Norfloxacin

Pronunciation: nor-FLOX-a-sin
Generic Name: Norfloxacin
Brand Name: Noroxin

Norfloxacin is associated with an increased risk of tendon problems. These include pain, swelling, inflammation, and possible breakage of tendons. The risk of tendon problems is greater in patients who are older than 60 years, patients who take corticosteroids (eg, prednisone), or in those who have received kidney, heart, or lung transplants. The Achilles tendon in the back of the foot/ankle is most often affected. However, problems may also occur in other tendons (eg, in the arm, hand, shoulder). Problems may occur while you take Norfloxacin or up to several months after you stop taking it.

Signs of tendon problems may include pain, soreness, redness, or swelling of a tendon or joint; bruising right after an injury in a tendon area; hearing or feeling a snap or pop in a joint or tendon area; or inability to move or bear weight on a joint or tendon area. Tell your doctor right away if you experience any of these symptoms while you take Norfloxacin or within several months after you stop it.

Norfloxacin may worsen muscle weakness and breathing problems in patients with myasthenia gravis. Do not take Norfloxacin if you have a history of myasthenia gravis.

Norfloxacin is used for:

Treating bacterial infections.

Norfloxacin is a fluoroquinolone antibiotic. It works by killing sensitive bacteria.

Do NOT use Norfloxacin if:

• you are allergic to any ingredient in Norfloxacin or to any other fluoroquinolone antibiotic (eg, levofloxacin)


• you have inflammation of a tendon (tendonitis) or a history of ruptured tendon caused by Norfloxacin or another fluoroquinolone (eg, levofloxacin)


• you have a history of myasthenia gravis


• you are taking certain antiarrhythmic medicines (eg, amiodarone, procainamide, quinidine, sotalol) or nitrofurantoin

Contact your doctor or health care provider right away if any of these apply to you.

Before using Norfloxacin:

Some medical conditions may interact with Norfloxacin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have a stomach infection, liver problems, brain or nervous system problems, muscle problems (eg, myasthenia gravis), increased pressure in the brain, Alzheimer disease, brain blood vessel problems, or a history of seizures


• if you have a history of severe or persistent diarrhea, skin sensitivity to the sun, a recent heart attack, blood problems (eg, anemia, hemolysis), or glucose-6-phosphate dehydrogenase (G6PD) problems


• if you have a personal or family history of irregular heartbeat (eg, QT prolongation), heart problems (eg, slow heartbeat), or low blood potassium levels


• if you have a history of joint or tendon problems; rheumatoid arthritis; kidney problems or decreased kidney function; or a heart, kidney, or lung transplant


• if you take a corticosteroid (eg, prednisone) or participate in strenuous physical work or exercise

Some MEDICINES MAY INTERACT with Norfloxacin. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Antiarrhythmics (eg, amiodarone, disopyramide, dofetilide, quinidine , sotalol), cisapride, diuretics (eg, furosemide, hydrochlorothiazide), macrolide or ketolide antibiotics (eg, erythromycin, telithromycin), medicines for mental or mood disorders, medicines that may affect your heartbeat, phenothiazines (eg, chlorpromazine), or tricyclic antidepressants (eg, amitriptyline) because the risk of serious side effects, including irregular heartbeat and other heart problems, may be increased. Check with your doctor or pharmacist if you are unsure if any of your medicines may affect your heartbeat


• Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of side effects, such as seizures, may be increased


• Corticosteroids (eg, prednisone) because the risk of tendon damage may be increased


• Probenecid because it may increase the risk of Norfloxacin's side effects


• Nitrofurantoin because it may decrease Norfloxacin's effectiveness


• Anticoagulants (eg, warfarin), caffeine, clozapine, cyclosporine, methotrexate, ropinirole, serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, venlafaxine), sulfonylureas (eg, glyburide), tacrine, theophyllines, or tizanidine because the risk of their side effects may be increased by Norfloxacin


• Live vaccines or mycophenolate because their effectiveness may be decreased by Norfloxacin

This may not be a complete list of all interactions that may occur. Ask your health care provider if Norfloxacin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Norfloxacin:

Use Norfloxacin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Norfloxacin comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Norfloxacin refilled.


