Apo-Moxifloxacin Hydrochloride: Uses, Side Effects and Dosage

Serious Warnings and Precautions

What is APO-MOXIFLOXACIN HYDROCHLORIDE used for?

Your doctor has prescribed APO-MOXIFLOXACIN HYDROCHLORIDE because you have a certain type of bacterial infection.

Antibacterial drugs like APO-MOXIFLOXACIN HYDROCHLORIDE treat only bacterial infections. They do not treat viral infections such as the common cold. Although you may feel better early in treatment, APO-MOXIFLOXACIN HYDROCHLORIDE should be used exactly as directed. Misuse or overuse of APO-MOXIFLOXACIN HYDROCHLORIDE could lead to the growth of bacteria that will not be killed by APO-MOXIFLOXACIN HYDROCHLORIDE (resistance). This means that APO-MOXIFLOXACIN HYDROCHLORIDE may not work for you in the future. Do not share your medicine.

How does APO-MOXIFLOXACIN HYDROCHLORIDE work?

APO-MOXIFLOXACIN HYDROCHLORIDE is an antibiotic. It kills many of the types of bacteria that can infect the lungs, sinuses, abdomen, and skin.

What are the ingredients in APO-MOXIFLOXACIN HYDROCHLORIDE Tablets?:

Medicinal ingredients: APO-MOXIFLOXACIN HYDROCHLORIDE tablets contain 400 mg of moxifloxacin as moxifloxacin hydrochloride (active ingredient).

Non-medicinal ingredients: colloidal silicon dioxide croscarmellose sodium, euroxide red iron oxide, magnesium stearate, polyethylene glycol, polyvinyl alcohol, powder cellulose, pregelatinised starch, talc, titanium dioxide.

APO-MOXIFLOXACIN HYDROCHLORIDE Tablets come in the following dosage forms:

APO-MOXIFLOXACIN HYDROCHLORIDE tablets, 400 mg: reddish brown coloured, modified capsule shaped, biconvex film-coated tablet containing 400 mg moxifloxacin (as moxifloxacin hydrochloride). They are engraved with “APO” on one side and “MX 400” on the other side.

Do not use APO-MOXIFLOXACIN HYDROCHLORIDE if:

• you are allergic to APO-MOXIFLOXACIN HYDROCHLORIDE (moxifloxacin hydrochloride) or other fluoroquinolone antibiotics.
• you are allergic to any other ingredient in the formulation (see “What are the ingredients in APO-MOXIFLOXACIN HYDROCHLORIDE Tablets?”).

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take APO-MOXIFLOXACIN HYDROCHLORIDE. Talk about any health conditions or problems you may have, including if you:

• have or have a family history of irregular heart rhythm (such as QT prolongation).
• have or have had heart problems such as heart failure, an irregular heartbeat, or a slow heartbeat.
• have low potassium blood levels (see “The following may interact with APO-MOXIFLOXACIN HYDROCHLORIDE”).
• have a history of seizures.

• are pregnant, planning to become pregnant, or if you are breast feeding.

• are less than 18 years of age.
• have a history of tendon problems (such as pain, swelling or rupture of a tendon) related to the use of fluoroquinolone antibiotics.
• have myasthenia gravis (a muscle disease).
• have diabetes as APO-MOXIFLOXACIN HYDROCHLORIDE may affect blood sugar levels. APO-MOXIFLOXACIN HYDROCHLORIDE may also affect blood sugar levels in those without diabetes.
• have an aortic aneurysm which is an abnormal bulge in a large blood vessel called the aorta.
• have or if anyone in your family has a condition called aneurysm disease which is an abnormal bulge in any large blood vessel in the body.
• have an aortic dissection which is a tear in the wall of the aorta.
• have any of the following conditions: Marfan syndrome, vascular Ehlers-Danlos syndrome, Takayasu arteritis, giant cell arteritis or Behcet’s disease.
• have high blood pressure.
• have atherosclerosis, which is a hardening of your blood vessels.

Other warnings you should know about:

Blood Sugar Changes

Medicines like APO-MOXIFLOXACIN HYDROCHLORIDE can cause blood sugar levels to rise and drop in patients with diabetes. Serious cases of hypoglycemia (low blood sugar levels) that caused coma or death have been seen with medicines like APO-MOXIFLOXACIN. HYDROCHLORIDE If you have diabetes, check your blood sugar levels often while taking APO-MOXIFLOXACIN HYDROCHLORIDE.

While taking APO-MOXIFLOXACIN HYDROCHLORIDE:

• Avoid too much sunlight or artificial ultraviolet light (such as sunlamps).
• Contact your doctor if a sunburn or rash occurs.

• Do not drive or use machinery if you feel dizzy or lightheaded.

Quinolones, including APO-MOXIFLOXACIN HYDROCHLORIDE have been associated with an enlargement or “bulge” of a large blood vessel called the aorta (aortic aneurysm) and a tear in the aorta wall (aortic dissection).

• The risk of these problems is higher if you:

  • are elderly
  • have or anyone in your family has had aneurysm disease
  • have an aortic aneurysm or an aortic dissection
  • have any of the following conditions: Marfan syndrome, vascular Ehlers-Danlos syndrome, Takayasu arteritis or giant cell arteritis or Behcet’s disease
  • have high blood pressure or atherosclerosis
• If you experience sudden, severe pain in your abdomen, chest or back, a pulsating sensation in your abdomen, dizziness or loss of consciousness, get immediate medical help.

