Clinical medicine profile
Norfloxacin eye drops
Fluoroquinolone antibiotic
- Route
- ORAL / IV
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
This profile needs source confirmation
A traceable source link is not attached to this profile. Confirm prescribing decisions against the current SmPC and Kenya STG/EML.
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Hypersensitivity to quinolones.
- History of quinolone-related tendon disorder.
- Avoid in myasthenia gravis (exacerbation).
- Generally avoid in children/adolescents except specific labelled indications.
- Caution pregnancy/lactation — prefer alternatives when possible.
Precautions
- FDA/EMA boxed risks: tendinopathy/rupture, peripheral neuropathy, CNS effects, aortic aneurysm risk in susceptible patients, QT prolongation (esp. moxifloxacin), dysglycaemia, psychiatric effects.
- Avoid in patients with significant risk factors unless benefits outweigh risks.
- Photosensitivity.
- Separate from polyvalent cations (antacids, Fe, Ca, dairy, sucralfate) by several hours.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
1-2 drops QID x 1/52. Depending on the severity of the infections, the dosage for the first day of therapy may be increased to 1-2 drops every 2 hrs during the waking hours.
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Many agents need CrCl-based adjustment (e.g. ciprofloxacin, levofloxacin).
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Hepatotoxicity uncommon but reported; moxifloxacin has more hepatic clearance.
Use, effects & interactions
Indications
- Therapeutic use is agent- and indication-specific within the class (Fluoroquinolone antibiotic).
- Use according to culture results, national guidelines (Kenya STG/EML where applicable) and the current product SmPC.
- Bacterial eye infections
Adverse effects
- GI upset, headache, dizziness, insomnia.
- Serious: tendon rupture, neuropathy, seizures, QT prolongation/TdP, severe hypersensitivity, C. difficile, aortic events (rare), dysglycaemia.
Drug interactions
Open multi-drug checker ↗- Reserve for infections where benefits outweigh class risks.
- Prefer culture-directed therapy.
- Counsel tendon pain stop-drug advice.
- Check ECG risk factors if using QT-prolonging FQ.
- Stewardship: avoid for uncomplicated cystitis/sinusitis when alternatives exist.
Mechanism & disposition
Interferes with bacterial DNA synthesis by inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV Fluoroquinolones inhibit bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, blocking DNA replication and transcription.
Read complete mechanism
Interferes with bacterial DNA synthesis by inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV Fluoroquinolones inhibit bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, blocking DNA replication and transcription. Bactericidal concentration-dependent killing with a post-antibiotic effect.
1–2 hours oral
12–24 hours (agent-dependent)
ORAL / IV
including prostate and bone (agent-dependent). Renal and/or hepatic clearance varies by agent — adjust dose in organ impairment as labelled.
Pregnancy, lactation & diet
Generally avoid unless no safer alternative; animal arthropathy concerns and limited human data for many agents.
Often avoided or used short-term with caution; check agent-specific guidance.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.