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Vigamox dosing: Uses, Dosage, Side Effects, Interactions, Warning

&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp Vigamox&nbsp&nbsp(U.S.N.L.M.)

Dosing/ conjunctivitis 1 drop tid for 7 days    (See Moxeza for bid dosing)
Dosing/ corneal ulcer In office loading dose then 2drops q15min for 2-3hr, then qhr,
q3-4hr overnight (ung hs less severe cases), qhr day 2, then
q2hr to significant resolution, then qid to day 14.
Chem Specs moxifloxacin 0.5%
Quantities 3 ml in 4ml bottle
Cost 123.00    generic
Class fourth-generation fluoroquinolone
Action Binds bacterial DNA gyrase topoisomerase II and topoisomerase IV
Activity Active against a very broad range of gram negative and positive
organisms. Click heading for details in package insert.
Active against a very broad range of gram negative and positive organisms. Click heading for details in package insert.
Usage Indicated for bacterial conjunctivitis, off label for corneal ulcer.
Enhanced gram positive activity with bulky side chains which combat
resistance and enhance potency. Superior time-kill characteristics.
Better solubility in ophthalmic solution allows higher concentration.
Biphasic molecule may explain enhanced corneal penetration.
Enhanced gram positive activity with bulky side chains which combat resistance and enhance potency. Superior time-kill characteristics. Better solubility in ophthalmic solution allows higher concentration. Biphasic molecule may explain enhanced corneal penetration.
Contraindications Hypersensitivity to Moxifloxacin, other quinolones or any components.
Pediatric useThe safety and effectiveness have been established in all ages.
PregnancyNo adequate and well-controlled studies in pregnant women.
Administration to pregnant rats, monkeys and rabbits did not produce
adverse effects at clinically relevant doses.
No adequate and well-controlled studies in pregnant women. Administration to pregnant rats, monkeys and rabbits did not produce adverse effects at clinically relevant doses.
Self preserved.    Slight yellowish color.
Ophthalmic patent expiration September 29, 2019.

    N.L.M. DailyMed page for Vigamox    
    PDR page for Vigamox
    

Содержание

Vigamox – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

Moxifloxacin belongs to the class of medications known as fluoroquinolones. Fluoroquinolones are antibiotics that are used to treat infections caused by certain types of bacteria. Moxifloxacin ophthalmic solution is an antibiotic eye drop used to treat eye infections called bacterial conjunctivitis (pink eye) in people 12 months and older. It works by killing the bacteria that cause the infection.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each mL of ophthalmic solution contains moxifloxacin base 5 mg. Nonmedicinal ingredients: boric acid, purified water, and sodium chloride. May also contain hydrochloric acid/sodium hydroxide to adjust pH.

How should I use this medication?

Moxifloxacin eye drops are usually used for a period of one week. Use one drop in the affected eye(s) 3 times a day while awake. You should space the doses evenly throughout the day.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. Use it for the full length of time your doctor has recommended, even if you have started to feel better.

To use the eye drops:

  1. Wash your hands before using the eye drops.
  2. Remove the cap and place it in a clean location. To avoid possible contamination, keep the tip of the container away from contact with any surface.
  3. Tilt your head back and look towards the ceiling.
  4. With your index finger, gently pull the lower eyelid down and away from the eye to form a pouch.
  5. Apply one drop into the pouch but do not allow the tip of the container to touch the eye or areas around the eye.
  6. Gently apply pressure to the inner corner of the eye (at the bridge of the nose) for about 30 seconds. (This is called nasolacrimal occlusion.) This prevents the medication from dripping down through the tear duct and entering the bloodstream, which could cause you to experience some side effects.
  7. Repeat with the other eye, if prescribed by your physician.
  8. Wash your hands again to remove any medication.

Safely discard any medication remaining in the dropper bottle after you have used the medication for the full length of time recommended by your doctor. Discard any remaining medication 28 days after opening the bottle.

Ask your doctor or pharmacist to show you the correct method of applying eye drops. It is very important to avoid touching the dropper tip to any surface, skin, or your eye. This contamination can result in a bacterial infection. Report any signs of an eye infection (e.g., redness, irritation, pain) to your doctor immediately.

If you miss a dose, instill it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to moxifloxacin or any ingredients of the medication
  • are allergic to any fluoroquinolone antibiotics (e.g., ciprofloxacin, levofloxacin, gatifloxacin, ofloxacin, norfloxacin)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dry eye
  • eye irritation
  • eye itchiness
  • mild, temporary burning and stinging with application
  • nausea

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • eye pain
  • other disorders of the area around the cornea
  • sensitivity to light
  • spots on the cornea
  • symptoms of a new eye infection (e. g., eye discharge, redness, itchiness or pain)
  • swelling of the cornea

Stop using the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction, e.g.:
    • abdominal cramps
    • difficulty breathing
    • nausea and vomiting
    • swelling of the face and throat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergic reactions: Moxifloxacin may cause a skin rash and other serious allergic reactions. If you notice a skin rash, skin blisters, skin itching, or hives, stop taking the medication and contact your doctor immediately.

Contact lenses: Avoid wearing contact lenses while you have signs and symptoms of bacterial conjunctivitis (eye infection).

New eye infections: Overgrowth of bacteria that are not affected by this medication may occur and cause a new eye infection. If you experience symptoms of a new eye infection (e.g., eye redness, discharge, pain or itching), contact your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if moxifloxacin ophthalmic solution passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 12 months old.

What other drugs could interact with this medication?

