Chibroxin

CHIBROXIN (norfloxacin) Ophthalmic Solution is indicated for the treatment of conjunctivitis when caused by susceptible strains of the following bacteria:

Acinetobacter calcoaceticus**

Aeromonas hydrophila**

Haemophilus influenzae

Proteus mirabilis**

Pseudomonas aeruginosa**

Serratia marcescens**

Staphylococcus aureus

Staphylococcus epidermidis

Staphylococcus warnerii**

Streptococcus pneumoniae

Appropriate monitoring of bacterial response to topical antibiotic therapy should accompany the use of CHIBROXIN (norfloxacin) Ophthalmic Solution.

**Efficacy for this organism was studied in fewer than 10 infections.

No Information Provided.

Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal and dietary supplements. Norfloxacin and other medicines can affect each other causing side effects.

Especially tell your healthcare provider if you take:

• an NSAID (Non-Steroidal Anti-Inflammatory Drug). Many common medicines for pain relief are NSAIDs. Taking an NSAID while you take norfloxacin or other fluoroquinolones may increase your risk of central nervous system effects and seizures.
• glyburide (Micronase, Glynase, Diabeta, Glucovance)
• a blood thinner (warfarin, Coumadin, Jantoven)
• a medicine to control your heart rate or rhythm (antiarrhythmics)
• an anti-psychotic medicine
• a tricyclic antidepressant
• erythromycin
• a water pill (diuretic)
• a steroid medicine. Corticosteroids taken by mouth or by injection may increase the chance of tendon injury.
• probenecid (Probalan, Col-probenecid)
• cyclosporine (Gengraf, Sandimmune, Neoral)
• products that contain caffeine
• clozapine (Fazaclo ODT, Clozaril)
• ropinirole (Requip, Requip XL)
• tacrine (Cognex)
• tizanidine (Zanaflex)
• theophylline (Theo-24, Elixophyllin, Theochron, Uniphyl, Theolair)
• cisapride (Propulsid)

Certain medicines may keep norfloxacin from working correctly. Take it either 2 hours before or 2 hours after taking these products:

• an antacid, multivitamin or other product that has iron or zinc
• sucralfate (Carafate)
• didanosine (Videx, Videx EC)

You should not take the medicine nitrofurantoin (Furadantin, Macrodantin, Macrobid) while taking norfloxacin.

Norfloxacin belongs to a class of antibiotics called fluoroquinolones. Norfloxacin can cause side effects that may be serious or even cause death. If you develop any of the following serious side effects, get medical help right away. Talk with your healthcare provider about whether you should continue to take norfloxacin.

Tendon rupture or swelling of the tendon (tendinitis). Tendon problems can happen in people of all ages who take norfloxacin. Tendons are tough cords of tissue that connect muscle to bones. Symptoms of tendon problems may include:

• Pain, swelling, tears and inflammation of tendons including the back of the ankle (Achilles), shoulder, hand, or other tendon sites.

The risk of getting tendon problems while you take norfloxacin is higher if you:

• are over 60 years of age
• are taking steroids (corticosteroids)
• have had a kidney, heart or lung transplant

Tendon problems can happen in people who do not have the above risk factors when they take norfloxacin. Other reasons that can increase your risk of tendon problems can include:

• physical activity or exercise
• kidney failure
• tendon problems in the past, such as in people with rheumatoid arthritis (RA)

Call your healthcare provider right away at the first sign of tendon pain, swelling or inflammation. Stop taking norfloxacin until tendinitis or tendon rupture has been ruled out by your healthcare provider. Avoid exercise and using the affected area. The most common area of pain and swelling is the Achilles tendon at the back of your ankle. This can also happen with other tendons.

• Talk to your healthcare provider about the risk of tendon rupture with continued use of norfloxacin. You may need a different antibiotic that is not a fluoroquinolone to treat your infection.
   
• Tendon rupture can happen while you are taking or after you have finished taking norfloxacin. Tendon ruptures have happened up to several months after patients have finished taking their fluoroquinolone.
   
• Get medical help right away if you get any of the following signs or symptoms of a tendon rupture:
  • hear or feel a snap or pop in a tendon area
  • bruising right after an incident in a tendon area
  • unable to move the affected area or bear weight

Worsening of myasthenia gravis (a disease which causes muscle weakness). Fluoroquinolones like norfloxacin may cause worsening of myasthenia gravis symptoms, including muscle weakness and breathing problems. Call your healthcare provider right away if you have any worsening muscle weakness or breathing problems.

Peripheral neuropathy may occur. Tell your healthcare provider right away if you experience the following:

• pain, burning, tingling, numbness, weakness, or a change in sensation to light touch, pain or temperature. These symptoms can occur early in treatment and may be permanent. It may be necessary to stop Avelox, but do not do so without first talking with your health care professional.

