Ofloxacin (Tarivid, Floxin) is a broad-spectrum antibiotic that is used to treat a variety of bacterial infections including pneumonia, enteric infections, eye, and ear infections.

Ofloxacin Uses:

• Acute exacerbations of chronic bronchitis
• Community-acquired pneumonia
• Uncomplicated Skin & skin structure infections
• nongonococcal urethritis & cervicitis due to Chlamydia trachomatis infection
• Mixed infections of the urethra and cervix
• Acute pelvic inflammatory disease
• Acute uncomplicated Urethral & cervical gonorrhea.
• Uncomplicated Cystitis
• Complicated Urinary tract infections
• Prostatitis

Note:

• The CDC no longer advises using fluoroquinolones to treat gonococcal illness as of April 2007.

• Off Label Use of Ofloxacin in Adults:

  • Epididymitis.
  • Leprosy (multibacillary).
  • Leprosy (paucibacillary).
  • Treatment of spontaneous bacterial peritonitis.
  • Traveler's diarrhea.

Ofloxacin Dose in Adults

Ofloxacin Dose in the treatment of Cervicitis and urethritis:

P/O:

• Nongonococcal (due to Chlamydia trachomatis):

  • For 7 days, 300 mg every 12 hours

• Gonococcal (acute, uncomplicated):

  • 400 mg as a single dose.

Note:

• • The CDC no longer advises the use of fluoroquinolones for the treatment of simple gonococcal illness as of April 2007.

Ofloxacin Dose in the treatment of acute exacerbation Chronic bronchitis, community-acquired pneumonia, skin, and uncomplicated skin structure infections:

P/O:

• For 10 days, 400 mg every 12 hours

Ofloxacin Dose in the treatment of acute Pelvic inflammatory disease:

• Manufacturer's labeling:

  • For 10-14 days, 400 mg every 12 hours.

Note:

• • The CDC advises against using it unless it is impossible to treat patients with severe cephalosporin allergies with normal cephalosporin medication and there is a low prevalence of quinolone-resistant gonococcal pathogens in the population.
  • The CDC advises using metronidazole in combination.
    Confirmation of follow-up, culture, and sensitivity (CDC [Workowski 2015]).

Ofloxacin Dose in the treatment of Prostatitis:

P/O:

•  For 6 weeks, 300 mg every 12 hours

Ofloxacin Dose in the treatment of UTI:

P/O:

• Uncomplicated:

  • Every 12 hours, 200 mg for 3 to 7 days,

• Complicated:

  • Every 12 hours, 200 mg for 10 days,

Ofloxacin Dose in the treatment of Epididymitis (off-label):

P/O

• Likely caused by enteric organisms:

  • 300 mg two times daily for 10 days
  • 200 mg two times daily for 14 days (Canadian STI Guidelines 2008 [Update 2014])

• Men who engage in insertive anal intercourse are more likely affected by sexually transmitted chlamydia, gonorrhoea, and enteric pathogens.:

  • Combining ceftriaxone with 300 mg twice daily for 10 days is recommended (CDC [Workowski 2015])

Ofloxacin Dose in the treatment of Leprosy (multibacillary) (off-label):

P/O:

• Alternatively, 400 mg once every 30 days (in conjunction with monthly rifampin and minocycline) for 24 months, or 400 mg once every 24 hours (in combination with dapsone and rifampin) for 12 months (WHO 2012).

Ofloxacin Dose in the treatment of Leprosy (paucibacillary) (off-label):

Multiple-dose regimen:

• • For 4 weeks, 400 mg orally once 24 hours (in combination with rifampin).

Single-dose regimen:

• • A single dose of 400 mg (in combination with single doses of rifampin & minocycline).

Note:

• • It was discovered to be less efficient than the typical WHO multiple drug therapy (WHO-MDT) for paucibacillary leprosy.
    only be used if relapse careful monitoring is possible

Ofloxacin Dose in the treatment of Spontaneous bacterial peritonitis (off-label):

P/O:

• 400 mg two times every 24 hours.

Ofloxacin Dose in the treatment of Traveler's diarrhea (off-label):

P/O:

• 400 mg once every 24 hours for three days, with or without loperamide, or 200 mg twice every 24 hours for one to three days.
• If symptoms do not go away after 24 hours, continue with a 3-day therapy cycle.
• A 3-day course of therapy is advised for individuals who have dysentery or fever.
• Shigella dysenteriae enteric infection is an exception, and a 5-day treatment course is preferable than single-dose or 3-day regimens.