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Vigamox

Vigamox Eye Medicine

VIGAMOX ANTIBACTERIAL EYE DROPS

(moxifloxacin hydrochloride ophthalmic solution 0.5%)

 

Vigamox is a topical ophthalmic antibiotic eye drop that is used for the treatment of bacterial conjunctivitis (a bacterial infection on the surface of the eye).  It is manufactured by Alcon (Ft. Worth, TX) and is one of many antibacterial eye drops available in the U.S.  Vigamox is available by doctor’s prescription only and is supplied in a 3 ML bottle.

 

Vigamox is similar to other fluoroquinolone eye drops such as Zymar (gatifloxacin), Ciloxan (ciprofloxacin) and Ocuflox (ofloxacin).

 

Possible Side Effects of Vigamox

Side effects after the use of Vigamox occur in 1-6% of the population.  Systemic side effects can be decreased if the patient gently applies pressure to the tear drainage ducts on the lower eyelids for1 minute after instilling Vigamox eye drops.  Possible side effects include the following:

 

Possible Mild effects of Vigamox:

  • Stinging/burning upon instillation of drops
  • Ocular irritation or redness
  • Increased tearing
  • Decrease in vision
  • Dry eyes

 

Possible Serious effects of Vigamox:

  • Fever
  • Increased coughing or difficulty breathing
  • Rash on skin
  • Swollen face and/or throat

 

Contraindications for Use of Vigamox

Vigmaox should not be used in any patients that have a known hypersensitivity or drug allergy to fluoroquinolones (a class of antibiotics).  Caution should be used in female patients who are pregnant or who are nursing.   Vigamox should not be used for viral or fungal infections of the eye.

Vigamox is in the FDA pregnancy category C (i.e. it is not known whether it will be harmful to an unborn baby). It is not known whether Vigamox passes into breast milk.

 

How to Use Vigamox

Standard dosing of Vigamox is 1 drop in the affected eye 3 times per day for 7 days. The dosing schedule may be altered depending on the severity of the bacterial infection. Vigamox is safe for use in patients over 1 year of age.

  • Contact lenses should not be worn while using Vigamox.  Glasses should be used to correct vision until resolution of the condition.
  • If any serious side effects or signs of fluoroquinolone hypersensitivity are experienced (rash, itching, swelling of the face/throat, or difficulty breathing), the patient should stop using Vigamox immediately and contact his/her eye doctor.
  • Avoid contamination of medication by avoiding contact of the tip of the eye dropper with anything and by washing hands prior to use.  
  • Use Vigamox for the entire time prescribed.  Do not decrease or discontinue use of medication if symptoms subside.
  • Vigamox is a solution so it is not necessary to shake the bottle before instilling drops.

VIGAMOX Dosage and Administration | Healthgrades

VIGAMOX (moxifloxacin hydrochloride solution/ drops) comes in different strengths and amounts, which is referred to as the dosing of VIGAMOX. The appearance of VIGAMOX can differ based on the dosing. Your doctor may change the dosage and prescription of VIGAMOX to get you the best results possible.

Instill one drop in the affected eye 3 times a day for 7 days.

Instill one drop in the affected eye 3 times a day for 7 days (2)

4 mL bottle filled with 3 mL sterile ophthalmic solution of moxifloxacin 0. 5%

4 mL bottle filled with 3 mL sterile ophthalmic solution of moxifloxacin 0.5% (3)

VIGAMOX® solution is supplied as a sterile ophthalmic solution in Alcon’s DROP-TAINER® dispensing system consisting of a natural low density polyethylene bottle and dispensing plug and tan polypropylene closure. Tamper evidence is provided with a shrink band around the closure and neck area of the package.

3 mL in a 4 mL bottle – NDC 0065-4013-03

Storage: Store at 2°C-25°C (36°F-77°F).

This drug label information is as submitted to the Food and Drug Administration (FDA) and is intended for informational purposes only. If you think you may have a medical emergency, immediately call your doctor or dial 911. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Tackle Extreme Clinical Cases

Patients right eye has a dense infiltrative keratitis with overlying epithelial defect.

Diagnosis
Dr. Kabat diagnosed a dense infiltrative keratitis with overlying epithelial defect on the patients right eye. We must assume that corneal ulcers that present in this fashion are bacterial (i.e., bacterial keratitis) until proven otherwise, Dr. Kabat says.

Given that this patient wears contact lenses and lives in southern Florida, Dr. Kabat suspected that Pseudomonas aeruginosa, a gram-negative bacteria, was the offender. P. aeruginosa is less common than Staphylococcus aureus and Streptococcus pneumoniae, but it is often associated with contact lens wear and is common in warm, moist climates. P. aeruginosa is more aggressive than most gram-positive bacteria, and it tends to invade the visual axis. In cases such as this, obtaining cultures is indicated.

In addition to severely decreased acuity, this patients eye was so in-flamed from the bacterial infection that she also developed an anterior chamber reaction (i.e., secondary uveitis), causing a hypopyon to develop. Bacterial keratitis is not uncommon, particularly in patients who wear contact lenses, Dr. Kabat says. However, severe central ulcers pose two significant risks. The first risk is permanent corneal scarring. An ulcer of this magnitude is likely to leave a scar, which leads to visual impairment if the visual axis is involved. The second risk is corneal thinning and perforation, which can lead to loss of the eye. Because this is risky business, Dr. Kabat says the attending O.D. has two options: treat the condition immediately and aggressively, or refer the patient to someone who can.

Signs and Symptoms
According to Dr. Kabat, signs and symptoms of bacterial keratitis include:

Conjunctival and episcleral injection.

Focal corneal infiltrate with overlying epithelial defect.

 Severe anterior chamber reaction.

 Mild mucopurulent discharge.

 Corneal edema.

 Reduced visual acuity.

 Extended contact lens wear.

 Corneal trauma or insult.

 Pain.

 Photophobia.

 Lacrimation.

 Blurred vision.

