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Ofloxacin oral

Updated 2 Feb 2023 | Quinolones


Oral formulations of ofloxacin.

Drugs List

  • ofloxacin 200mg tablets
  • ofloxacin 400mg tablets
  • Therapeutic Indications


    Acute exacerbation of chronic bronchitis
    Community acquired pneumonia
    Complicated urinary tract infections
    Non-gonococcal urethritis / cervicitis
    Pelvic inflammatory disease
    Skin and soft tissue infections
    Uncomplicated gonorrhoea
    Uncomplicated lower urinary tract infection



    The dosage range is 200mg to 800mg daily. Up to 400mg may be taken as a single dose, preferably in the morning. Larger doses should be given as two divided doses. Individual doses are to be given at approximately equal intervals.

    Uncomplicated urinary tract infection
    200mg once daily or 200mg twice daily or 400mg once daily.

    Complicated urinary tract infection
    200mg twice daily to 400mg twice daily.

    200mg twice daily to 400mg twice daily.

    200mg twice daily to 400mg twice daily.

    Acute exacerbation of chronic bronchitis
    400mg once daily to 400mg twice daily.

    Community acquired pneumonia
    400mg once daily to 400mg twice daily.

    Uncomplicated gonorrhoea
    Single dose of 400mg.

    Non-gonococcal urethritis and cervicitis
    400mg daily in single or divided doses or 300mg twice daily.

    Complicated skin and soft tissue infections
    400mg twice daily.

    Acute or Chronic prostatitis
    200mg twice daily to 400mg twice daily.

    Pelvic inflammatory disease
    400mg twice daily.

    Duration of treatment
    Duration of treatment depends on the severity of the infection and the response to treatment.
    Where not stated above, the usual treatment period is 5 to 10 days except in uncomplicated gonorrhoea where a single dose is recommended.
    Treatment should not exceed 2 months duration.

    Patients with Renal Impairment

    Creatinine clearance 20ml/minute to 50ml/minute
    Reduce dosage by half (100mg to 200mg daily).

    Creatinine clearance less than 20ml/minute
    100mg every 24 hours.

    Haemodialysis or peritoneal dialysis
    100mg every 24 hours.

    Patients with Hepatic Impairment

    Recommended maximum dose: 400mg daily.


    Children under 18 years
    G6PD deficiency
    History of seizures
    History of tendon disorder secondary to quinolone use
    Long QT syndrome
    Reduced seizure threshold
    Torsade de pointes

    Precautions and Warnings

    Family history of long QT syndrome
    Organ transplant recipients
    Patients over 60 years
    Predisposition to aortic aneurysm
    Predisposition to aortic dissection
    Aortic aneurysm
    Aortic dissection
    Cardiac disorder
    Diabetes mellitus
    Electrolyte imbalance
    Glucose-galactose malabsorption syndrome
    History of psychiatric disorder
    History of torsade de pointes
    Lactose intolerance
    Myasthenia gravis
    Psychiatric disorder
    Renal impairment
    Severe hepatic impairment

    Correct electrolyte disorders before treatment
    May exacerbate myasthenia gravis
    Monitor for haemolysis in G6PD deficiency
    Reduce dose in patients with creatinine clearance below 50ml/min
    Advise ability to drive/operate machinery may be affected by side effects
    Consult national/regional policy on the use of anti-infectives
    Contains lactose
    Consider monitoring ECG in patients at risk of QT prolongation
    Diabetic control may need adjustment
    Discontinue at first sign of pain/inflammation of limb(possible tendonitis)
    Discontinue treatment if patient develops seizures
    If rash develops, consider possibility of Stevens-Johnson Syndrome
    Monitor blood glucose closely in patients with diabetes mellitus
    Monitor for signs of superinfection with non-susceptible organisms
    Monitor serum electrolytes
    Advise patient to report any blurred vision or any other eye symptoms
    Advise patient to report any changes in vision, taste, smell or hearing
    Advise patient to report mucosal/skin reactions (blistering or peeling)
    Advise patient to report signs of neuropathy
    Advise patient to report signs of tendinitis
    Advise patient to report tiredness, mood, memory or sleep disturbances
    Advise patient to rest affected limb if tendonitis occurs
    Advise patient to seek medical advice if joint aches or pain occur
    Advise patients to report muscle pain/tenderness/weakness
    Advise patients to report signs of hepatic damage (malaise, jaundice etc.)
    Consider pseudomembranous colitis if patient presents with diarrhoea
    Discontinue if central nervous disturbances occur
    Discontinue if psychiatric disturbances develop
    May cause anaphylactic / anaphylactoid reactions
    May cause convulsions
    Patients over 60 years are prone to tendon inflammation
    Prolonged use may result in infection due to resistant organisms
    Transplant patients are prone to tendon inflammation
    May affect results of some laboratory tests
    Discontinue at once if pseudomembranous colitis occurs
    Discontinue if anaphylactoid reaction occurs
    Discontinue if drug-related rash or other hypersensitivity reactions occur
    Discontinue if peripheral neuropathy occurs
    Discontinue if photosensitivity occurs
    Discontinue if serious allergic or anaphylactic reaction occurs
    Discontinue in patients showing suicidal behaviour
    Course of treatment should not exceed 2 months
    Advise to avoid antacids/mineral supplements 2 hours before or after dose
    Avoid excessive exposure to sunlight or sunlamps

