Gemifloxacin Dose in Adults

Risk Factor C (Monitor therapy)

Aminolevulinic Acid (Topical)

Aminolevulinic Acid's photosensitizing impact may be enhanced by photosensitizing agents (Topical).

BCG Vaccine (Immunization)

Antibiotics may reduce the BCG vaccine's therapeutic effect (Immunization).

Blood Glucose Lowering Agents

Blood Glucose Lowering Agents' hypoglycemic effects may be strengthened by quinolones. Blood Glucose Lowering Agents' therapeutic impact may be lessened by quinolones. In particular, the use of quinolones may result in a loss of blood sugar control if an agent is being used to treat diabetes.

Corticosteroids (Systemic)

Quinolones' harmful or poisonous effects could be increased. Particularly, there may be an increased risk of tendonitis and tendon rupture.

Haloperidol

May increase the action of quinolone antibiotics that prolong QTc (Moderate Risk). When using these medications together, watch out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

Heroin

Quinolones may intensify Heroin's harmful or toxic effects.

Lactobacillus and Estriol

The therapeutic effects of Lactobacillus and Estriol may be reduced by antibiotics.

Mycophenolate

Quinolones may lower the level of mycophenolate in the blood. Quinolones in particular may lower levels of mycophenolate's active metabolite.

Nonsteroidal Anti-Inflammatory Agents

Quinolones' neuroexcitatory and/or seizure-potentiating effects might be enhanced. Quinolones' serum concentration may rise in response to non-steroidal anti-inflammatory drugs.

Ondansetron

May increase the action of quinolone antibiotics that prolong QTc (Moderate Risk). When using these medications together, watch out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

Pentamidine (Systemic)

May increase the action of quinolone antibiotics that prolong QTc (Moderate Risk). When using these medications together, watch out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

Porfimer

The photosensitizing effect of Porfimer may be strengthened by photosensitizing agents.

Probenecid

Gemifloxacin serum concentration can rise.

QT-prolonging Antidepressants (Moderate Risk)

The QTc-prolonging action of QT-prolonging antidepressants may be enhanced by QT-prolonging Quinolone Antibiotics (Moderate Risk) (Moderate Risk). When using these medications together, watch out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

QT-prolonging Antipsychotics (Moderate Risk)

QT-prolonging Antibiotics with quinolones (moderate risk) may increase the QTc-prolonging effects of antipsychotics (Moderate Risk). Management: When these medications are combined, keep an eye out for QTc interval prolongation and cardiac arrhythmias. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors. Examples include pimozide.

QT-prolonging Class IC Antiarrhythmics (Moderate Risk)

QT-prolonging QT-prolonging Class IC Antiarrhythmics' QTc-prolonging effect may be enhanced by quinolone antibiotics (Moderate Risk) (Moderate Risk). When using these medications together, watch out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

QT-prolonging Kinase Inhibitors (Moderate Risk)

The QTc-prolonging impact of QT-prolonging Kinase Inhibitors may be enhanced by QT-prolonging Quinolone Antibiotics (Moderate Risk) (Moderate Risk). When using these medications together, watch out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

QT-prolonging Miscellaneous Agents (Moderate Risk)

May increase the action of quinolone antibiotics that prolong QTc (Moderate Risk). When using these medications together, watch out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors. Domperidone is an exception.

QT-prolonging Moderate CYP3A4 Inhibitors (Moderate Risk)

Quinolone antibiotics with a moderate risk of QT prolongation may increase the QTc-prolonging effects of moderate CYP3A4 inhibitors (Moderate Risk). When using these medications together, watch out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

QT-prolonging Quinolone Antibiotics (Moderate Risk)

May increase the action of other quinolone antibiotics that prolong QTc (Moderate Risk). When using these medications together, watch out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

QT-prolonging Strong CYP3A4 Inhibitors

(QT-prolonging Strong QT-prolonging CYP3A4 Inhibitors may have a greater QTc-prolonging impact when used with quinolone antibiotics (Moderate Risk) (Moderate Risk). When using these medications together, watch out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

Moderate Risk)

Varenicline's serum levels may rise in response to quinolones. Management: Keep an eye out for any increased varenicline side effects when levofloxacin or other quinolone antibiotics are also being taken, especially in patients who have severe renal impairment. Different international standards exist for product labelling. Look up the relevant labelling.

Varenicline

Verteporfin's photosensitizing effect may be strengthened by photosensitizing agents.

Verteporfin

Quinolones might make Vitamin K antagonists' anticoagulant effects even more potent.

Risk Factor D (Consider therapy modification)

Antacids

Quinolones' absorption might be decreased. a problem only when quinolones are taken orally. To lessen the effects of this combination, avoid giving quinolones and antacids at the same time. Optimal dosage separation recommendations differ depending on the particular quinolone. Bicarbonate of sodium is an exception.

Calcium Salts

Quinolones' absorption might be decreased. only when both drugs are administered orally. Examples include calcium chloride.

Delamanid

May increase the action of quinolone antibiotics that prolong QTc (Moderate Risk). Delamanid's ability to prolong QTc may be enhanced by QT-prolonging quinolone antibiotics (moderate risk). Management: If at all feasible, avoid using delamanid and quinolone antibiotics concurrently. Electrocardiograms should be frequently checked throughout the entire delamanid treatment period if coadministration is thought to be unavoidable.

Didanosine

Didanosine's serum levels may be reduced by quinolones. Didanosine may lower the level of quinolones in the serum. Treatment: Give oral quinolones at least two hours prior to or six hours following didanosine. Check for diminished quinolone therapeutic effects, especially if dosages cannot be separated as advised. Didanosine with an unbuffered enteric coating is exempt from this rule.