Pathophysiology
Bacterial keratitis begins when a bacterial pathogen gains entry to the cornea. This process is known as stromal induction. Contact lenses can cause microabrasions in the epithelium that enable bacteria to enter the cornea. As bacteria proliferate, inflammation and corneal damage can occur. This happens because white blood cells infiltrate the corneal stroma in an attempt to fight off invading bacteria, says Dr. Kabat. But, these white blood cells also damage the cornea by their presence, and the inflammatory effect induces collagenolysis, which causes the cornea to begin breaking down. Therefore, to properly manage a corneal ulcer, the bacteria must be neutralized and the inflammatory response must be quelled.

Management
Bacterial keratitis should be treated with both a broad-spectrum antibiotic and a potent corticosteroid, Dr. Kabat says. The antibiotic serves to destroy the bacteria, while the corticosteroid addresses the inflammatory response. The following antibiotics are FDA approved to treat bacterial keratitis:

 Fortified aminoglycosides and cephalosporins. These drugs were the standard treatments for bacterial keratitis before fluoroquinolones were introduced. 

Ciloxan (ciprofloxacin 0.3%, Alcon).

 Ocuflox (ofloxacin 0.3%, Allergan).

 Iquix (levofloxacin 1.5%, Santen). This drug has been FDA approved for the treatment of bacterial keratitis, but it is not yet available on the market.

Many practitioners now also use the two fourth-generation fluoroquinolones off-label to treat bacterial keratitis. These are:

 Vigamox (moxifloxacin 0.5%, Alcon).

 Zymar (gatifloxacin 0.3%, Allergan).

Vigamox and Zymar may be used in the same way as older-generation drugs, says Dr. Kabat. First, provide the patient with a loading dose (i.e., several drops while he or she is in your office). Then, dose one drop every 15 minutes to one hour, depending on the severity of the corneal ulcer, for the remainder of the day. Continue dosing every one to four hours overnight. You can modify the regimen depending on the resolution of the ulcer, but never administer the drug less than q.i.d. because sublethal dosing promotes the development of bacterial resistance.

Because the organisms are embedded in the cornea, bacterial keratitis requires more frequent instillation of an antibiotic than does conjunctivitis. If the corneal ulcer is stabilized or resolving 24 hours after initiating antibiotic treatment, only then does Dr. Kabat recommend adding a corticosteroid to reduce inflammation.

Dr. Kabat administered a loading dose of Vigamox (i.e., two drops) to this patient and told her to administer one drop every hour while awake and one drop every three hours overnight. He saw her the next day and told her to continue using Vigamox hourly. He also added Pred Forte (predniso-lone acetate 1.0%, Allergan) one drop every hour while awake, alternating on the half-hour with Vigamox.

Dr. Kabat saw this patient daily for the next five days to ensure that her condition was improving. On day six, there was significant resolution, and
both drugs were reduced to q.i.d. dosing. After four more days of this treatment, the inflammation was eradicated and the epithelium was healed, so the medications were discontinued.

Outcome
This patients corneal ulcer resolved within 10 days of her initial visit with this therapy, says Dr. Kabat. At this point, he referred her to the contact lens department for re-evaluation of her lens fit and to re-emphasize the importance of an appropriate contact lens wear schedule. Two weeks after her first visit, her visual acuity was 20/30 O.S., which is remarkable considering her initial presentation, says Dr. Kabat. Remember that patients with central ulcers should expect to have some degree of diminished acuity, even with proper treatment. Dr. Kabat always advises patients of this, and then works aggressively to restore vision to its fullest.


Clinical Pearls
When managing patients who have severe bacterial keratitis, Dr. Kabat recommends that you remember the following:

 Small corneal lesions with disproportionate inflammation, patient discomfort and overlying staining are corneal ulcers and should be treated as such.

 Always manage bacterial keratitis promptly and aggressively.

 Empirical antibiotic therapy is acceptable in most cases, but obtain a culture in certain situations (see When to Culture).

 Always employ corticosteroids after sufficient antibiosis has been achieved, usually on day two or three. Corticosteroids will not cause the infection to worsen, but they will quell the inflammatory response, which can threaten vision.

When to Culture
Obtain cultures if:
Central ulcers are severe.
 Ulcers show impending perforation.
 Corneal ulcers are not responding to therapy. The bacterial strain could be resistant.
 You are not comfortable with empiric treatment.
 Patients are in institutional settings. Resistant bacterial strains are more likely to be present in institutional settings, and may not respond to conventional drugs. AK

Case: Not Another Binocular Vision Case!
A 17-year-old black female presented and reported that she was experiencing intermittent double vision, primarily while reading. She reported having this problem for the past three months and said it seemed to be worsening. She also reported experiencing occasional headaches, which she thought were associated with reading. She denied any eye pain and neurological symptoms, including nausea, vomiting, motor weakness and paraesthesias. Her ocular and medical histories were unremarkable.

Examination
This patients visual acuity measured 20/20 O.U. Biomicroscopy, tonometry and ophthalmoscopy results were normal. Her motility was full in the right eye, but her left eye showed mild underaction in left lateral gaze (i.e., an abduction deficit). Dr. Kabat performed a forced-duction test in which he tried to move her left eye. The result was negative (i.e., he could move it, but she could not), which implied muscle weakness or a nerve problem.

Diagnosis
This patient demonstrated a left abduction deficit, suggesting that either her sixth nerve or medial rectus muscle were not working properly. The forced duction test all but confirmed a sixth nerve (abducens) palsy, Dr. Kabat says.

Signs and Symptoms
According to Dr. Kabat, classic signs and symptoms of sixth nerve palsy with an intracranial pathology may include:

 Papilledema.

 Nausea.

 Vomiting.

 Tinnitus.

 Pronounced headaches.

