ofloxacin: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
ofloxacin: clinical details
Prescribing considerations
- Reserve systemic ofloxacin for susceptible infections when other commonly recommended antibiotics are inappropriate; review microbiology and local resistance.
- Check previous serious quinolone reactions, tendon history, seizure risk, psychiatric history, renal and hepatic function, QT risk, dysglycaemia risk, aortic or valvular disease and myasthenia gravis.
- Avoid unnecessary UV exposure during systemic treatment. Assess corneal integrity, dry eye and concomitant ocular anti-inflammatory treatment before eye-drop use.
Contraindications and cautions
- Tablets: hypersensitivity to ofloxacin or another fluoroquinolone; epilepsy or lowered seizure threshold; previous fluoroquinolone-related tendon disorder; pregnancy, breastfeeding, childhood or growth; and latent or established G6PD deficiency.
- Eye drops: hypersensitivity to ofloxacin, another quinolone or an excipient.
Monitoring
- Renal function for systemic treatment; exposure increases with renal impairment.
- Tendon, neurological, musculoskeletal, psychiatric and sensory symptoms throughout and after systemic exposure.
- INR with vitamin K antagonists and blood glucose in people receiving glucose-lowering therapy.
- Clinical response and superinfection; review prolonged ocular use and monitor compromised corneal surfaces.
- ECG or electrolyte assessment when clinically indicated by QT-risk factors or interacting medicines.
Clinical pharmacology
Ofloxacin is a bactericidal fluoroquinolone inhibiting DNA gyrase and topoisomerase IV. Oral absorption is rapid and near complete, metabolism is limited and elimination is predominantly renal. Ophthalmic administration produces sustained tear-film exposure with minimal systemic absorption.
Formulation and product differences
- Tablets provide systemic exposure and carry fluoroquinolone restrictions and systemic safety warnings.
- Eye drops provide topical treatment for external ocular infection and contain benzalkonium chloride, which can irritate the eye, affect the corneal surface and discolour soft contact lenses.
- Transient blurred vision may follow ocular application. The opened eye-drop bottle should be discarded after 28 days.
ofloxacin preparations and strengths
Tablet
Route: Oral
Strengths: 200 mg
ofloxacin interactions
Interaction risk is greatest with tablets, although all current medicines should be checked before either formulation is used.
Antacids, sucralfate, iron, zinc or buffered/chewable didanosine
They reduce tablet absorption and must be separated from oral ofloxacin.
Warfarin and other vitamin K antagonists
Ofloxacin may increase anticoagulant effect and bleeding risk; monitor coagulation closely.
Systemic corticosteroids
Concurrent use increases the risk of tendinitis and tendon rupture.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.