Note:

• Resistance to fluoroquinolones is rising.
• Particularly in areas with a high frequency of Campylobacter, such Southeast Asia or India, azithromycin may be preferable (ACG [Riddle 2016]).

Ofloxacin Dose in Children

Ofloxacin Dose in the treatment of Susceptible infections in children:

P/O:

• • Rvery 12 hours 15 mg/kg/day in divided doses.

Pregnancy Risk Factor C

• Animal reproduction studies revealed certain unfavourable outcomes.
• Ofloxacin is present in the amniotic fluid and passes through the placenta.
• Pregnant women's blood levels of ofloxacin may be lower than those of non-pregnant women.
• According to available data, there is no evidence that ofloxacin can cause an increase in teratogenic effects during pregnancy.

Ofloxacin use during breastfeeding:

• Ofloxacin is produced in breast milk.
• The manufacturer advises making a decision regarding whether to cease nursing or stop using the medication.
• This consideration should be taken in light of the possibility of serious adverse reactions in the infant while nursing.

Ofloxacin Dose in Kidney Disease:

P/O:

• After a normal initial dose, adjust as follows:

  • CrCl >50 mL/min:

    • Dosage adjustment is not necessary.

  • CrCl 20-50 mL/min:

    • Give the typical dose as directed every 24 hours.

  • CrCl <20 mL/minute:

    • Give half of the regular dose advised every 24 hours.

  • Intermittent hemodialysis (IHD):

    • After dialysis, 100-200 mg.

  • Peritoneal dialysis:

    • Every 24 hours, 200 mg.

  • Continuous renal replacement therapy (CRRT):

    • Every 24 hours, 300 mg.

Ofloxacin Dose in Liver Disease:

• Mild to moderate impairment:

  • In the manufacturer’s labeling, there are no dosage adjustments provided.
  • use cautiously.

• Severe impairment (eg, cirrhosis with or without ascites):

  • Max dose:
  • 400 mg per day

Side Effects of Ofloxacin:

• Cardiovascular:

  • Chest Pain

• Central Nervous System:

  • Headache
  • Insomnia
  • Dizziness
  • Fatigue
  • Drowsiness
  • Sleep Disorder
  • Nervousness
  • Pain

• Dermatologic:

  • Pruritus
  • Skin Rash
  • Genital Pruritus

• Gastrointestinal:

  • Nausea
  • Diarrhea
  • Vomiting
  • Abdominal Cramps
  • Constipation
  • Decreased Appetite
  • Dysgeusia
  • Flatulence
  • Gastrointestinal Distress
  • Xerostomia

• Genitourinary:

  • Vaginitis

• Ophthalmic:

  • Visual Disturbance

• Respiratory:

  • Pharyngitis

• Miscellaneous:

  • Fever

Contraindications to Ofloxacin:

• Intolerance to ofloxacin, other quinolones, or any other ingredient in the formulation

Warnings and precautions

• Modified cardiac conduction

  • The QTc interval may be prolonged by fluoroquinolones.
  • Avoid administering Class Ia and Class III antiarrhythmics, cisapride, erythromycin, antipsychotics, or tricyclic antidepressants to patients who have a history of QTc prolongation, uncorrected hypokalemia, hypomagnesemia, or concurrent administration of other medications known to prolong the QT interval.

• Aneurysm of the aorta and dissection

  • The use of fluoroquinolones has been associated with aortic aneurysm ruptures in older people.
  • Patients who have a history of aneurysms or who are at higher risk, such as those with hypertension, peripheral atherosclerotic diseases, hypertension, and patients with genetic disorders affecting blood vessels (such as Marfan syndrome, Ehlers Danlos syndrome), should avoid taking fluoroquinolones unless there is no effective alternative.
  • Extended therapy (e.g., more than 14 days) may raise the risk (Lee 2018)

• CNS effects

  • The use of fluoroquinolones has been associated with an increased risk of CNS side effects, including tremors, high intracranial pressure (including pseudotumor cerebri), disorientation, and seizures.
  • Patients should exercise caution if they have any CNS problems, such as severe cerebral arteriosclerosis, epilepsy, or any other risk factors.