Pathophysiology
Sixth nerve palsy has several possible etiologies. In adults, the most common cause of acute-onset, non-traumatic sixth nerve palsy is ischemic-vascular disease, such as diabetes. In children and young adults, the most common cause is a mass lesion of the central nervous system, followed by multiple sclerosis, viral infection and pseudomotor cerebri. Significant intracranial pathology may be present even when classic signs and symptoms are absent, says Dr. Kabat.

Management
Young patients (i.e., those younger than age 30) with acute-onset sixth nerve palsy warrant immediate neuro-imaging because a mass lesion is likely implicated, Dr. Kabat says. He immediately sent this patient for an MRI. Then, he consulted with her neurologist.

MRI revealed a golf ball-sized mass growing within her cerebral ventricular system in the fourth ventricle. The mass prevented outflow of cerebral spinal fluid, so pressure was building. This abnormal accumulation of fluid is known as hydrocephalus.

MRI revealed a mass growing within this patients cerebral ventricular system.

Outcome
A neurosurgeon removed the mass, which was found to be a choroid plexus papillomaa benign tumor. Although the mass did not invade other parts of her brain, the hydrocephalus could have caused death. After her surgery, the diplopia abated. The patient recovered fully and remains in good health.

Clinical Pearls
 Something as seemingly benign as double vision in a child can be a significant problem and warrants further investigation.

 Sixth nerve palsy is a frequent cause of neurogenic diplopia.

 Young patients with acute-onset sixth nerve palsy warrant immediate neuro-imaging. If youre unsure about a diagnosis, refer the patient for neuro-imaging. Not all patients will have classic symptoms, such as nausea, vomiting and headaches.

Case: Agave Myself an Abrasion
A 44-year-old white female presented with a very painful, red left eye, four hours after she poked it with a pointy agave plant.

Examination
This patients visual acuity measured 20/30 in her left eye, and her motilities were full. She had limbal injection and a mild anterior chamber reaction. During her slit lamp examination, Dr. Kabat saw a 5mm vertical abrasion with ragged edges on the central cornea of her left eye.

This patients left eye had a 5mm vertical abrasion with ragged edges on the central cornea.

Management
Dr. Kabat treated this patient with cyclopentolate, as it was the only cycloplegic available to him at the time. However, it was not the appropriate treatment for her corneal abrasion. He also administered two drops of Ocuflox to prevent infection, and two drops of the NSAID Voltaren (diclofenac sod-ium 0.1%, CIBA Vision) to alleviate the patients pain. He then bandaged her left eye with a soft contact lens and instructed her to continue using Ocuflox and Voltaren every four hours. A follow-up visit was scheduled for the next morning.

Later that evening, the patient paged Dr. Kabat because she was still experiencing excessive pain. When she arrived at his clinic, she had severe corneal edema and a flapping epithelium. Since the abrasion occurred only a few hours before her initial appointment, Dr. Kabat had hoped that the soft contact lens would tack down the loose epithelium. However, he soon learned that this does not happen in corneal abrasions. The minute the epithelium loses contact with the underlying stroma, it begins to die, becoming antigenic and initiating an inflammatory response. Seeing how the situation had deteriorated, Dr. Kabat elected to debride the abrasion. He then administered Pred Forte and 0.25% scopolamine in-office to reduce the inflammation. He reapplied a bandage contact lens and prescribed 800mg of ibuprofen (the maximum recommended dosage) to ease her pain. The following morning, she looked and felt better, says Dr. Kabat.

To effectively manage corneal abrasions, Dr. Kabat recommends:

 Quelling the inflammatory cascade with a potent cycloplegic agent, such as 0.25% scopolamine.

 Facilitating re-epithelialization by removing loose, dead epithelium.

 Preventing secondary infection with an antibiotic.

Clinical Pearls
 Always remove loose epithelium associated with corneal abrasions. Loose epithelium is non-viable tissue, and it will become antigenic if left behind. 

Antibiotics are prophylactic and not therapeutic in situations like this, so administer them accordingly. Remember too that antibiotics, particularly those preserved with benzalkonium chloride, can be corneotoxic and delay re-epithelialization if used excessively.

 Steroids and NSAIDs are important to manage pain and secondary inflammation.

To modify a line from the film Forrest Gump, Optometry is like a box of chocolates. You never know what youre going to get. In other words, you never know what will walk into your office on any day, and if what you are seeing and hearing from a patient represents the entire story. So, always be prepared to encounter extreme and challenging cases, and know how to respond to ensure the safety and well-being of your patients.




Vol. No: 142:10Issue:
10/15/2005




moxifloxacin ophthalmic | CS Mott Children’s Hospital

What is the most important information I should know about moxifloxacin ophthalmic?

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What is moxifloxacin ophthalmic?

Moxifloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic that fights bacteria in the body.

Moxifloxacin ophthalmic (for use in the eyes) is used to treat bacterial infections of the eyes.

Moxifloxacin will not treat a viral or fungal infection of the eye. This medicine is for use in treating only bacterial infections.

Moxifloxacin ophthalmic may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using moxifloxacin ophthalmic?

You should not use this medicine if you are allergic to moxifloxacin or other fluoroquinolone antibiotics (ciprofloxacin, gemifloxacin, levofloxacin, ofloxacin, norfloxacin, and others).

Tell your doctor if you are pregnant or breastfeeding.

How should I use moxifloxacin ophthalmic?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

If you wear contact lenses, remove them before applying moxifloxacin ophthalmic. Ask your doctor if contact lenses can be reinserted after application of the medication.

Wash your hands before using eye medication.

To apply the eye drops: Tilt your head back slightly and pull down your lower eyelid to create a small pocket. Hold the dropper above the eye and squeeze a drop into this pocket. Close your eyes for 1 or 2 minutes.

Use only the number of drops your doctor has prescribed.