    There is an increased risk of aortic aneurysm and dissection following treatment with ofloxacin. Use ofloxacin only after careful benefit risk assessment in patients with positive family history of aneurysm disease, or in patients diagnosed with pre-existing aortic aneurysm and or aortic dissection, or in the presence of other risk factors or conditions predisposing for aneurysm and dissection (e.g. Marfan syndrome, vascular Ehlers-Danlos syndrome, Takayasu arteritis, giant cell arthritis, Behcet's disease, hypertension, known atherosclerosis.)

    Disabling, long-lasting and potentially irreversible adverse reactions mainly affecting musculoskeletal and nervous systems have been reported with quinolone and fluoroquinolone antibiotics. Treatment should be discontinued at the first signs of a serious adverse reaction such as tendinitis, pain or inflammation.

    Pregnancy and Lactation


    Ofloxacin is contraindicated during pregnancy.

    The manufacturer does not recommend using ofloxacin during pregnancy.

    Based on limited amount of human data, the use of fluoroquinolones in the first trimester of pregnancy has not been associated with an increased risk of major malformations or other adverse effects on pregnancy outcome.

    Ofloxacin has been shown to cause arthropathy in immature animals. Reproduction studies in rats and rabbits did not reveal any evidence of teratogenicity, impairment of fertility or impairment of peri- and post-natal development. Animal studies do not entirely exclude the risk of damage to the cartilage of joints in the growing subject.

    Schaefer (2015) suggests quinolones should only be used in case of complicated infections resistant to the antibiotics of choice in pregnancy. Ciprofloxacin and norfloxacin have a relatively large amount of documented experience. Even the first trimester use of a quinolone antibiotic is not an indication for termination of pregnancy, but detailed foetal ultrasonography can be offered.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    Ofloxacin is contraindicated during breastfeeding.

    The manufacturer does not recommend breastfeeding whilst taking ofloxacin.

    Quinolones have been shown to cause arthropathy in animal studies.

    Ofloxacin is excreted into breast milk in concentrations similar to those in maternal serum. Avoiding breastfeeding for 4 to 6 hours after a dose should decrease the exposure of the infant to ofloxacin in breast milk.

    Schaefer (2015) suggests as a rule, a standard antibiotic with a lower potential for risk can be substituted for the use of quinolones.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at

    Side Effects

    Abdominal pain
    Acute generalised exanthematous pustulosis
    Acute hepatic failure
    Acute hepatic injury
    Acute renal failure
    Aggravation of porphyria
    Anaphylactoid reaction
    Angioneurotic oedema
    Antibiotic-associated colitis
    Blood disorders
    Blood sugar changes
    Bone marrow depression
    Cholestatic jaundice
    Erythema multiforme
    Exfoliative dermatitis
    Extrapyramidal effects
    Eye irritation
    Fungal infection
    Haemolytic anaemia
    Hearing disturbances
    Hearing loss
    Hot flushes
    Hypersensitivity reactions
    Increases in hepatic enzymes
    Interstitial nephritis
    Ligament rupture
    Muscle rupture
    Pseudomembranous colitis
    Psychotic reactions
    Serum bilirubin increased
    Serum creatinine increased
    Skin necrosis
    Sleep disturbances
    Smelling disturbances
    Stevens-Johnson syndrome
    Suicidal tendencies
    Taste disturbances
    Tendon rupture
    Torsades de pointes
    Toxic epidermal necrolysis
    Ventricular arrhythmias
    Visual disturbances

    Effects on Laboratory Tests

    Determination of opiates in urine may give false positive results during treatment with ofloxacin. The use of more specific methods may be necessary to confirm positive opiate screens.


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: January 2019

    Reference Sources

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Ofloxacin 200mg tablets. Generics UK T/A Mylan. Revised March 2016.
    Summary of Product Characteristics: Ofloxacin 400mg tablets. Generics UK T/A Mylan. Revised March 2016.
    Summary of Product Characteristics: Tarivid 400 mg tablets. Sanofi. Revised November 2017.

    MHRA Drug Safety Update March 2019
    Available at:
    Last accessed: 20 May 2019

    NICE Evidence Services Available at: Last accessed: 04 January 2019

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Ofloxacin. Last revised: 31 October 2018
    Last accessed: 04 January 2018

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