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Lomefloxacin Hydrochloride: Dosage and Administration

Administration

Lomefloxacin hydrochloride is administered orally. Lomefloxacin hydrochloride may be administered without regard to meals. Food decreases the rate of GI absorption of the drug, but only decreases the extent of absorption by 12%.

Antacids containing magnesium or aluminum, sucralfate, buffered didanosine preparations (chewable/dispersible tablets, buffered powder for oral solution), and metal cations such as iron or zinc may interfere with oral absorption of lomefloxacin resulting in subtherapeutic concentrations of the fluoroquinolone.

To minimize the possibility of an interaction, patients should be informed not to ingest magnesium- and aluminum-containing antacids, buffered didanosine preparations, or sucralfate within 4 hours prior to or 2 hours after a dose of lomefloxacin, or to ingest preparations (e.g., multivitamin supplements) containing divalent or trivalent cations such as iron or zinc within 2 hours of a lomefloxacin dose.

Dosage

Dosage of lomefloxacin, which is available for oral use as the hydrochloride, is expressed in terms of lomefloxacin. Geriatric patients generally can receive usual dosages of lomefloxacin unless creatinine clearance is less than 40 mL/minute per 1.73 m.

Respiratory Tract Infections

For the treatment of acute bacterial exacerbations of chronic bronchitis, the usual adult dosage of lomefloxacin is 400 mg once daily for 10 days.

Urinary Tract Infections

The usual adult dosage of lomefloxacin for the treatment of uncomplicated urinary tract infections (cystitis) is 400 mg once daily for 10 days, although a duration of 3 days may be adequate for the treatment of cystitis in women caused by Escherichia coli. The usual dosage for the treatment of complicated urinary tract infections is 400 mg once daily for 14 days.

Perioperative Prophylaxis

For perioperative prophylaxis in adults undergoing transrectal prostate biopsy, lomefloxacin is administered as a single 400-mg dose 1-6 hours prior to the procedure. When perioperative prophylaxis is considered appropriate in adults undergoing transurethral surgical procedures, lomefloxacin is administered as a single 400-mg dose 2-6 hours prior to the procedure.

Gonorrhea and Associated Infections

If oral lomefloxacin is used as an alternative agent for the treatment of uncomplicated cervical, urethral, or rectal gonorrhea in adults or adolescents, the US Centers for Disease Control and Prevention (CDC) recommends a single 400-mg dose. Unless presence of coexisting chlamydial infection has been excluded by appropriate testing, patients receiving lomefloxacin for the treatment of uncomplicated gonorrhea should also receive an anti-infective regimen effective for presumptive treatment of chlamydia (e.g., a single dose of oral azithromycin or a 7-day regimen of oral doxycycline).

Dosage in Renal and Hepatic Impairment

Dosage of lomefloxacin should be modified according to the degree of renal impairment for patients with creatinine clearances less than 40 mL/minute per 1.73 m. The patient’s creatinine clearance (Ccr) can be estimated by using the following formulas:

For adults with a creatinine clearance of at least 10 mL/minute per 1.73 m, the manufacturer recommends an initial 400-mg loading dose, followed by 200 mg once daily for the duration of therapy. However, the manufacturer also recommends that serial determinations of plasma lomefloxacin concentration be performed to determine whether any adjustment in the usual dosing interval is necessary.

Renal and Hepatic Impairment

Because hemodialysis removes only a negligible amount of lomefloxacin, the guidelines for dosing nondialyzed patients with renal impairment can be followed in patients undergoing hemodialysis. The manufacturer states that dosage of lomefloxacin should be modified according to the degree of renal function and plasma lomefloxacin concentration in patients with impaired hepatic function.

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