Do not touch the tip of the eye dropper or place it directly on your eye. A contaminated dropper can infect your eye, which could lead to serious vision problems.

Moxifloxacin ophthalmic is usually used for 7 days in a row. Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication.

Store at cool room temperature. Do not freeze. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

An overdose of moxifloxacin ophthalmic is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

What should I avoid while using moxifloxacin ophthalmic?

Do not use other eye medications unless your doctor tells you to.

Avoid wearing contact lenses until you no longer have symptoms of the eye infection.

This medicine may cause blurred vision and may impair your reactions. Avoid driving or hazardous activity until you know how this medicine will affect you.

What are the possible side effects of moxifloxacin ophthalmic?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • severe burning, stinging, or irritation after using this medicine; or
  • eye swelling, redness, severe discomfort, crusting or drainage (may be signs of infection).

Common side effects may include:

  • dry eyes or watery eyes;
  • eye pain or discomfort;
  • blurred vision; or
  • mild itching, redness, or other irritation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect moxifloxacin ophthalmic?

Medicine used in the eyes is not likely to be affected by other drugs you use. But many drugs can interact with each other. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

Where can I get more information?

Your pharmacist can provide more information about moxifloxacin ophthalmic.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. (‘Multum’) is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum’s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum’s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2021 Cerner Multum, Inc. Version: 4.01. Revision date: 8/1/2019.

Vigamox – Moxifloxacin Eye Drops for Pets

What is Vigamox Ophthalmic Solution for Dogs and Cats?

  • Vigamox is a prescription eye drop that contains Moxifloxacin, a fluoroquinolone antibiotic that kills certain types of bacteria.
  • It is used to treat conditions of the eye such as bacterial infections and conjunctivitis.

Why do cats and dogs use Vigamox?

  • If your dog or cat has been diagnosed with an eye infection, your veterinarian may prescribe an antibiotic eye drop such as Vigamox.

What else should I know about Vigamox?

  • Prescription medication.
  • Antibiotic that kills certain types of bacteria in eye infections and conjunctivitis.
  • There are approximately 20 drops per milliliter in the solution.
  • Vigamox is not an effective treatment for viral infections.
  • Store Vigamox at room temperature, away from moisture and sunlight.

What problems could my dog or cat have with Vigamox?

  • Crystals may appear in the eyes for a few days after beginning treatment with Moxifloxacin, but these are harmless.
  • Do not use the Vigamox if it changes color, becomes cloudy, or you see particles in the solution.
  • Vigamox may cause mild burning, stinging, irritation, or redness of the eyes.
  • Humans report a bad taste in the mouth while using Moxifloxacin eye drops.
  • Another side effect may be sensitivity to bright sunlight.

How do you use Vigamox?

  • Wait 5 minutes after administering Vigamox before giving any other eye medication.
  • Use appropriate administration techniques to avoid contamination of the medication. Keep the cap on when not in use.

What is in Vigamox?

  • The drug in Vigamox is the fluoroquinolone antibiotic Moxifloxacin.
  • Moxifloxacin kills certain types of bacteria.

Will I get what I see in the picture?

  • Vigamox is a brand name. You will receive the exact brand that you request.

Is it important for my dog or cat to finish all of the Vigamox?

  • Vigamox contains an antibiotic. Resistance is a major concern when using antibiotics. To help avoid resistance, it is important for you to use this for as long as your veterinarian has prescribed, even if you dog or cat is looking and feeling better.

instructions for use, analogs, composition, indications

Vigamox eye drops are contraindicated in patients with existing hypersensitivity to the active substance, other quinolones or to any of the excipients listed in the “Composition” section.

Special warnings and special precautions

In patients using systemic drugs of the quinolone series, severe and in some cases fatal hypersensitivity reactions (anaphylaxis) were observed, sometimes immediately after taking the first dose.Some reactions were accompanied by acute vascular insufficiency, loss of consciousness, Quincke’s edema (including edema of the larynx, pharynx, or face), airway obstruction, shortness of breath, urticaria, and pruritus.

If you experience an allergic reaction to Vigamox, you must stop using the drug. In the event of an acute hypersensitivity reaction to moxifloxacin or other components, resuscitation may be required. When clinically indicated, oxygen and airway restoration are used.

As with other antibiotics, prolonged use can lead to overgrowth of resistant microorganisms, including fungi. In case of superinfection, it is necessary to discontinue the drug and prescribe an alternative therapy.

With the systemic administration of fluoroquinolones, including moxifloxacin, inflammation and tendon rupture are possible, especially in elderly patients and patients receiving concomitant corticosteroids.The concentration of moxifloxacin in plasma after ophthalmic administration of Vigamox is much lower than after therapeutic oral administration of moxifloxacin (see sections “Interaction with drugs and other forms of interaction” and “Pharmacokinetics”), however, care must be taken and treatment with Vigamox should be discontinued when first signs of tendon inflammation.

There are limited data on the efficacy and safety of Vigamox in the treatment of conjunctivitis in newborns.Therefore, the drug is not recommended for the treatment of conjunctivitis in newborns.

Vigamox eye drops should not be prescribed for prophylaxis or as an empirical therapy for gonoblenorrhea in newborns, due to the possibility of developing resistance of Neisseria gonorrhoeae to fluoroquinolones. Patients with Neisseria gonorrhoeae eye infections should receive appropriate systemic treatment.

It is not recommended to use the drug in the treatment of Chlamydia trachomatis in patients under two years of age, since the use of the drug in this case has not been studied.Patients over 2 years of age with eye infections caused by Chlamydia trachomatis are prescribed appropriate systemic treatment.

With conjunctivitis of newborns, treatment is prescribed corresponding to the condition, that is, systemic treatment of diseases caused by Chlamydia trachomatis and Neisseria gonorrhoeae.