• Regulation of Glucose

  • Fluoroquinolones have been connected to problems with the regulation of glucose, including hypo- and hyperglycemia.
  • Patients who are also taking insulin or oral hypoglycemic drugs have been most affected by these events.
  • There have been several cases of severe hypoglycemia including death and coma.
  • Patients with diabetes should have a thorough examination to look for indications of poor glucose regulation.
  • Stop taking the medication if you experience hypoglycemia.

• Hypersensitivity reactions

  • Anaphylaxis and severe hypersensitivity reactions can occur with quinolone therapy.
  • These reactions may have a wide spectrum.
  • Itching, urticaria and rash may be the most common reactions after one dose. However, severe idiosyncratic dermatologic symptoms may also occur after multiple doses.
  • You should immediately stop taking any drugs if you experience a skin rash, or other symptoms.

• Peripheral neuropathy:

  • It  has been rarely reported.
  • The effects of therapy can be immediate and irreversible.
  • Stop taking medication if you experience symptoms of sensorimotor or sensory neuropathy.

• Phototoxicity:

  • Avoid too much sun and take safety precautions (e.g., wearing loose-fitting clothes, using sunscreen).
  • Phototoxicity reactions may range from mild to severe.
  • If you experience photosensitivity, stop using the product.

• Psychiatric reactions

  • Fluoroquinolones are linked to a higher incidence of psychiatric side effects. Hallucinations and toxic psychosis are examples of this.
  • Additionally, it can lead to agitation, delirium, confusion, disorientation, anxiety, concentration deficits, and memory loss.
  • Patients with depression history or other risk factors should be cautious.
  • Stop using the medication if you experience a reaction.

• Superinfection

  • Prolonged use of the medicine might result in fungal and bacterial superinfections, such as pseudomembranous collitis and C. difficile-associated diarrhoea (CDAD).
  • Several months after receiving antibiotics, CDAD was monitored.

• Tendon rupture/ inflammation: [US Boxed Warn]

  • Reports of tendon inflammation and rupture have been reported after using quinolone antibiotics.
  • For patients over 60 and those undergoing organ transplants, concurrent corticosteroids may raise the risk.
  • Achilles tendon ruptures are most frequently treated surgically. Other tendon locations, like the rotator cuff and biceps, have been documented, nevertheless.
  • Tendonitis can be caused by strenuous exercise.
  • Stop using the medication immediately if there is any tendon inflammation.
  • This may occur even after therapy is stopped.

• Hepatic impairment

  • Hepatic patients need to exercise caution.

• Myasthenia gravis: [US Boxed Warning]:

  • Can make myasthenia gravis-related muscular weakness worse.
  • Both fatalities and severe exacerbations have occurred.
  • Patients with myasthenia gravis should not use.

• Renal impairment

  • Patients with impaired renal function should be cautious.
  • Adjustment of dosage is required.
  • Increased risk of tendon rupture.

• Rheumatoid arthritis:

  • Patients with rheumatoid arthritis should be cautious.
  • Tendon rupture risk is more. 

• Seizures:

  • When giving medication to patients who are at high risk for seizures, exercise caution (CNS disorders, or concurrent therapy with medications that may lower the seizure threshold).
  • Despite the rarity of seizures, they can be made worse by concurrent NSAID therapy.

• Syphilis:

  • Syphilis should be checked on all patients at the time they are diagnosed with gonorrhea and three months later. Ofloxacin is not effective in treating syphilis, and can mask symptoms.

Note:

• The CDC no longer advises using fluoroquinolones to treat simple gonococcal illness as of April 2007.

