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Why it's used

Norfloxacin is used to treat urinary tract infections, sexually transmitted diseases and inflammation of the prostate gland. It is a prescription medicine. This medicine works by binding to a specific cell site of the bacteria and stopping the protein synthesis. This medicine helps by killing the bacteria.
When not to use
Norfloxacin will not work to treat viral infections such as common cold.
Fluoroquinolone Antibacterial
Norfloxacin belongs to a class of medicines called Fluoroquinolone Antibacterial. Fluoroquinolones are medicines used for the treatment and prevention of certain types of bacterial infections. These medicines are commonly used to treat respiratory and urinary tract infections.

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How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Norfloxacin. If you have any questions related to this medicine, ask your doctor or pharmacist. Eat this medicine as recommended by your doctor.
Norfloxacin is eaten without food. Within 2 hours of taking Norfloxacin, products containing zinc or iron, antacids having magnesium and aluminum, multivitamins, didanosine or sucralfate, oral solution powder for children, or chewable/buffered tablets should not be taken. This medicine should be taken with a glass of water. Patients should be well hydrated while taking Norfloxacin.

Typical Dosage

The typical dose of Norfloxacin is 400 mg twice a day (not more than 800 mg daily). The maximum adult dose of Norfloxacin is 800 mg once daily in a day. This medicine is typically used for a period of 3-10 days for uncomplicated urinary tract infection, 10-21 days for complicated urinary tract infection, 1 day for uncomplicated gonorrhea, and 28 days for inflammation of the prostate gland. This medicine is not known to be habit-forming.
You should continue to use this medicine as directed by the doctor even if you feel well.

Talk to Your Doctor

Talk to your doctor if your condition persists or worsens or if you develop new symptoms. Tell your doctor if swelling of the tendon, tendon rupture, tears, pain and inflammation of tendons, pain, burning, tingling, numbness, or weakness in limbs, seizures, insomnia, nightmares, hallucinations, feel lightheaded or dizzy, feel restless, feel more suspicious (paranoia), tremors, suicidal thoughts or acts, feel anxious or nervous, headaches, confusion, depression, and worsening of muscle weakness. If you have any kidney disease, 400 mg tablet of Norfloxacin once daily is recommended.

Use in Children

The safety and effectiveness of using Norfloxacin in children has not been established. The safety and effectiveness of Norfloxacin have not been established in children aged under 18 years.

Lab Tests

Your doctor may request that specific lab tests be performed before you start using Norfloxacin. You may need to have Antibiotic Susceptibility test. Antibiotic susceptibility test is required to help in selecting an appropriate antibacterial drug for the treatment.

Storage

You should store Norfloxacin at 15-30°C (59-86°F), and away from moisture. Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Norfloxacin for conditions for which it was not prescribed. Do not give Norfloxacin to other people who might have the same conditions or symptoms that you have. Self-medication may harm them.

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How to take Norfloxacin

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Norfloxacin depends on the following factors:
  • patient's age
  • gender
  • patient's weight
  • patient's health
  • the health of the patient's liver

Norfloxacin Dosage

Dosage for uncomplicated urinary tract infections

Adult
  • Recommended: 400 mg twice daily for 3-10 days
  • Maximum: 800 mg daily

Dosage for complicated urinary tract infections

Adult
  • Recommended: 400 mg twice daily for 10-21 days
  • Maximum: 800 mg daily

Dosage for uncomplicated gonorrhea

Adult
  • Recommended: 800 mg for 1 day
  • Maximum: 800 mg daily

Dosage for inflammation of the prostate gland

Adult
  • Recommended: 400 mg twice daily for 28 days
  • Maximum: 800 mg daily

Minimum Age

18 years

Forms

Tablet
Strength: 400 mg
Ophthalmic Solution
Strength: 3 mg
Tablet, film coated
Strength: 400 mg

Special Instructions

Creatinine clearance more than 30 mL/min/1.73 m^2
Elderly patients with creatinine clearance more than 30 mL/min/1.73 m^2 should receive 400 mg twice daily dose of Norfloxacin for urinary tract infections.
Creatinine clearance less than 30 mL/min/1.73 m^2
Patients with creatinine clearance less than 30 mL/min/1.73 m^2 should receive 400 mg once daily dose of Norfloxacin for urinary tract infections.