Patients should be advised not to wear contact lenses if signs and symptoms of a bacterial ocular infection are present.

Interaction with medicinal products and other forms of interaction

The interaction of Vigamox eye drops 5 mg / ml with other drugs has not been studied.Taking into account the low systemic concentration of moxifloxacin after topical administration of the drug (see section “Pharmacokinetics”), the development of interactions with other drugs is unlikely.

Pregnancy and breastfeeding

Pregnancy

There is no sufficient data on the use of Vigamox during pregnancy. However, the effect of the drug on the body during pregnancy is not expected, since the systemic effect of moxifloxacin is insignificant.The drug can be used during pregnancy.

Lactation

It is not known whether moxifloxacin passes into breast milk. Animal studies have shown a negligible degree of penetration into breast milk after oral administration of moxifloxacin. However, when using therapeutic doses, the effect of the drug on infants is not expected. The drug can be used while breastfeeding.

Side effects

Security Profile Overview

During clinical trials, in which 2252 people took part, Vigamox was used up to 8 times a day, of which 1900 patients took the drug 3 times a day.The safety assessment involved 1,389 patients from the United States and Canada, 586 patients from Japan, and 277 patients from India. Clinical trials have not shown any serious ophthalmic or systemic adverse effects associated with the use of the drug. The most frequent undesirable effects from the use of the drug are eye irritation and eye pain, observed in 1-2% of cases. Adverse effects were mild in 96% of patients in whom they manifested; treatment was discontinued in only 1 patient.

The following side effects caused by the use of Vigamox have been classified according to the following principle: very frequent (≥1 / 10), frequent (≥1 / 100 to <1/10), infrequent (≥1 / 1000 to <1/100) , rare (≥1 / 10,000 to <1/1000), very rare (<1/10000), or unknown (cannot be estimated from the available data). Within each group, the frequency of adverse effects is presented in decreasing order of severity.

System organ classification Frequency Adverse Reactions
Disturbances from the hematopoietic and lymphatic systems Rarely Decreased hemoglobin
Immune system disorders Unknown Increased sensitivity
CNS disorders Uncommon Rarely Unknown Headache Paresthesia Dizziness
Ophthalmic disorders Often Uncommon Rarely Unknown Eye pain, eye irritation Pinpoint keratitis, dry eyes, conjunctival hemorrhages, eye flushing, ocular itching, eyelid edema, ocular discomfort Corneal epithelial damage, corneal damage, conjunctivitis, blepharitis, eye edema, conjunctival edema, blurred vision, blurred vision asthenopia, erythema of the eyelids Endophthalmitis, ulcerative keratitis, corneal erosion, thinning of the cornea, increased intraocular pressure, opacity of the cornea, corneal infiltrate, corneal deposits, eye allergies, keratitis, corneal edema, sensation of photophobia, edema of the eyelids, increased lacrimation body in the eye.
Heart disorders Unknown Cardiopalmus
Respiratory, Chest and Mediastinal Disorders Rarely Unknown Nasal discomfort, laryngeal pain, foreign body sensation (in the throat) Shortness of breath
Gastrointestinal disorders Uncommon Rarely Unknown Taste disorders Vomiting Nausea
Liver and biliary tract disorders Rarely Increased levels of ALT, gamma glutamyl transferase
Skin and subcutaneous tissue disorders Unknown Redness, rash, itching, urticaria

Description of some side effects

In patients using systemic drugs of the quinolone series, severe and in some cases fatal hypersensitivity reactions (anaphylaxis) were observed, sometimes immediately after taking the first dose.Some reactions were accompanied by acute vascular collapse, loss of consciousness, Quincke’s edema (including edema of the larynx, pharynx or face), airway obstruction, shortness of breath, urticaria, and pruritus (see section “Special warnings and special precautions”).

There have been reports of ruptured tendons of the shoulder, arm, Achilles tendon, and other tendons that required surgical repair and resulted from long-term disability in patients receiving systemic fluoroquinolones.Studies and post-marketing data on the systemic administration of quinolones indicate that the risk of these ruptures may be increased in patients receiving corticosteroids, especially in elderly patients and for tendons that are exposed to high stress, including the Achilles tendon (see section “Special warnings and special precautions” ).

Application in children

Clinical studies have shown that Vigamox is safe for pediatric patients, including newborns.In patients under the age of 18, the most common two adverse reactions were eye irritation and eye pain, occurring in 0.9% of cases.

Based on data obtained from clinical studies involving pediatric patients, including infants (see section “Pharmacodynamics”), the type and severity of adverse reactions in children were the same as in adults.

Reporting suspected adverse reactions

It is important to report suspected adverse reactions after registration of the medicinal product, i.e.This allows monitoring the benefit / risk ratio of the medicinal product. Healthcare professionals should report all adverse reactions in accordance with local regulations.

Method of application and dosage

For topical use in ophthalmology only. Not for injection. Vigamox eye drops 5 mg / ml should not be injected under the conjunctiva or directly into the anterior chamber of the eye.

Dosage

Adults, including the elderly (over 65)

Instill one drop into the affected eye 3 times a day.Improvement, as a rule, occurs after 5 days, the treatment should be continued in the next 2-3 days. If no improvement is observed within 5 days, the diagnosis and / or treatment should be reviewed. The duration of treatment depends on the severity of the condition, as well as the clinical and bacteriological course of the disease.

Use in children

Dose selection is not required.

Application for hepatic and renal failure

No dose selection required

Mode of application

To prevent microbial contamination of the dropper and solution, be careful not to touch the eyelids, eye contour, or other surfaces with the dropper.

To prevent the absorption of drops through the nasal mucosa, especially in newborns or children, it is necessary to close the nasolacrimal canals for 2-3 minutes after using the drops. After removing the cap, remove the protective ring that controls the first tampering.