Ofloxacin (systemic): Drug Interaction

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	The QTcprolonging action of haloperidol may be enhanced by QT-prolonging agents (Indeterminate Risk - Avoid).
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.
Porfimer	The photosensitizing effect of Porfimer may be strengthened by photosensitizing agents.
Probenecid	Quinolone excretion may be decreased. Probenecid specifically may reduce the renal excretion of quinolone antibiotics. Quinolones' serum levels may rise in response to probenecid.
QT-prolonging Agents (Highest Risk)	The QTc-prolonging action of QT-prolonging Agents may be enhanced by QT-prolonging Agents (Indeterminate Risk - Avoid) (Highest 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.
Varenicline	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 for the relevant labelling.
Verteporfin	Verteporfin's photosensitizing effect may be strengthened by photosensitizing agents.
Vitamin K Antagonists (eg, warfarin)	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	Quinolones may increase Delamanid's ability to extend QTc. Management: If at all possible, avoid concurrent use. Electrocardiograms (ECGs) should be frequently checked throughout the whole delamanid therapy duration if coadministration is unavoidable. A separate monograph is dedicated to discussing exceptions.
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.
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. Ferric Gluconate, Ferric Hydroxide Polymaltose Complex, Ferric Pyrophosphate Citrate, and Ferumoxytol are exceptions.
Lanthanum	Quinolones' serum concentration can drop. Treatment: Give oral quinolone antibiotics at least an hour before or after lanthanum, whichever comes first.
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).
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. Administration of the oral quinolone at least 2 hours before or 6 hours after the intake of a multivitamin containing polyvalent chelators will help reduce interactions.
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).
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.
Theophylline Derivatives	Theophylline derivatives' metabolism may be slowed down by quinolones. The most dangerous antibiotics include ciprofloxacin and enoxacin. The potential for any of the separate drugs to cause seizures may be increased by theophylline/quinolone therapy. Dyphylline is an exception.
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). Exceptions: chloride of zinc.
Risk Factor X (Avoid combination)
Aminolevulinic Acid (Systemic)	Aminolevulinic Acid's photosensitizing impact may be enhanced by photosensitizing agents.
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.
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.

Monitoring Parameters:

• If therapy is prolonged, examine CBC, renal, and hepatic function periodically.
• Signs and symptoms of disordered glucose regulation.

How to administer Ofloxacin?

• Both with and without food, administer.
• Sucralfate, didanosine, iron, zinc, and antacids made of magnesium, calcium, or aluminium shouldn't be taken within two hours of each other.

Mechanism of action of Ofloxacin:

• A DNA-gyrase inhibitor is ofloxacin.
• The DNA's superhelical shape is preserved by the essential bacterial enzyme DNA gyrase.
• DNA replication, DNA transposition, and DNA repair and transcription all require DNA gyrase.
• Bactericidal.

Absorption:

• Well absorbed

Distribution:

• Widely disseminated throughout body fluids and tissues, including sputum, skin, prostatic tissue, lung, cervix, blister fluid, and ovary.

Protein binding:

• 20%-32 %

Bioavailability:

• 98 %

Half-life elimination:

• Nine hours (biphasic: four to five hours [6.4 to seven hours in older patients] and twenty to twenty-five hours [accounts for about 5%]).
  with renal impairment extended

Time to peak serum concentration:

• 1-2 hours

Excretion:

• Urine:
  • 65 %-80 % (as unchanged drug).
• Feces:
  • 4 %-8 %.
  • <10 % is metabolized.

International Brands of Ofloxacin:

• Akilen
• Avaflox
• Biloxcin
• Cilox 200
• Cinaflox
• Danoflox
• Evaflox
• Flobacin
• Flogirax
• Floksan
• Flotavid
• Flovid
• Floxil
• Floxitop
• Floxstat
• Fugacin
• Hyflox
• Kinflocin
• Kinoxacin
• Loxinter
• Loxwin
• Medofloxine
• Mefoxa
• Menazin
• Microbac
• Novecin
• Nufafloqo
• Ofcin
• Ofla
• Oflacin
• Oflamed
• Oflin
• Oflobid
• Oflocee
• Oflocet
• Oflocin
• Oflodal
• Oflodex
• Oflodura
• Oflovir
• Ofloxin
• Ofloxol
• Oltrex
• Onexacin
• Orivid
• Orocin
• Oxacid
• Oxacin
• Pharflox
• Quotavil
• Rilox
• Sinflo
• Tabrin
• Tafloc
• Taravid
• Tariflox
• Tarivid
• Taroflex
• Telbit
• Uro Tarivid
• Vioflox
• Vioson
• Viotisone
• Zanocin

Ofloxacin Brand Names in Pakistan:

