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NOROXIN is indicated for the treatment of adults with the following infections caused by susceptible strains of the designated microorganisms:
Urinary Tract Infections
Uncomplicated urinary tract infections (including cystitis) due to Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus epidermidis, Staphylococcus saprophyticus, Citrobacter freundii1, Enterobacter aerogenes1, Enterobacter cloacae1, Proteus vulgaris1, Staphylococcus aureus1, or Streptococcus agalactiae1.
Because fluoroquinolones, including NOROXIN, have been associated with serious adverse reactions (see WARNINGS), and for some patients uncomplicated urinary tract infection is self-limiting, reserve NOROXIN for treatment of uncomplicated urinary tract infections (including cystitis) in patients who have no alternative treatment options.
Complicated urinary tract infections due to Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, or Serratia marcescens1. Sexually transmitted diseases (see WARNINGS)
Prostatitis due to Escherichia coli.
(See DOSAGE AND ADMINISTRATION for appropriate dosing instructions.)
Penicillinase production should have no effect on norfloxacin activity.
Appropriate culture and susceptibility tests should be performed before treatment in order to isolate and identify organisms causing the infection and to determine their susceptibility to norfloxacin. Therapy with norfloxacin may be initiated before results of these tests are known; once results become available, appropriate therapy should be given. Repeat culture and susceptibility testing performed periodically during therapy will provide information not only on the therapeutic effect of the antimicrobial agents but also on the possible emergence of bacterial resistance.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of NOROXIN and other antibacterial drugs, NOROXIN should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
DOSAGE AND ADMINISTRATION
Tablets NOROXIN should be taken at least one hour before or at least two hours after a meal or ingestion of milk and/or other dairy products. Multivitamins, other products containing iron or zinc, antacids containing magnesium and aluminum, sucralfate, or Videx® (Didanosine), chewable/buffered tablets or the pediatric powder for oral solution, should not be taken within 2 hours of administration of norfloxacin. Tablets NOROXIN should be taken with a glass of water. Patients receiving NOROXIN should be well hydrated (see PRECAUTIONS).
Normal Renal Function
The recommended daily dose of NOROXIN is as described in the following chart:
|Infection||Description||Unit Dose||Frequency||Duration||Daily Dose|
|Urinary Tract||Uncomplicated UTI's (cystitis) due to E. coli, K. pneumoniae, or P. mirabilis||400 mg||q12h||3 days||800 mg|
|Uncomplicated UTI's due to other indicated organisms||400 mg||q12h||7-10 days||800 mg|
|Complicated UTI's||400 mg||q12h||10-21 days||800 mg|
|Sexually Transmitted Diseases||Uncomplicated Gonorrhea||800 mg||single dose||1 day||800 mg|
|Prostatitis||Acute or Chronic||400 mg||q12h||28 days||800 mg|
NOROXIN may be used for the treatment of urinary tract infections in patients with renal insufficiency. In patients with a creatinine clearance rate of 30 mL/min/1.73 m² or less, the recommended dosage is one 400-mg tablet once daily for the duration given above. At this dosage, the urinary concentration exceeds the MICs for most urinary pathogens susceptible to norfloxacin, even when the creatinine clearance is less than 10 mL/min/1.73 m².
When only the serum creatinine level is available, the following formula (based on sex, weight, and age of the patient) may be used to convert this value into creatinine clearance. The serum creatinine should represent a steady state of renal function.
|Males:||(weight in kg) x (140 – age)|
|(72) x serum creatinine (mg/100 mL)|
|Females:||(0.85) x (above value)|
Elderly patients being treated for urinary tract infections who have a creatinine clearance of greater than 30 mL/min/1.73 m² should receive the dosages recommended under Normal Renal Function.
Elderly patients being treated for urinary tract infections who have a creatinine clearance of 30 mL/min/1.73 m² or less should receive 400 mg once daily as recommended under Renal Impairment.
No. 8338 — Tablets NOROXIN 400 mg are white to off-white, oval shaped, film-coated tablets, coded 705 on one side and plain on the other. They are supplied as follows:
NDC 0006-0705-20 unit of use bottles of 20. Storage
Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature]. Keep container tightly closed.
Manufactured by: Merck Sharp & Dohme (Italia) S.p.A. Via Emilia, 21 27100 Pavia, Italy. Manufactured for: Merck Sharp & Dohme Corp., a subsidiary of MERCK & CO., INC., Whitehouse Station, NJ 08889, USA. Revised: July 2016This monograph has been modified to include the generic and brand name in many instances.
Last reviewed on RxList: 8/4/2016
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