Moxifloxacin with Hydrocortisone Interaction Details
Brand Names Associated with Moxifloxacin
- Avelox®
- Moxifloxacin
Brand Names Associated with Hydrocortisone
- Alkindi Sprinkle®
- Cortef®
- Cortisol
- Cortril®
- Hydrocortisone
- Hydrocortone®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jan 04, 2024
Interaction Effect
An increased risk of tendon rupture
Interaction Summary
Fluoroquinolones have been associated with an increased risk of tendinitis and tendon rupture. This risk is increased especially in patients over the age of 60, in patients taking concomitant corticosteroids, and in patients with kidney, heart, or lung transplants. Discontinue the fluoroquinolone immediately if the patient experiences pain, swelling, inflammation, or rupture of a tendon. In several case-control studies evaluating the outcomes of giving a fluoroquinolone and corticosteroid together, tendon rupture incidence rates and odds ratios were significantly increased .
Severity
Major
Onset
Delayed
Evidence
Established
How To Manage Interaction
Fluoroquinolones have been associated with an increased risk of tendinitis and tendon rupture. This risk is increased especially in patients over the age of 60, in patients taking concomitant corticosteroids, and in patients with kidney, heart, or lung transplants. Discontinue the fluoroquinolone immediately if the patient experiences pain, swelling, inflammation, or rupture of a tendon.
Mechanism Of Interaction
Additive effect of risk for tendon rupture
Literature Reports
A) In a case-control study comparing patients with tendon rupture (n=4836) to matched controls without tendon rupture (n=18,356), systemic fluoroquinolone exposure with concomitant oral corticosteroid exposure was associated with a significant increase in adjusted incidence rate ratios (aIRR) for any tendon rupture and Achilles tendon rupture; aIRRs were 6.88 (95% CI, 3.93 to 12.03) and 19.36 (95% CI, 7.78 to 48.19), respectively .
B) The increased risk of developing tendinitis or tendon rupture in patients taking a quinolone and corticosteroid has been established in several case-control studies. In study 1, the odds of developing Achilles tendonitis (n=28,907) was increased 9.1-fold when a quinolone and corticosteroid was given together compared to when a quinolone was given by itself (odd ratio (OR), 9.1; 95% CI, 4.6 to 18). The odds of developing tendon rupture (n=7685) was also increased 3.7 fold when given together, however the difference between the groups was not significant . In study 2 (N=127,100), concomitant use of a quinolone and a corticosteroid increased the odds of developing a tendon rupture by 3.1-fold (OR, 3.1; 95% CI, 1.5 to 6.3) and rupture of the Achilles tendon by more than 43-fold (OR, 43.2; 95% CI, 5.5 to 341.1) . In study 3 (N=51,367), the odds of developing Achilles tendon disorders in patients 60 years or older was increased 5.3-fold when given a quinolone (OR, 5.3; 95% CI, 1.8 to 15.2) and increased to more than 17-fold when a corticosteroid was added (OR, 17.5; 95% CI, 5 to 60.9) .
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.
Hydrocortisone Overview
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Hydrocortisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Hydrocortisone is also used to treat other conditions in patients with normal corticosteroid levels. These conditions include certain types of arthritis; severe allergic reactions; lupus (a disease in which the body attacks many of its own organs); and certain conditions that affect the lungs, skin, eyes, kidneys, blood, thyroid, stomach, and intestines. It is also sometimes used to treat the symptoms of certain types of cancer. Hydrocortisone is in a class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids by replacing steroids that are normally produced naturally by the body. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.
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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.
Where Does Our Information Come From?
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.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.