Ofloxacin Injection 500 mg/10ml
Ketalin	Saturn Pharmaceuticals (Pvt) Ltd

Ofloxacin Injection 500 Mg/10ml
Ketalin	Saturn Pharmaceuticals (Pvt) Ltd

Ofloxacin Inf 200 Mg
Albacat	Nabiqasim Industries (Pvt) Ltd.
Infuxac	Elko Organization (Pvt) Ltd.
Oranex	Isis Pharmaceutical
Sterioflox	Frontier Dextrose Ltd
Technoflox	Hygeia Pharmaceuticals

Ofloxacin Infusion 200 mg/100ml
Tranxcin	Treat Pharmaceuticals

Ofloxacin Infusion 200 mg/100ml
Adios	Wilshire Laboratories (Pvt) Ltd.
Bactivid	Dr. Raza Pharma (Private) Limited
Bidflox	Ahad International Pharmaceuticals
Curitol	Standpharm Pakistan (Pvt) Ltd.
Epoflox	Epoch Pharmaceutical
Exact	Saydon Pharmaceutical Industries (Pvt) Ltd.
Florains	Mac & Rans Pharmaceuticals (Pvt) Ltd
Floxy	Glaxosmithkline
G-Vid	Akson Pharmaceuticals (Pvt) Ltd.
Geoflox	Geofman Pharmaceuticals
Lebx	Raazee Theraputics (Pvt) Ltd.
Loxat	Siza International (Pvt) Ltd.
Ofcil	Mediceena Pharma (Pvt) Ltd.
Ofcil	Mediceena Pharma (Pvt) Ltd.
Oflobid	Hilton Pharma (Pvt) Limited
Oflocin	Helix Pharma (Private) Limited
Ofloquin	Global Pharmaceuticals
Oflosave	Medisave Pharmaceuticals
Oflosol I.V	Marions Laboratories Pakistan
Ofloxa-Z	Z-Jans Pharmaceutical (Pvt) Ltd.
Oftin	Mass Pharma (Private) Limited
Oloxin	Eg Pharmaceuticals
Quinox	Brookes Pharmaceutical Laboratories (Pak.) Ltd.
Tariflox	Bosch Pharmaceuticals (Pvt) Ltd.
Tarivid	Sanofi Aventis (Pakistan) Ltd.

Ofloxacin Eye Drops 3 mg/ml
Taripharm	Epharm Laboratories

Ofloxacin Eye Drops 0.3 % W/V
Ciof	Remington Pharmaceutical Industries (Pvt) Ltd.
Exocin	Barrett Hodgson Pakistan (Pvt) Ltd.
Eyeforex	Atco Laboratories Limited
Floxy	Glaxosmithkline
Gw Floxy	Glaxosmithkline
Ofcil	Mediceena Pharma (Pvt) Ltd.
Oflexer	The Schazoo Laboratories Ltd.
Oflo-V	Remington Pharmaceutical Industries (Pvt) Ltd.
Oflobiotic	Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Oflocin	Helix Pharma (Private) Limited
Oflocin-D	Helix Pharma (Private) Limited
Oflonim	Nimrall Laboratories
Ofloquin	Global Pharmaceuticals
Op Lox	Epoch Pharmaceutical
Ophth-Flox	Ophth-Pharma (Pvt) Ltd.
Optiquin	Azron Pharmaceuticals (Pvt) Ltd
Optoflox	Sante (Pvt) Limited
Ponoflox	Zinta Pharmaceuticals Industries
Tariflox	Bosch Pharmaceuticals (Pvt) Ltd.
Veflox	Vega Pharmaceuticals Ltd.

Ofloxacin Ear Drops 0.3 % W/V
Earocin	Vega Pharmaceuticals Ltd.
Kunoxy	Remington Pharmaceutical Industries (Pvt) Ltd.
Oflocin	Helix Pharma (Private) Limited
Otoflox	Sante (Pvt) Limited

Ofloxacin Ear Drops 0.6 %W/V
Earocin	Vega Pharmaceuticals Ltd.
Kunoxy	Remington Pharmaceutical Industries (Pvt) Ltd.
Oflocin	Helix Pharma (Private) Limited
Otoflox	Sante (Pvt) Limited

Ofloxacin Eye Ointment 0.3 % W/W
Exocin	Barrett Hodgson Pakistan (Pvt) Ltd.
Oflo	Remington Pharmaceutical Industries (Pvt) Ltd.
Ophth-Oflox	Ophth-Pharma (Pvt) Ltd.
Optoflox	Sante (Pvt) Limited