When prescribing several ophthalmic medicinal products, the interval between their use should be at least 5 minutes. Eye ointments should be applied last.

Compliance with the following recommendations will help when instilling the drug:

WASH HANDS CAREFULLY BEFORE INSERTION.

REMOVE THE HEAD BACK. PULL THE LOWER LID DOWN AND LOOK UP. ADD 1 DROP INTO THE SPACE BETWEEN THE EYEBLUE AND THE EYEBALL BY PRESSING THE BOTTOM OF THE BOTTLE.

DO NOT TOUCH THE TIP OF THE BOTTLE TO THE EYES, EYELASHES, OR TOUCH IT WITH YOUR HANDS.

CLOSE YOUR EYES AND RINSE IT WITH A DRY Cotton Swab.

WITHOUT OPENING EYES, SLIGHTLY PRESS THE INNER ANGLE FOR 3-5 MINUTES. THIS WILL ALLOW TO INCREASE THE EFFICIENCY OF THE DROPS.

Influence on the ability to drive vehicles and work with mechanisms

Vigamox does not affect or has little effect on the ability to drive and operate machinery. As with any eye drops, temporary blurred vision or other visual disturbances can affect the ability to drive or operate machinery. If visual impairment occurs after instillation, the patient should wait until vision is restored before driving or operating machinery.

indications and contraindications, composition and dosage – Pharmacy Mos

Dosage forms

International Non-Proprietary Name

?

Moxifloxacin

Composition of Vigamox drops 0.5% 5ml

Active ingredient: moxifloxacin hydrochloride 5.45 mg equivalent to moxifloxacin 5 mg.Excipients: sodium chloride, boric acid, hydrochloric acid and / or sodium hydroxide to adjust the pH, purified water.

Group

?

Antimicrobials – fluoroquinolones

Manufacturers

Alcon-Couvrer N.V. (Belgium), Alcon Laboratories (United States of America)

Indications for use Vigamox drops 0.5% 5ml

Bacterial conjunctivitis caused by microorganisms sensitive to moxifloxacin.

Method of application and dosage Vigamox drops 0.5% 5ml

Locally.Adults and children over 1 year old are instilled 1 drop into the affected eye 3 times a day. Usually improvement
the condition occurs after 5 days and treatment should be continued for the next 2-3 days. If the condition does not improve after 5 days, the question of the correct diagnosis should be raised
and / or prescribed treatment.
The duration of treatment depends on the severity of the condition and the clinical and bacteriological course of the disease.

Contraindications Vigamox drops 0.5% 5ml

Hypersensitivity to any of the components of the drug or to other quinolones, lactation period, children under 1 year of age.

Pharmacological action

Moxifloxacin is a IV generation fluoroquinolone antibacterial drug that has a bactericidal effect.Shows activity against a wide range of gram-positive and gram-negative microorganisms, anaerobic, acid-fast and atypical bacteria.
The mechanism of action is associated with inhibition of topoisomerase II
(DNA gyrase) and topoisomerase IV. DNA gyrase is an enzyme involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV – an enzyme involved in the cleavage of chromosomal DNA during division
bacterial cell.
There is no cross-resistance with macrolides, aminoglycosides and tetracyclines.Reported development
cross-resistance between systemically used
moxifloxacin and other fluoroquinolones.

Overdose

In case of contact with the eyes of an excessive amount of the drug, it is recommended to rinse the eyes with warm water.

Special instructions

In patients who used systemic drugs of the quinolone series, severe, in some cases fatal hypersensitivity reactions (anaphylaxis) were observed, sometimes immediately after taking the first dose (!).Some reactions were accompanied by collapse, loss of consciousness, Quincke’s edema (including laryngeal and / or facial edema), airway obstruction, shortness of breath, urticaria, and itching of the skin. If the above conditions occur, resuscitation may be required.
Long-term use of an antibiotic can lead to an overgrowth of refractory microorganisms, including
the number of mushrooms. In case of superinfection, it is necessary to discontinue the drug and prescribe adequate therapy.After using the drug, a temporary decrease in the clarity of visual perception is possible, and until it is restored
it is recommended to drive and engage in activities that require increased attention and
reactions. Do not touch the tip of the dropper bottle to any surface to avoid contamination of the bottle and its contents. The bottle must be closed after each use.

Storage conditions

Store at a temperature of 2 to 25 ° C out of the reach of children.

Vigamox eye drops 5mg / ml 5ml No. 1 – Planet of Health

Description

Transparent solution of greenish-yellow color.

Composition

1 ml of solution contains:
active substance moxifloxacin hydrochloride 5.45 mg, equivalent to 5 mg moxifloxacin;
auxiliary substances, sodium chloride boric acid, hydrochloric acid and / or sodium hydroxide to adjust the pH, purified water.

Pharmacotherapeutic group

Medicines for use in ophthalmology; antimicrobial agents; fluoroquinolones.
ATC code: S01AE07.

Pharmacological properties
Pharmacodynamics

Mechanism of action:
Moxifloxacin is a IV generation fluoroquinolone that disrupts the processes of replication, repair and recombination of bacterial DNA by inhibiting DNA gyrase and topoisomerase IV.

Pharmacokinetics

With local application of the drug Vigamox, systemic absorption of moxifloxacin occurs.Plasma concentrations of moxifloxacin were measured in 21 men and women who received topical bilateral eye doses of a medication 3 times a day for 4 days. The average Cmax and AUC values ​​upon reaching a steady state were 2.7 ng / ml and 41.9 ng-h / ml, respectively. These values ​​are approximately 1600 times and 1200 times less than Cmax and AUC after a therapeutic dose of moxifloxacin 400 mg orally. The plasma half-life of moxifloxacin is 13 hours.