Missed Dose

Take the missed dose as soon as you remember. Skip the missed dose if it's time for the next dose. Avoid taking a double dose to make up for the missed dose.

Overdose

What to do if you overdose on Norfloxacin?
In the case of overdose, close supervision and supportive care according to the symptoms should be provided. Stomach emptying should be performed by cleaning out the contents of the stomach or by vomiting. Proper maintenance of adequate hydration should be done in these patients.
If you think you have overdosed on Norfloxacin, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Norfloxacin

Before you use Norfloxacin, tell your doctor of your medical and health history including the following:
  • Clostridium difficile associated diarrhea
  • epilepsy
  • inflammation of the tendon (tendinitis)
  • irregular heartbeat (prolonged QTc interval)
  • joint inflammation (rheumatoid arthritis)
  • joint problem
  • kidney disease
  • low blood potassium level
  • nerve problems
  • reduced oxygen supply to the heart (myocardial ischemia)
  • seizures
  • skeletal muscle weakness
  • slow heart rate (bradycardia)
  • tendon rupture
The use of Norfloxacin in patients with a history of muscle weakness may cause worsening of muscle weakness which can be fatal and may require ventilation support. The incidence of inflammation and rupture of a tendon is more in patients with a history of tendon disorders. The treatment with Norfloxacin may alter the microorganisms present in the intestine leading to overgrowth of the bacteria (C. difficile). Thus patients with such history should remain alert.
Before you use Norfloxacin, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic to quinolone antimicrobial agent.
The use of this medicine may change blood cell count. An increase in the white blood cell count and an increase in a type of white blood cell (eosinophils) count has been seen in patients using this medicine.
The use of Norfloxacin may change Liver enzyme level. An increase in the aspartate transaminase and alanine transaminase level has been seen in patients using this medicine.
The use of this medicine may change hematocrit and hemoglobin. The patients may have decreased ratio of red blood cell volume to total blood volume (hematocrit) and hemoglobin level while using Norfloxacin.
The use of this medicine may change glucose and protein level in urine. The patients may have an increased amount of protein and glucose in the urine while using Norfloxacin.
The use of Norfloxacin may change creatinine. The creatinine level in the blood increases while using Norfloxacin.

Use in Pregnancy

Norfloxacin should be used in pregnancy only when required. The safety and effectiveness of Norfloxacin have not been established in pregnant women. Therefore, this medicine should be used only when the benefit is greater than the risk to the fetus.

Use while Breastfeeding

Norfloxacin should be used while breastfeeding only when required. It is unknown that Norfloxacin passes into the milk or not. Other drugs belonging to this class are excreted in the milk and may cause harmful effects to the baby. Thus, a decision should be made to either stop using Norfloxacin or to stop breastfeeding the baby.

Impact on Fertility

Consult with your doctor on the use of Norfloxacin, if you are trying to conceive.

Seizures

Norfloxacin can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Norfloxacin can make you feel more sleepy. Norfloxacin may cause seizures in some people. Discuss with your doctor if you perform activities where a loss of consciousness may cause you or others harm.

Increased Risk

This medicine may increase your sensitivity to sunlight. If this happens, limit your time outdoors and prevent sunburns. Cover your skin or use a sunscreen.

Side-effects in Older Patients

Norfloxacin may increase side-effects in older patients. Elderly patients may see an increased risk of tendon rupture, and tendinitis.