Ofloxacin Ointment 0.3 %W/W
Tifcin	Valor Pharmaceuticals

Ofloxacin Tablets 200 Mg
A-Vid	Alliance Pharmaceuticals (Pvt) Ltd.
Adiflox	Davis Pharmaceutical Laboratories
Adios	Wilshire Laboratories (Pvt) Ltd.
Alcin	Alina Combine Pharmaceuticals (Pvt) Ltd.
Ankavid	Ankaz Pharmex (Pvt) Ltd.
Arixtra Tablet	Meditech Pharmaceuticals
Arloxin	Pakistan Pharmaceutical Products (Pvt) Ltd.
Avocin	Harmann Pharmaceutical Laboratories (Pvt) Ltd.
Azoflox	Delta Pharma (Pvt) Ltd.
Bacivid	Umersons
Bacrid	Neutro Pharma (Pvt) Ltd.
Bactacin	Pharmacare Laboratories (Pvt) Ltd.
Bacteflox	Drugs Inn Pakistan
Bactivid	Dr. Raza Pharma (Private) Limited
Bacus	Elko Organization (Pvt) Ltd.
Beflo	Basel Pharmaceuticals
Capflo	Zesion Pharmaceutical (Pvt) Ltd
Cinax	Aptcure Private Limited
Cinvolox	Everest Pharmaceuticals
Ciof	Remington Pharmaceutical Industries (Pvt) Ltd.
Citivid	City Pharma
Civra	Gaba Pharmaceuticals Labs
Clamocid	Rock Pharmaceuticals
Curitol	Standpharm Pakistan (Pvt) Ltd.
Danvid	Danas Pharmaceuticals (Pvt) Ltd
Delvid	Delta Pharma (Pvt) Ltd.
Dintoflox	Combat Pharma
Divirat	Polyfine Chempharma (Pvt) Ltd.
Dyramid	Don Valley Pharmaceuticals (Pvt) Ltd.
E-Flox	English Pharmaceuticals Industries
Ecoflox	Candid Pharmaceuticals
Ecolox	Stalwart Pharmaceuticals (Pvt) Ltd
Edox	Zephyr Pharmatec (Pvt) Ltd.
Eflox	Eros Pharmaceuticals
Eracin	Consolidated Chemical Laboratories (Pvt) Ltd.
Euvid	Unexo Labs (Pvt) Ltd.
Exact	Saydon Pharmaceutical Industries (Pvt) Ltd.
Fasbact	Fassgen Pharmaceuticals
Flostad	Standard Drug Co.
Flovix	Bryon Pharmaceuticals (Pvt) Ltd.
Floxicare	Wise Pharmaceuticals (Pvt) Ltd
Floxicon	Cibex (Private) Limited
Floxiwin	Wns Field Pharmaceuticals
Floxol	P.D.H. Pharmaceuticals (Pvt) Ltd.
Floxtat	Welmark Pharmaceuticals
Floxyan	Roryan Pharmaceutical Industries (Pvt) Ltd
Fugacin	High - Q International
G-Vid	Akson Pharmaceuticals (Pvt) Ltd.
Geoflox	Geofman Pharmaceuticals
Grexcin	Gray`S Pharmaceuticals
Gw Floxy	Glaxosmithkline
Gyrasid	Ferozsons Laboratoies Ltd.
Gyrex	Platinum Pharmaceuticals (Pvt.) Ltd.
Haloxin	Lowitt Pharmaceuticals (Pvt) Ltd
Hocin	Honig Pharmaceuticals Laboratories
Hoxidal	Ambrosia Pharmaceuticals
Idevid	Ideal Pharmaceutical Industries
Irzaflox	Irza Pharma (Pvt) Ltd.
Joxacin	Jawa Pharmaceuticals(Pvt) Ltd.
Jp-Flox	Jinnah Pharmaceuticals
Kapcin	Cirin Pharmaceuticals (Pvt) Ltd.
Kemyvid	Alkemy Pharmaceutical Laboratories (Private) Ltd.
Kenvid	Shrooq Pharmaceuticals
Korvid	Venture Chemical & Pharmaceuticals (Pvt) Ltd.
Lebx	Raazee Theraputics (Pvt) Ltd.
Loxacin	Shazals Pharmaceuticals
Loxat	Siza International (Pvt) Ltd.
Loxin	Dosaco Laboratories
Loxpro	Adamjee Pharmaceuticals (Pvt) Ltd.
Medi-Xin	Medicon Pharmaceuticals Industries (Pvt) Ltd
Mediox	Medera Pharmaceuticals (Pvt) Ltd.
Megavid	Mega Pharmaceuticals (Pvt) Ltd
Miroxin	Miracle Pharmaceuticals(Pvt) Ltd
Mykuin	Envoy Pharma
Negabact	Adfa San Pharmaceuticals.
O Oxacin	Bio Labs (Pvt) Ltd.
O-Max	Ferroza International Pharmaceuticals (Pvt) Ltd.
O-Quine	Nova Med Pharmaceuticals
Oblx	Batala Pharmaceuticals.
Ofacin	Heal Pharmaceuticals Pvt Ltd
