic risk). Ofloxacin tablets are nevertheless classified as a reserve agent in pregnancy. Local application to the eyes and ears is acceptable. The same applies to breastfeeding.
How to obtain medicines containing ofloxacin
Ofloxacin is available in Germany, Austria and Switzerland in any dosage form (tablet, eye drops, etc.) and in any dosage by prescription, i.e. only with a doctor’s prescription at the pharmacy.