Norfloxacin Side-effects

The following side-effects may commonly occur when using Norfloxacin. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
Rarely, the use of Norfloxacin may cause the following side-effects:
The following severe side-effects may also occur when using Norfloxacin:
  • Stomach and intestinal disorders (Contact the doctor immediately if you suffer from watery diarrhea for a long time or bloody stools.)
    Symptoms: vomiting, constipation, diarrhea inflammation of the intestine (Pseudomembranous colitis)
  • Symptoms: anxiety, depression, abnormal thinking and behaviour (psychotic reactions), hallucinations, feel more suspicious (paranoia) confusion
  • Symptoms: decrease in the number of white blood cells, decrease in the number of platelet count, abnormal breakdown of red blood cells (hemolytic anemia) prolonged prothrombin time
  • Heart disorders
    Symptoms: irregular heartbeat (prolonged QTc interval/ventricular arrhythmia), torsades de pointes heart attack
    If this occurs, contact the doctor immediately.
  • Kidney disorders
    Symptoms: swelling in between kidney tubules (interstitial nephritis), kidney failure, elevated kidney enzyme (creatine kinase), increased blood urea nitrogen (BUN) levels pain due to a stone in urinary tract (urinary clolic)
  • Allergic reactions
    Symptoms: hives, swelling of the lips, swelling of the tongue, swelling of the face, hoarseness, itching, joint pain (arthralgia), muscle pain, tingling, skin rash, trouble in breathing or swallowing, throat tightness or swelling, rapid heartbeat, fainting, yellowing of the skin or eyes, dark urine, decreased blood pressure in heart and blood vessels, severe skin reactions (Stevens-Johnson syndrome), drug-induced skin reaction, allergic reaction to a foreign protein, an inflammation of the lungs (allergic pneumonitis), inflammation of the liver (hepatitis), jaundice, liver injury, liver failure, lack of red blood cells (anemia), abnormal breakdown of red blood cells (hemolytic anemia ), reduced production of red blood cells (aplastic anemia), abnormally low levels of platelets, reduced white blood cell count, deficiency of all types of blood cells (pancytopenia), increased bile secretion (biliousness), shortness of breath (dyspnea), fever inflammation of the blood vessels (vasculitis)
    If any of these symptoms occur, contact the doctor immediately.
  • Central nervous system disorders
    Symptoms: generalized seizures, involuntary muscle jerking (myoclonus), tremors loss of muscle function in parts of the body (Guillain-Barré syndrome)
  • Liver disorders (can be possibly fatal)
    Symptoms: inflammation of the liver (hepatitis), jaundice, cholestatic jaundice, elevated liver enzymes liver cell injury (hepatic necrosis)
  • Metabolism and nutrition disorders
    Symptoms: enzyme deficiency (glucose-6­ phosphate dehydrogenase deficiency), elevation or decrease in blood glucose level, increased cholesterol and triglycerides levels in the blood, increased potassium level in the blood, presence of glucose in the urine (glycosuria) presence of blood in the urine (hematuria)
Your doctor has prescribed this medicine because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious cases of side-effects. This page does not contain a complete list of all possible side-effects.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Inflammation and Rupture of Tendons

Patients aged over 60 years, taking corticosteroids, patients with heart, kidney, or lung transplants, kidney failure, pain and stiffness in joints, and exhausting physical activity are at an increased risk while taking Norfloxacin. Inflammation and rupture of tendons of the back of leg, shoulder, biceps, hand, thumb, and other tendons occurs after starting Norfloxacin treatment within hours or days, or months after completion of the therapy. Immediately stop the use of Norfloxacin if the patient experiences any of these symptoms. Avoid the use of Norfloxacin if patients have a history of tendon disorders. Patients should be advised to take rest if these events occur and contact the doctor for changing the medicine.

Nerve Damage

Patients taking Norfloxacin are at an increased risk. Such patients may experience an increased risk of nerve damage with a tingling, reduced and abnormal unpleasant sensation, and weakness. These symptoms may occur after starting treatment with Norfloxacin, and in some patients these are irreversible. The use of Norfloxacin should be stopped immediately if the patient experiences any of these nerve damage related symptoms. Avoid the use of Norfloxacin in patients with a history of nerve damage.

Central Nervous System Effects

Patients taking Norfloxacin are at an increased risk. These patients may see an increased risk of central nervous system effects, such as seizures, increased pressure inside the skull, and drug-induced mental disorder. The use of quinolones may increase brain activity (CNS stimulation), that may cause restlessness, confusion, lightheadedness, hallucinations, and shaking. If such conditions occur, the use of Norfloxacin should be stopped and start appropriate measures. Norfloxacin should be used with caution in patients with central nervous system disorders including severe fat accumulations in the blood vessels in the brain, epilepsy, and other factors which trigger seizures.