Tendon problems can happen within the first 48 hours of treatment.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

The following may interact with APO-MOXIFLOXACIN HYDROCHLORIDE:

• Antacids or vitamin/mineral supplements
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Antidiabetic medicines (such as, insulin, glyburide, glibenclamide)
• Quinidine, procainamide, amiodarone, sotalol, cisapride^b, erythromycin, antipsychotics, tricyclic antidepressants, diuretics (furosemide, hydrochlorothiazide).

^b no longer marketed in Canada

How to take APO-MOXIFLOXACIN HYDROCHLORIDE:

• You must take APO-MOXIFLOXACIN HYDROCHLORIDE exactly as prescribed by your doctor. YOU SHOULD NOT INCREASE THE PRESCRIBED DOSE.

• You can take APO-MOXIFLOXACIN HYDROCHLORIDE with or without food.

• You should drink lots of fluids while taking APO-MOXIFLOXACIN HYDROCHLORIDE.
• If your doctor decides to stop the treatment, dispose of all unused APO-MOXIFLOXACIN HYDROCHLORIDE tablets.

Usual dose:

• Take one 400 mg APO-MOXIFLOXACIN HYDROCHLORIDE tablet once a day.
• Swallow each APO-MOXIFLOXACIN HYDROCHLORIDE tablet whole with a drink of water. Do not crush or chew APO-MOXIFLOXACIN HYDROCHLORIDE tablets.
• If you are taking antacids or vitamin/mineral supplements which contain magnesium or aluminium, take APO-MOXIFLOXACIN HYDROCHLORIDE at least 4 hours before or 8 hours after taking the supplement or antacid.
• Your doctor has decided on the best dose for you and for how long based on your needs.
• The usual length of treatment with APO-MOXIFLOXACIN HYDROCHLORIDE is 5-10 days. IT IS IMPORTANT TO COMPLETE THE FULL LENGTH OF TREATMENT, EVEN IF YOU BEGIN TO FEEL BETTER.

Overdose:

Missed Dose:

If you forget to take your tablet you should take it as soon as you remember on the same day. If you do not take your tablet on one day, take your normal dose (one tablet) on the next day. Do not take a double dose to make up for a forgotten dose. If you are unsure about what to do, consult your healthcare professional.

What are possible side effects from using APO-MOXIFLOXACIN HYDROCHLORIDE?

All medicines, including APO-MOXIFLOXACIN HYDROCHLORIDE, can cause side effects, although not everyone gets them.

These are not all the possible side effects you may feel when taking APO-MOXIFLOXACIN HYDROCHLORIDE. If you have any side effects not listed here or if conditions worsen or do not improve then:

• contact your healthcare professional.
• see the “To help avoid side effects and ensure proper use, …” section.

Stop taking APO-MOXIFLOXACIN HYDROCHLORIDE and contact your doctor if:

1. a)

   you have symptoms of an allergic reaction such as:

   • rash, hives, blistering or other skin reaction
   • swelling of the mouth, throat, limbs
   • difficulty breathing
   • irregular or rapid heartbeat, or fainting spells
2. b)

   you have pain, swelling or rupture of a tendon. These side effects may last more than 30 days. You should:

   • rest
   • avoid physical exercise
3. c)

   you have neuropathy (damage to the nerves) with symptoms such as:

   • pain, burning, tingling, numbness or weakness
4. d)

   you have severe diarrhea (bloody or watery) with or without:

   • fever
   • stomach pain or tenderness

You may have Clostridium difficile colitis (bowel inflammation). See your doctor right away.

Other side effects include:

• your eyesight worsens or changes. These side effects may last more than 30 days. See your doctor or eye specialist right away.
• nausea, dizziness

• worsening of myasthenia gravis (a muscle disease) with symptoms such as:

  • weakness
  • difficulty walking, swallowing, drooping eyelids

Do not use APO-MOXIFLOXACIN HYDROCHLORIDE if you have this condition.

• mental problems such as:

  • confusion, headache, shaking
  • hallucinations, depression, agitation
  • difficulty sleeping, anxiety, nervousness, suicidal thoughts

These side effects may last more than 30 days.

Contact your doctor if you have suicidal thoughts.

Self-Limiting Side Effects:

• feeling lightheaded
• insomnia (difficulty sleeping)
• nightmares

If any of these affect you severely, tell your doctor or pharmacist.

Serious Side Effects and What to do About Them

Serious Side Effects and What to do About Them

Serious Side Effects and What to do About Them

Serious Side Effects and What to do About Them

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, talk to your healthcare professional.

Reporting Side Effects

Storage:

Keep your APO-MOXIFLOXACIN HYDROCHLORIDE tablets in a safe place where children cannot reach them.

APO-MOXIFLOXACIN HYDROCHLORIDE tablets should be stored at room temperature (15°C to 30°C). Avoid freezing.

If you want more information about APO-MOXIFLOXACIN HYDROCHLORIDE:

• Talk to your healthcare professional.
• Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website ( https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html). Find the Patient Medication Information on the manufacturer’s website (http://www.apotex.ca/products), or by calling 1-800-667-4708.

Last Revised: June 14, 2021