Ofaxin	Fynk Pharmaceuticals
Ofcil	Mediceena Pharma (Pvt) Ltd.
Oflaban	Friends Pharma (Pvt) Ltd
Oflamac	Macter International (Pvt) Ltd.
Oflan	Lisko Pakistan (Pvt) Ltd
Oflaxa-Z	Z-Jans Pharmaceutical (Pvt) Ltd.
Oflazat	Hizat Pharmaceutical Industries (Pvt) Ltd.
Ofloban	Saffron Pharmaceutical Company
Oflobid	Hilton Pharma (Pvt) Limited
Oflobid	Hilton Pharma (Pvt) Limited
Oflobiotic	Zafa Pharmaceutical Laboratories (Pvt) Ltd.
Oflobro	Albro Pharma
Oflofine	Medifine Laboratories
Oflogen	Genera Pharmaceuticals
Oflogood	Goodman Laboratories
Ofloheim	Pakheim Internanational Pharma
Oflom	Well & Well Pharma (Pvt) Ltd
Oflomax	Dyson Research Laboratories
Oflomed	Medicraft Pharmaceuticals (Pvt) Ltd.
Oflonim	Nimrall Laboratories
Oflonim	Nimrall Laboratories
Ofloquin	Global Pharmaceuticals
Oflosave	Medisave Pharmaceuticals
Ofloscot	Scotmann Pharmaceuticals
Oflowan	Swan Pharmaceuticals(Pvt) Ltd
Oflowin	Medicraft Pharmaceuticals (Pvt) Ltd.
Oflox	Indus Pharma (Pvt) Ltd.
Ofloxadvan	Advanced Pharmaceuticals
Ofloxin	Werrick Pharmaceuticals
Ofloxy	Safina Pharma (Pvt) Ltd
Ofspan	Genome Pharmaceuticals (Pvt) Ltd
Oftab	Akhai Pharmaceuticals.
Oftag	Obsons Pharmaceuticals
Oftin	Mass Pharma (Private) Limited
Ofus	Rehman Medicine Co.
Okcin-200	Evergreen Pharmaceuticals Pvt Limited
Olaxcin	Paramount Pharmaceuticals
Oliflox	Olive Laboratories
Olox	Shaheen Pharmaceuticals
Onid	Silver Oak Corporation.
Oracin	Orta Labs. (Pvt) Ltd.
Oraflox	Sante (Pvt) Limited
Otacin	Glaxosmithkline
Otaking	Biogen Pharma
Oxacin	Nenza Pharmaceuticals (Pvt) Limited
Oxil	Himont Pharmaceuticals (Pvt) Ltd.
Oxinof	Zanctok Pharmaceuticals
Oxopulse	Pulse Pharmaceuticals
Ponolox	Zinta Pharmaceuticals Industries
Q-Span	Spencer Pharma
Quinox	Brookes Pharmaceutical Laboratories (Pak.) Ltd.
Quinzi	Noa Hemis Pharmaceuticals
Qulavid	Helicon Pharmaceutek Pakistan (Pvt) Ltd.
Rakavid	Rakaposhi Pharmaceutical (Pvt) Ltd.
Rakavid	Rakaposhi Pharmaceutical (Pvt) Ltd.
Re-Ved	Rasco Pharma
Rekoflox	Reko Pharmacal (Pvt) Ltd.
Rewell	Fozan Pharmaceuticals Industriers (Pvt) Ltd
Rivid	Regent Laboratories Ltd.
Rovid	Roryan Pharmaceutical Industries (Pvt) Ltd
Royflox	Royal Consumer Manufacturing Company
Salmocine	Rasco Pharma
Shaflo	Shawan Pharmaceuticals
Sydacin	Sayyed Pharmaceuticals
Synoflox	Syntex Pharmaceuticals
T-Vid	Tagma Pharma (Pvt) Ltd.
Tabroxacin	Tabros Pharma
Tafy	Pliva Pakistan (Pvt) Limited
Taricin	Hansel Pharmacueutical Pvt (Ltd)
Taridix	Neo Medix
Tariflox	Bosch Pharmaceuticals (Pvt) Ltd.
Taripharm	Epharm Laboratories
Tarivid	Sanofi Aventis (Pakistan) Ltd.
Tasoflox	F.M. Pharmaceuticals International
Teknoflox	Hygeia Pharmaceuticals
Telbit	Hamaz Pharmaceutical (Pvt) Ltd.
Tifcin	Valor Pharmaceuticals
Tissot	Macquins International
Tyfox	Rakaposhi Pharmaceutical (Pvt) Ltd.
Utixan	Leama Chemi Pharma (Pvt.) Ltd.
Visoflox	Vision Pharmacueticals
Wefloxacin	Webros Pharmaceuticals
Wiloxin	Wilsons Pharmaceuticals
Xarivid	Axis Pharmaceuticals
Zarevid	Zumars Pharma (Pvt) Ltd.
Zippy	Everest Pharmaceuticals
Zoflox	Pharmatec Pakistan (Pvt) Ltd.
Zoxam	Medisure Laboratories Pakistan (Pvt.) Ltd.