Other serious side effects of norfloxacin include:

• Central Nervous System Effects: Seizures have been reported in people who take fluoroquinolone antibiotics including norfloxacin. Tell your healthcare provider if you have a history of seizures. Ask your healthcare provider whether taking norfloxacin will change your risk of having a seizure.
  
  Central Nervous System (CNS) side effects may happen as soon as after taking the first dose of norfloxacin. Talk to your healthcare provider right away if you get any of these side effects, or other changes in mood or behavior:
  • feel lightheaded
  • seizures
  • hear voices, see things, or sense things that are not there (hallucinations)
  • feel restless
  • tremors
  • feel anxious or nervous
  • confusion
  • feel more suspicious (paranoia)
• Serious allergic reactions: Allergic reactions can happen in people who take fluoroquinolones, including norfloxacin, even after only one dose. Stop taking norfloxacin and get emergency medical help right away if you get any of the following symptoms of a severe allergic reaction:
  • hives
  • trouble breathing or swallowing
  • swelling of the lips, tongue, face
  • throat tightness, hoarseness
  • rapid heartbeat
  • faint
  • skin rash accompanied by fever and feeling unwell
  • yellowing of the skin or eyes. Stop taking norfloxacin and tell your healthcare provider right away if you get yellowing of your skin or white part of your eyes, or if you have dark urine. These can be signs of a serious reaction to norfloxacin (a liver problem).
• Skin rash: Skin rash may happen in people taking norfloxacin, even after only one dose. Stop taking norfloxacin at the first sign of a skin rash and call your healthcare provider. Skin rash may be sign of a more serious reaction to norfloxacin.
• Serious heart rhythm changes (QTc prolongation and torsade de pointes): Tell your healthcare provider right away if you have a change in your heart beat (a fast or irregular heartbeat), or if you faint. norfloxacin may cause a rare heart problem known as prolongation of the QTc interval. This condition can cause an abnormal heartbeat and can be very dangerous. The chances of this happening are higher in people:
  • who are elderly
  • with a family history of prolonged QTc interval
  • with low blood potassium (hypokalemia)
  • who take certain medicines to control heart rhythm (antiarrhythmics)
• Intestine infection (Pseudomembranous colitis): Pseudomembranous colitis can happen with most antibiotics, including norfloxacin. Call your healthcare provider right away if you get watery diarrhea, diarrhea that does not go away, or bloody stools. You may have stomach cramps and a fever. Pseudomembranous colitis can happen 2 or more months after you have finished your antibiotic.
• Changes in sensation and possible nerve damage (Peripheral Neuropathy): Damage to the nerves in arms, hands, legs, or feet can happen in people taking fluoroquinolones, including norfloxacin. Talk with your healthcare provider right away if you get any of the following symptoms of peripheral neuropathy in your arms, hands, legs, or feet:
  • pain
  • burning
  • tingling
  • numbness
  • weakness

• Low blood sugar (hypoglycemia): People taking norfloxacin and other fluoroquinolone medicines with the oral anti-diabetes medicine glyburide (Micronase, Glynase, Diabeta, Glucovance) can get low blood sugar (hypoglycemia) which can sometimes be severe. Tell your healthcare provider if you get low blood sugar while taking norfloxacin. Your antibiotic medicine may need to be changed.
• Sensitivity to sunlight (photosensitivity).

Do not take norfloxacin if you:

• have ever had a severe allergic reaction to an antibiotic known as a fluoroquinolone, or are allergic to any of the ingredients in norfloxacin. Ask your healthcare provider if you are not sure. See the list of ingredients in norfloxacin at the end of this Medication Guide.
• have had tendinitis or tendon rupture with the use of norfloxacin or another fluoroquinolone antibiotic.

Food and dairy can decrease the body's ability to fully absorb this medication. Take norfloxacin on an empty stomach, either one hour before or 2 hours after eating dairy products or drinking milk.

Tell your healthcare provider if you are breastfeeding or planning to breastfeed. It is not known if norfloxacin passes into breast milk. You and your healthcare provider should decide whether you will take norfloxacin or breastfeed.

The dose your doctor recommends will depend on the infection being treated as well as your kidney function and your age. 

The recommended dose for urinary tract infections is 400 mg every 12 hours (twice daily) for 3 to 21 days.

The recommended dose for sexually transmitted diseases (gonorrhea) is a single dose of 800 mg.

For prostatitis, the recommended dose is 400 mg every 12 hours for 28 days.

Norfloxacin ophthalmic is an antibiotic.

Norfloxacin ophthalmic is used to treat bacterial infections of the eyes.

Norfloxacin ophthalmic may also be used for purposes other than those listed in this medication guide.