Moxifloxacin with Dihydroxyaluminum Sodium Carbonate Interaction Details
Brand Names Associated with Moxifloxacin
- Avelox®
- Moxifloxacin
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jan 04, 2024
Interaction Effect
Decreased oral moxifloxacin effectiveness
Interaction Summary
A significant decrease in the oral bioavailability of moxifloxacin (approximately 40%) was observed when coadministered with Maalox(R). When a single dose of moxifloxacin 400 mg was administered two hours before, concurrently, or four hours after a single dose of an antacid preparation containing aluminum hydroxide and magnesium hydroxide to 12 healthy volunteers, there was a 26%, 60%, and 23% decrease in the moxifloxacin area under the concentration-time curve (AUC), respectively. Oral moxifloxacin should be administered at least four hours before or eight hours after an aluminum or magnesium containing product . Concomitant administration of calcium has been shown not to significantly affect bioavailability of moxifloxacin .
Severity
Moderate
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Oral moxifloxacin should be administered four hours before or eight hours after aluminum or magnesium containing antacids.
Mechanism Of Interaction
Decreased moxifloxacin absorption due to chelation
Literature Reports
A) Coadministration of aluminum- and magnesium-containing antacids with moxifloxacin impairs the absorption of moxifloxacin. Twelve healthy male subjects were enrolled in a randomized, nonblinded, 4-way crossover study. The four treatments consisted of a single dose of moxifloxacin 400 mg given alone, or with Maalox 70(R) suspension (aluminum hydroxide 900 mg and magnesium hydroxide 600 mg) administered simultaneous with, 4 hours before, or 2 hours after moxifloxacin. Administration of the antacid in the treatments including antacid was continued for 2 days. The rate and extent of moxifloxacin absorption are reduced when coadministered with Maalox70(R). The AUC of moxifloxacin is reduced by less than 27% when moxifloxacin is administered two hours before or 4 hours after ingestion of Maalox(R). The half-life was decreased by three hours. When moxifloxacin is administered two hours before or four hours after the antacid, the subjects had antibacterial exposure below the cut-off points (minimum values of AUC/MIC were 57 and those of Cmax/MIC were 3.8) suggesting that these drugs should not be administered simultaneously. Absorption of moxifloxacin is impaired by concurrent administration of Maalox70(R), an aluminum and magnesium-containing antacid. For maximal bactericidal effect it is recommended to stagger the administration of antacids and moxifloxacin either two hours before or four hours after the antacid .
Moxifloxacin Overview
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Moxifloxacin is used to treat certain infections caused by bacteria such as pneumonia, and skin, and abdominal (stomach area) infections. Moxifloxacin is also used to prevent and treat plague (a serious infection that may be spread on purpose as part of a bioterror attack. Moxifloxacin may also be used to treat bronchitis or sinus infections but should not be used for these conditions if there are other treatment options available. Moxifloxacin is in a class of antibiotics called fluoroquinolones. It works by killing the bacteria that cause infections.
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Antibiotics such as moxifloxacin will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
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Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
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