Norfloxacin

(nor flox' a sin)

Taking norfloxacin increases the risk that you will develop tendinitis (swelling of a fibrous tissue that connects a bone to a muscle) or have a tendon rupture (tearing of a fibrous tissue that connects a bone to a muscle) during your treatment or for up to several months afterward. These problems may affect tendons in your shoulder, your hand, the back of your ankle, or in other parts of your body. Tendinitis or tendon rupture may happen to people of any age, but the risk is highest in people over 60 years of age. Tell your doctor if you have or have ever had a kidney, heart, or lung transplant; kidney disease; a joint or tendon disorder such as rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function); or if you participate in regular physical activity. Also tell your doctor if you have ever had any tendon problems during or after your treatment with norfloxacin or another quinolone or fluoroquinolone antibiotic. Tell your doctor and pharmacist if you are taking oral or injectable steroids such as dexamethasone (Decadron, Dexpak), methylprednisolone (Medrol), or prednisone (Sterapred). If you experience any of the following symptoms of tendinitis, stop taking norfloxacin, rest, and call your doctor immediately: pain, swelling, tenderness, stiffness, or difficulty in moving a muscle. If you experience any of the following symptoms of tendon rupture, stop taking norfloxacin and get emergency medical treatment: hearing or feeling a snap or pop in a tendon area, bruising after an injury to a tendon area, or inability to move or bear weight on an affected area. Taking norfloxacin may worsen muscle weakness in people with myasthenia gravis (a disorder of the nervous system that causes muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. Your doctor may tell you not to take norfloxacin. If you have myasthenia gravis and your doctor tells you that you should take norfloxacin, call your doctor immediately if you experience muscle weakness or difficulty breathing during your treatment. Talk to your doctor about the risks of taking norfloxacin.

Norfloxacin is used to treat certain types of infections, including infections of the urinary tract and prostate (a male reproductive gland). Norfloxacin is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections. Antibiotics will not work for colds, flu, or other viral infections.

Norfloxacin comes as a tablet to take by mouth. It is usually taken twice a day for 3 to 28 days. The length of treatment depends on the type of infection being treated. Your doctor will tell you how long to take norfloxacin. Take norfloxacin at around the same times every day and try to space your doses 12 hours apart. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take norfloxacin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Take norfloxacin at least 1 hour before or 2 hours after meals or after drinking milk or eating dairy products. Swallow the tablets with a full glass of water. You should begin to feel better during the first few days of your treatment with norfloxacin. If your symptoms do not improve or if they get worse, call your doctor. Take norfloxacin until you finish the prescription, even if you feel better. Do not stop taking norfloxacin without talking to your doctor unless you experience certain serious side effects listed in the IMPORTANT WARNING or SIDE EFFECT sections. If you stop taking norfloxacin too soon or if you skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