• Take Norfloxacin by mouth on an empty stomach at least 1 hour before or 2 hours after a meal or eating or drinking milk or other dairy products.


• Take Norfloxacin with a full glass of water (8 oz/240 mL).


• Drinking extra fluids while you are taking Norfloxacin is recommended. Check with your doctor for instructions.


• Do not take any products containing magnesium, aluminum, calcium, iron, or zinc (eg, antacids, quinapril, vitamins/minerals); didanosine; sucralfate; or bismuth subsalicylate within 2 hours before or 2 hours after taking Norfloxacin.


• To clear up your infection completely, take Norfloxacin for the full course of treatment. Keep taking it even if you feel better in a few days.


• Do not miss any doses. If you miss a dose of Norfloxacin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Norfloxacin.

Important safety information:

• Norfloxacin may cause drowsiness, dizziness, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use Norfloxacin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Tell your doctor or dentist that you take Norfloxacin before you receive any medical or dental care, emergency care, or surgery.


• Be sure to use Norfloxacin for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.


• Long-term or repeated use of Norfloxacin may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.


• Norfloxacin only works against bacteria; it does not treat viral infections (eg, the common cold).


• Avoid large amounts of food or drink that have caffeine (eg, chocolate, cocoa, coffee, cola, tea).


• If you experience pain or swelling of a tendon or weakness or loss of use of a joint area, notify your doctor right away. Rest the area and avoid exercise until your doctor gives you instructions.


• Diabetes patients - Norfloxacin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.


• Norfloxacin may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Norfloxacin. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.


• Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.


• Norfloxacin may cause changes in certain heart tests (eg, electrocardiogram [ECG]). Be sure to your doctor and lab personnel know you are using Norfloxacin.


• Lab tests, including complete blood cell counts and liver and kidney function, may be performed while you use Norfloxacin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Norfloxacin with caution in the ELDERLY; they may be more sensitive to its effects (eg, tendon problems), especially if they take corticosteroids (eg, prednisone). They may also be more sensitive to other effects (eg, irregular heartbeat).


• Norfloxacin should be used with extreme caution in CHILDREN younger than 18 years; safety and effectiveness in these children have not been confirmed. The risk of joint and tendon problems may be increased in CHILDREN.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking Norfloxacin while you are pregnant. It is not known if Norfloxacin is found in breast milk. Do not breast-feed while taking Norfloxacin.

Possible side effects of Norfloxacin:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; headache; loss of appetite; nausea; stomach upset or cramps; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or tarry stools; burning, numbness, tingling, pain, or weakness of the arms, hands, legs, or feet; change in sense of touch or temperature; chest pain; dark urine or change in the amount of urine; decreased amount of urine; fainting; fever, chills, or unusual cough; hallucinations; hearing changes (eg, ringing in the ears, hearing loss); inability to move or bear weight on a joint or tendon area; irregular heartbeat; joint pain or swelling; moderate to severe sunburn; mood or mental changes (eg, new or worsening anxiety, agitation, confusion, depression, restlessness, sleeplessness); muscle pain or weakness; pain, soreness, redness, swelling, weakness, or bruising of a tendon or joint area; pale stools; persistent sore throat; red, swollen, blistered, or peeling skin; seizures; severe or persistent dizziness; severe or persistent diarrhea; severe stomach pain or cramps; shortness of breath or trouble breathing; suicidal thoughts or actions; tremors; unusual bruising or bleeding; unusual fatigue; vaginal yeast infection; vision changes; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Norfloxacin:

Store Norfloxacin at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Do not freeze. Keep Norfloxacin out of the reach of children and away from pets.

General information:

• If you have any questions about Norfloxacin, please talk with your doctor, pharmacist, or other health care provider.


• Norfloxacin is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Norfloxacin. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Norfloxacin resources

• Norfloxacin Dosage
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• Norfloxacin Drug Interactions
• Norfloxacin Support Group
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• Norfloxacin Professional Patient Advice (Wolters Kluwer)


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• Noroxin Prescribing Information (FDA)

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