Ofloxacin 400 Mg Tablets
Adiflox	Davis Pharmaceutical Laboratories
Adiflox	Davis Pharmaceutical Laboratories
Adios	Wilshire Laboratories (Pvt) Ltd.
Ankavid	Ankaz Pharmex (Pvt) Ltd.
Ankavid	Ankaz Pharmex (Pvt) Ltd.
Clamocid	Rock Pharmaceuticals
Curitol	Standpharm Pakistan (Pvt) Ltd.
Ecolox	Stalwart Pharmaceuticals (Pvt) Ltd
Edox	Zephyr Pharmatec (Pvt) Ltd.
Fasbact	Fassgen Pharmaceuticals
Floxicon	Cibex (Private) Limited
Floxtat	Welmark Pharmaceuticals
Jp-Flox	Jinnah Pharmaceuticals
Kapcin	Cirin Pharmaceuticals (Pvt) Ltd.
Loxacin	Shazals Pharmaceuticals
Myobid	Panacea Pharmaceuticals
Oflobid	Hilton Pharma (Pvt) Limited
Oflomed	Medicraft Pharmaceuticals (Pvt) Ltd.
Ofloquin	Global Pharmaceuticals
Ofloscot	Scotmann Pharmaceuticals
Oflowin	Medicraft Pharmaceuticals (Pvt) Ltd.
Oflox	Indus Pharma (Pvt) Ltd.
Olax	Linear Pharma
Olaxcin	Paramount Pharmaceuticals
Olaxcin	Paramount Pharmaceuticals
Oxacin	Nenza Pharmaceuticals (Pvt) Limited
Oxopulse	Pulse Pharmaceuticals
Ponolox	Zinta Pharmaceuticals Industries
Quinof	Hisun Pharmaceuticals
Rovid	Roryan Pharmaceutical Industries (Pvt) Ltd
Tafy	Pliva Pakistan (Pvt) Limited
Tafy	Pliva Pakistan (Pvt) Limited
Taridix	Neo Medix
Tariflox Forte	Bosch Pharmaceuticals (Pvt) Ltd.
Taripharm	Epharm Laboratories
Unox	Unison Chemical Works
Unox	Unison Chemical Works
Visoflox	Vision Pharmacueticals

Ofloxacin 200 mg Capsules
Biovid	Biorex Pharmaceuticals
Joxacin	Jawa Pharmaceuticals (Pvt) Ltd.
Orvacin	Bloom Pharmaceuticals (Pvt) Ltd.