Before taking norfloxacin,
• tell your doctor and pharmacist if you are allergic or have had a severe reaction to norfloxacin; other quinolone or fluoroquinolone antibiotics such as ciprofloxacin (Cipro), gatifloxacin (Tequin) (not available in the U.S.), gemifloxacin (Factive), levofloxacin (Levaquin), lomefloxacin (Maxaquin) (not available in the U.S.), moxifloxacin (Avelox), nalidixic acid (NegGram), ofloxacin (Floxin), and sparfloxacin (Zagam) (not available in the U.S.), or any other medications.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, herbal products, and nutritional supplements you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: other antibiotics; anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); certain antidepressants; antipsychotics (medications to treat mental illness); caffeine or medications that contain caffeine (Excedrin, NoDoz, Vivarin, others); cisapride (Propulsid) (not available in the U.S.); clozapine (Clozaril, Fazaclo); cyclosporine (Gengraf, Neoral, Sandimmune); diuretics ('water pills'); erythromycin (E.E.S, E-Mycin, Erythrocin, others); glyburide (DiaBeta, in Glucovance, Micronase, others); certain medications for irregular heartbeat such as amiodarone (Cordarone), procainamide (Procanbid), quinidine, and sotalol (Betapace, Betapace AF, Sorine); nitrofurantoin (Furadantin, Macrobid, Macrodantin); probenecid (in Col-Probenecid, Probalan); nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others); ropinirole (Requip); tacrine (Cognex); theophylline (Elixophyllin, Theo-24, Uniphyl, others); and tizanidine (Zanaflex). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• if you are taking antacids containing aluminum hydroxide or magnesium hydroxide (Maalox, Mylanta, Tums, others), didanosine (Videx) sucralfate (Carafate), or supplements or multivitamins that contain iron or zinc, take these medications 2 hours before or 2 hours after you take norfloxacin.
• tell your doctor if you or anyone in your family has or has ever had a prolonged QT interval (a rare heart problem that may cause irregular heartbeat, fainting or sudden death) or an irregular heartbeat and if you have or have ever had nerve problems, a low level of potassium in your blood, a slow heartbeat, chest pain, seizures, myasthenia gravis (condition that causes weakness of certain muscles), cerebral arteriosclerosis (narrowing of blood vessels in or near the brain that can lead to stroke or mini-stroke), or glucose-6-phosphate dehydrogenase (G-6PD) deficiency (an inherited blood disorder).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking norfloxacin, call your doctor.
• you should know that this medication may cause dizziness, lightheadedness, and tiredness. Do not drive a car, operate machinery, or participate in activities requiring alertness and coordination until you know how norfloxacin affects you.
• plan to avoid unnecessary or prolonged exposure to sunlight or ultraviolet light (tanning beds and sunlamps) and to wear protective clothing, sunglasses, and sunscreen. Norfloxacin may make your skin sensitive to sunlight or ultraviolet light. If your skin becomes reddened, swollen, or blistered, call your doctor.

Do not drink or eat a lot of caffeine-containing products as coffee, tea, energy drinks, cola, or chocolate. Norfloxacin may increase nervousness, sleeplessness, heart pounding, and anxiety caused by caffeine. Make sure you drink plenty of water or other fluids every day while you are taking norfloxacin.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one and do not take more than 2 doses of norfloxacin in one day.

Norfloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• diarrhea
• heartburn
• dizziness
• stomach cramps
• headache
• weakness

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately, but do not stop taking norfloxacin without talking to your doctor:

• severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment)
• confusion
• hallucinations (seeing things or hearing voices that do not exist)
• anxiety
• not trusting others or feeling that others want to harm you
• restlessness
• uncontrollable shaking of a part of the body

If you experience any of the following symptoms, or the symptoms of tendinitis or tendon rupture described in the IMPORTANT WARNING section, stop taking norfloxacin and call your doctor immediately or get emergency medical help:

• rash
• hives
• itching
• peeling or blistering of the skin
• fever
• swelling of the eyes, face, mouth. lips, tongue, throat, hands, feet, ankles or lower legs
• hoarseness
• difficulty breathing or swallowing
• fast heartbeat
• fainting
• loss of consciousness
• yellowing of the skin or eyes
• dark urine
• decreased urination
• seizures
• unusual bruising or bleeding
• joint or muscle pain

Norfloxacin may cause problems with bones, joints, and tissues around joints in children. Norfloxacin should not be given to children younger than 18 years of age. Norfloxacin may cause nerve damage that may not go away even after you stop taking norfloxacin. This damage may occur soon after you begin taking norfloxacin. If you experience any of the following symptoms, call your doctor immediately: numbness, tingling, pain, or burning in the arms or legs; or a change in your ability to feel light touch, pain, heat, or cold. If you experience these symptoms, do not take any more norfloxacin until you talk to your doctor. Your doctor may prescribe a different antibiotic for you to take instead of norfloxacin. Talk to your doctor about the risks of taking norfloxacin or giving norfloxacin to your child. Norfloxacin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to norfloxacin. Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish taking norfloxacin, call your doctor. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.