Lomefloxacin is a synthetic broad-spectrum fluoroquinolone with antibacterial activity. Lomefloxacin inhibits DNA gyrase, a type II topoisomerase involved in the induction or relaxation of supercoiling during DNA replication. This inhibition leads to a decrease in DNA synthesis during bacterial replication, resulting in cell growth inhibition and eventually cell lysis.
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Lomefloxacin is only found in individuals that have used or taken this drug. It is a fluoroquinolone antibiotic, used to treat bacterial infections including bronchitis and urinary tract infections. It is also used to prevent urinary tract infections prior to surgery. Lomefloxacin is a bactericidal fluoroquinolone agent with activity against a wide range of gram-negative and gram-positive organisms. The bactericidal action of lomefloxacin results from interference with the activity of the bacterial enzymes DNA gyrase and topoisomerase IV, which are needed for the transcription and replication of bacterial DNA. DNA gyrase appears to be the primary quinolone target for gram-negative bacteria. Topoisomerase IV appears to be the preferential target in gram-positive organisms. Interference with these two topoisomerases results in strand breakage of the bacterial chromosome, supercoiling, and resealing. As a result DNA replication and transcription is inhibited.
Mechanism of Action of Lomefloxacin
Lomefloxacin is a bactericidal fluoroquinolone agent with activity against a wide range of gram-negative and gram-positive organisms. The bactericidal action of lomefloxacin results from interference with the activity of the bacterial enzymes DNA gyrase and topoisomerase IV, which are needed for the transcription and replication of bacterial DNA. DNA gyrase appears to be the primary quinolone target for gram-negative bacteria. Topoisomerase IV appears to be the preferential target in gram-positive organisms. Interference with these two topoisomerases results in strand breakage of the bacterial chromosome, supercoiling, and resealing. As a result DNA replication and transcription is inhibited.
Indications of Lomefloxacin
- For the treatment of bacterial infections of the respiratory tract (chronic bronchitis) and urinary tract, and as a pre-operative prophylactic to prevent urinary tract infection caused by S.pneumoniae, H.influenzae, S.aureus, P.aeruginosa, E. cloacae, P. mirabilis, C. civersus, S. asprphyticus, E.coli, and K.pneumoniae.
- Bronchitis
- Escherichia coli Infections
- Klebsiella Infections
- Proteus Infections
- Pseudomonas Infections
- Staphylococcal Infections
- Streptococcal Infections
- Urinary Tract Infections
- Bladder Infection
- Prostatitis
- Salmonella Enteric Fever
- Salmonella Gastroenteritis
- Shigellosis
- Transurethral Prostatectomy
Contra-Indications of Lomefloxacin
- Clostridium difficile infection
- Low amount of magnesium in the blood
- Low amount of potassium in the blood
- Peripheral neuropathy
- Very Rapid Heartbeat – Torsades de Pointes
- prolonged QT interval on EKG
- Abnormal EKG with QT changes from Birth
- Severe renal impairment
- Drug or Chemical-Induced Sensitivity to Sunlight
- Inflammation of the Tendon
- Rupture of a Tendon
- Seizures
- A mother who is producing milk and breastfeeding
- Allergies to Quinolones
Side Effects of Lomefloxacin
The most common
- Abdominal or stomach cramps and pain (severe)
- diarrhea (watery and severe), which may also be bloody
- pain, inflammation, or swelling in calves, shoulders, or hands
- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- pain, swelling, irritation where injected
- sweating
- skin color change, mild diarrhea
- mild nausea
- loss of appetite
- swelling of feet or legs
- chest pain
- constipation
- cough
- difficulty with breathing
- dizziness
- heartburn
More common
- Abdominal or stomach pain, discomfort, or tenderness
- chills or fever
- headache, severe and throbbing
- joint or back pain
- muscle aching or cramping
- muscle pains or stiffness
- chest pressure or squeezing pain in chest
- excessive sweating
- feeling of heaviness, pain, warmth and/or swelling in a leg or in the pelvis
- sudden tingling or coldness in an arm or leg
- sudden slow or difficult speech
- sudden drowsiness or need to sleep
- fast breathing
- sharp pain when taking a deep breath
- fast or slow heartbeat
- coughing up blood
- decreased amount of urine
Rare
- Anxiety
- change in vision
- seizures
- tremors
- weight loss
- chest pain or tightness
- confusion
- cough
- Agitation
- blurred vision
- chest pain or discomfort
- convulsions
- extra heartbeats
- hallucinations
Dosage of Lomefloxacin
- Strengths: 400 mg
Bronchitis
- 400 mg orally once a day for 10 days
Cystitis
- 400 mg orally once a day for 3 days
- Duration: 3 days if caused by E coli in females; 10 days if caused by K pneumoniae, P mirabilis, or S saprophyticus
Prostatitis
- 400 mg orally once a day for 14 to 30 days
Salmonella Enteric Fever
- 400 mg orally once a day for 7 to 14 days
Salmonella Gastroenteritis
- 400 mg orally once a day for 3 days
Shigellosis
- 400 mg orally once a day for 3 to 5 days
Transurethral Prostatectomy
- 400 mg orally 2 to 6 hours prior to the procedure
Urinary Tract Infection
- Complicated: 400 mg orally once a day for 14 days
Drug Interactions of Lomefloxacin
Lomefloxacin may interact with following drugs, supplements, & may change the efficacy of drugs
- antacids containing aluminum hydroxide, calcium, and magnesium hydroxide
- antihistamines (e.g., cetirizine, hydroxyzine, loratadine)
- antipsychotics (e.g. clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
- calcium supplements and multivitamins containing calcium
- inhaled corticosteroids
- oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
- diabetes medications (e.g., metformin, nateglinide, rosiglitazone)
- formoterol
- iron supplements and multivitamins containing iron (do not take within 2 hours of levofloxacin)
- macrolide antibiotics (e.g., clarithromycin, erythromycin)
- magnesium supplements (e.g., magnesium hydroxide, magnesium oxide, magnesium sulfate)
- multivitamins
- nilotinib
- nonsteroidal anti-inflammatory medications (e.g., diclofenac, ibuprofen, ketoprofen, naproxen)
- other quinolone antibiotics (e.g., ciprofloxacin, ofloxacin)
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
- serotonin antagonists (e.g., granisetron, ondansetron)
- sotalol
- theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
- trimethoprim
- tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
- tyrosine kinase inhibitors (e.g., dasatinib, imatinib, nilotinib, sunitinib)
- vardenafil
- warfarin
Pregnancy and Lactation of Lomefloxacin
FDA Pregnancy Risk Category C
Pregnancy
In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans, though. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.
Lactation
There are no well-controlled studies that have been done in pregnant women. Lomefloxacin should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby.
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