Domperidone

The QTc-prolonging action of Domperidone may be strengthened by QT-prolonging Agents (Moderate Risk). Management: Take into account different pharmacological combinations. If combined, keep an eye out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

Iron Salts

Quinolones' serum concentration can drop. Treatment: Give oral quinolones at least several hours before (four hours for moxi- and sparfloxacin, two hours for others) or after (six hours for cipro/dela-, four hours for lome-, three hours for gemi-, and two hours for levo-, nor-, oflox-, pefloxacin, or nalidixic acid) taking oral iron salts. Iron Carboxymaltose, Iron Gluconate, Iron Hydroxide Polymaltose Complex, Iron Pyrophosphate Citrate, Ferumoxytol, Iron Dextran Complex, Iron Isomaltoside, and Iron Sucrose are exceptions.

Magnesium Salts

Quinolones' serum concentration can drop. Treatment: Give oral quinolones before or after oral magnesium salts, depending on the drug (8 h for moxi, 6 h for cipro/dela, 4 h for lome/pe, 3 h for gemi, and 2 h for levo, nor, or ofloxacin or nalidixic acid).

Methadone

Gemifloxacin may increase Methadone's ability to prolong QTc. Management: Take into account different pharmacological combinations. If combined, keep an eye out for cardiac arrhythmias and a prolonged QTc interval. Patients who have other QTc prolongation risk factors may be at even greater risk.

Multivitamins/Minerals (with ADEK, Folate, Iron)

Quinolones' serum concentration can drop. Particularly, oral quinolone antibiotics may be less effectively absorbed when used with polyvalent cations found in multivitamin supplements. Treatment: By taking the oral quinolone at least two hours before or six hours after taking the dose of a multivitamin containing polyvalent cations, interactions can be reduced (i.e., calcium, iron, magnesium, selenium, zinc).

Multivitamins/Minerals (with AE, No Iron)

Quinolones' serum concentration can drop. Particularly, elements in the multivitamin/mineral supplement may hinder quinolone medicines' absorption. Treatment: By taking the oral quinolone at least two hours before or six hours after taking the dose of a multivitamin containing polyvalent cations, interactions can be reduced (i.e., calcium, iron, magnesium, selenium, zinc).

QT-prolonging Kinase Inhibitors (Highest Risk)

The QTc-prolonging effects of gemifloxacin might be improved. Management: Take into account different pharmacological combinations. If combined, keep an eye out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors.

QT-prolonging Miscellaneous Agents (Highest Risk)

Gemifloxacin may increase the effect of QT-prolonging additional agents on QTc (Highest Risk). Management: Take into account different pharmacological combinations. If combined, keep an eye out for cardiac arrhythmias and a prolonged QTc interval. Patients may be considerably more at risk for QTc prolongation if they have additional risk factors. Delamanian is an exception.

Quinapril

Quinolones' serum concentration can drop. Treatment: To lessen the possibility of an interaction, provide oral quinolones and quinapril at least two hours apart. If both of these medicines are administered at the same time, keep an eye out for any quinolone efficacy reduction.

Sevelamer

Quinolones' absorption might be decreased. Treatment: Oral quinolones should be taken at least two hours before or six hours after sevelamer.

Sodium Picosulfate

Antibiotics may reduce Sodium Picosulfate's therapeutic impact. Management: If a patient previously used or is currently using an antibiotic, think about utilising an alternative product for bowel cleansing prior to a colonoscopy.

Sucralfate

Quinolones' serum concentration can drop. Treatment: Give oral quinolones at least two hours prior to or six hours following the dosage of sucralfate. Greater dose spacing may further reduce the possibility of a harmful interaction.

Typhoid Vaccine

The Typhoid Vaccine's therapeutic benefits may be reduced by antibiotics. The only strain impacted is the live attenuated Ty21a strain. Treatment: Patients receiving systemic antibacterial drugs should refrain from receiving the live attenuated typhoid vaccination (Ty21a). It is recommended to wait at least 3 days following the last dose of antibacterial medication before administering this vaccine.

Zinc Salts

Quinolones' serum concentration can drop. Treatment: Oral quinolones should be administered at least a few hours before or after oral zinc salts (8 h for moxi, 6 h for cipro/dela, 4 h for lome, 3 h for gemi, and 2 h for levo, nor, pe, or ofloxacin or nalidixic acid). ZnCl2 is an exception.

Risk Factor X (Avoid combination)

Aminolevulinic Acid (Systemic)

Aminolevulinic Acid's photosensitizing impact may be enhanced by photosensitizing agents (Systemic).

Amiodarone

Amiodarone's ability to prolong QTc may be enhanced by gemifloxacin.

BCG (Intravesical)

Antibiotics may lessen BCG's therapeutic effects (Intravesical).

Cholera Vaccine

The therapeutic benefit of the cholera vaccine may be reduced by antibiotic use. Management: Cholera vaccine should not be administered to individuals taking systemic antibiotics or within 14 days after taking oral or parenteral antibiotics.

Nadifloxacin

Quinolones' harmful or poisonous effects could be increased.

Pimozide

Could make QT-prolonging agents' effect on QTc longer (Moderate Risk).

QT-prolonging Class IA Antiarrhythmics (Highest Risk)

Gemifloxacin may increase the effect of class IA antiarrhythmics that prolong QTc (Highest Risk).

QT-prolonging Class III Antiarrhythmics (Highest Risk)

Gemifloxacin may increase the effect of Class III antiarrhythmics that prolong QTc (Highest Risk).

Strontium Ranelate

Quinolones' serum concentration can drop. Management: It is advised that strontium ranelate medication be stopped during quinolone therapy in order to reduce any potential effects of strontium ranelate on quinolone antibiotic concentrations.