Worsening of Muscle Pain

Patients with muscle weakness are at an increased risk while taking Norfloxacin. The use of Norfloxacin in such patients may cause worsening of muscle weakness which can be fatal and may require ventilation support. Avoid the use of Norfloxacin in such patients.

Interactions with Norfloxacin

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Norfloxacin. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Antibiotic

Norfloxacin may interact with Antibiotic such as nitrofurantoin, which is used to treat urinary tract infections. The use of Norfloxacin with nitrofurantoin may block the antibacterial effect of Norfloxacin in the urinary system. The combined use of Norfloxacin with nitrofurantoin is not recommended.

Xanthines

There may be an interaction of Norfloxacin with Xanthine such as theophylline, which is used to treat lung diseases. When Norfloxacin is used in combination with theophylline, it may cause an increase in the level of theophylline in the blood. The theophylline level in the blood should be monitored, and dosage should be adjusted accordingly.

Drugs Metabolized by CYP1A2

Norfloxacin interacts with drugs metabolized by CYP1A2 (caffeine, clozapine, and ropinirole), which are used to improve mental alertness and treat schizophrenia, and restless legs syndrome. The use of Norfloxacin with drugs metabolized by CYP1A2 may increase the level of drugs metabolized by CYP1A2 in the blood. Such patients should be monitored carefully.

Immunosuppressant

Special instructions need to be followed while taking this medicine along with Immunosuppressant such as cyclosporin, which is used to prevent organ rejection. When Norfloxacin is used with cyclosporin, it may cause an increase in the level of cyclosporin in the blood. The cyclosporin level in the blood should be monitored and its dosage should be adjusted accordingly.

Anticoagulants

Your doctor's guidelines may need to be followed while taking this medicine along with Anticoagulant such as warfarin, which is used to prevent blood clot formation. The use of Norfloxacin with anticoagulants may enhance the effects of anticoagulant medicines. Such patients should be monitored for blood clotting parameters including prothrombin time.

Sulfonylurea

Norfloxacin may interact with Sulfonylurea such as glyburide, which is used to treat high blood sugar level. When Norfloxacin is used with glyburide, it may cause an excessive lowering of blood sugar level. The blood glucose level should be monitored regularly.

Multivitamins

There may be an interaction of Norfloxacin with Multivitamins, which are used to treat or prevent vitamin deficiency. The use of Norfloxacin with multivitamins may cause a decrease in the urine levels of Norfloxacin. Multivitamins should not be given with or within 2 hours of taking Norfloxacin.

Antacids or Antiulcers

Norfloxacin interacts with Antacids or Sucralfate, which are used to treat stomach acidity and ulcers respectively. Absorption and elimination of Norfloxacin may get decreased while using antacids or sucralfate with Norfloxacin. Antacids or sucralfate should not be given with or within 2 hours of taking Norfloxacin.

Products containing Iron or Zinc

Special instructions need to be followed while taking this medicine along with products containing iron or zinc, which are used as dietary supplements. The use of Norfloxacin with products containing iron or zinc may cause a decrease in Norfloxacin absorption and elimination. Products containing iron or zinc should not be given with or within 2 hours of taking Norfloxacin.

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

Your doctor's guidelines may need to be followed while taking this medicine along with Nucleoside reverse transcriptase inhibitors (NRTIs) such as didanosine, which are used to treat HIV/AIDS. When Norfloxacin is used with didanosine, it may cause a decrease in the urine levels of Norfloxacin. Didanosine should not be given with or within 2 hours of taking Norfloxacin.

Non-Steroidal Anti-inflammatory Drugs

Norfloxacin may interact with Non-Steroidal Anti-inflammatory Drugs, which are used to treat pain and fever. The use of Norfloxacin with non-steroidal anti-inflammatory drugs may increase the risk of enhanced brain activity (CNS stimulation) and seizures. Take necessary precautions while using Norfloxacin in such patients.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Norfloxacin is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

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