Indications for use

Vigamox eye drops are indicated for the treatment of purulent bacterial conjunctivitis caused by strains of microorganisms sensitive to moxifloxacin. It is recommended to take into account official guidelines on the proper use of antibacterial agents.

Contraindications

Vigamox eye drops are contraindicated in patients with existing hypersensitivity to the active substance, other quinolones or to any of the excipients listed in the “Composition” section.

Special warnings and special precautions

Severe and in some cases fatal hypersensitivity reactions (anaphylaxis) have been observed in patients using systemic quinolone drugs, sometimes immediately after taking the first dose. Some reactions were accompanied by acute vascular insufficiency, loss of consciousness, Quincke’s edema (including edema of the larynx, pharynx, or face), airway obstruction, shortness of breath, urticaria, and pruritus.
If you experience an allergic reaction to Vigamox, you must stop using the drug.In the event of an acute hypersensitivity reaction to moxifloxacin or other components, resuscitation may be required. When clinically indicated, oxygen and airway restoration are used.
As with other antibiotics, prolonged use can lead to overgrowth of resistant microorganisms, including fungi. In case of superinfection, it is necessary to discontinue the drug and prescribe an alternative therapy.With the systemic administration of fluoroquinolones, including moxifloxacin, inflammation and tendon rupture are possible, especially in elderly patients and patients receiving concomitant corticosteroids. The concentration of moxifloxacin in plasma after ophthalmic administration of Vigamox is much lower than after therapeutic oral administration of moxifloxacin (see sections “Interaction with drugs and other forms of interaction” and “Pharmacokinetics”), however, care must be taken and treatment with Vigamox should be discontinued when first signs of tendon inflammation.There are limited data on the efficacy and safety of Vigamox in the treatment of conjunctivitis in newborns. Therefore, the drug is not recommended for the treatment of conjunctivitis in newborns.
Vigamox eye drops should not be prescribed for prophylaxis or as an empirical therapy for gonoblenorrhea in newborns, due to the possibility of developing resistance of Neisseria gonorrhoeae to fluoroquinolones. Patients with Neisseria gonorrhoeae eye infections should receive appropriate systemic treatment.It is not recommended to use the drug in the treatment of Chlamydia trachomatis in patients under two years of age, since the use of the drug in this case has not been studied. Patients over 2 years of age with eye infections caused by Chlamydia trachomatis are prescribed appropriate systemic treatment.
With conjunctivitis of newborns, treatment is prescribed corresponding to the condition, that is, systemic treatment of diseases caused by Chlamydia trachomatis and Neisseria gonorrhoeae.
Patients should be advised not to wear contact lenses if signs and symptoms of a bacterial ocular infection are present.

Interaction with drugs and other forms of interaction

Interaction of Vigamox eye drops 5 mg / ml with other drugs has not been studied. Taking into account the low systemic concentration of moxifloxacin after topical administration of the drug (see section “Pharmacokinetics”), the development of interactions with other drugs is unlikely.

Pregnancy and breastfeeding

Pregnancy
There is no sufficient data on the use of Vigamox during pregnancy.However, the effect of the drug on the body during pregnancy is not expected, since the systemic effect of moxifloxacin is insignificant. The drug can be used during pregnancy.
Lactation
It is not known whether moxifloxacin passes into breast milk. Animal studies have shown a negligible degree of penetration into breast milk after oral administration of moxifloxacin. However, when using therapeutic doses, the effect of the drug on infants is not expected. The drug can be used while breastfeeding.

Side effects

Safety profile review
During clinical trials, in which 2252 people took part, Vigamox was used up to 8 times a day, of which 1900 patients took the drug 3 times a day. The safety assessment involved 1,389 patients from the United States and Canada, 586 patients from Japan, and 277 patients from India. Clinical trials have not shown any serious ophthalmic or systemic adverse effects associated with the use of the drug.The most frequent undesirable effects from the use of the drug are eye irritation and eye pain, observed in 1-2% of cases. Adverse effects were mild in 96% of patients in whom they manifested; treatment was discontinued in only 1 patient.
The following side effects caused by the use of Vigamox were classified according to the following principle: very frequent (≥1 / 10), frequent (≥1 / 100 to

Route of administration and dosage

For topical use in ophthalmology only.Not for injection. Vigamox eye drops 5 mg / ml should not be injected under the conjunctiva or directly into the anterior chamber of the eye.
Dosage
Adults, including seniors (over 65)
Instill one drop into the affected eye 3 times a day. Improvement, as a rule, occurs after 5 days, the treatment should be continued in the next 2-3 days. If no improvement is observed within 5 days, the diagnosis and / or treatment should be reviewed. The duration of treatment depends on the severity of the condition, as well as the clinical and bacteriological course of the disease.Application in children
Dose selection is not required.
Application for hepatic and renal failure
No dose selection required

Directions for use

To prevent microbial contamination of the dropper and solution, be careful not to touch the eyelids, areas around the eyes and other surfaces with the dropper.
To prevent the absorption of drops through the nasal mucosa, especially in newborns or children, it is necessary to close the nasolacrimal canals for 2-3 minutes after using the drops.After removing the cap, remove the protective ring that controls the first tampering.
When prescribing several ophthalmic medicinal products, the interval between their use should be at least 5 minutes. Eye ointments should be applied last.
Compliance with the following recommendations will help when instilling the drug:
WASH HANDS CAREFULLY BEFORE INSERTION.
REMOVE THE HEAD BACK. PULL THE LOWER LID DOWN AND LOOK UP. ADD 1 DROP INTO THE SPACE BETWEEN THE EYEBLUE AND THE EYEBALL BY PRESSING THE BOTTOM OF THE BOTTLE.DO NOT TOUCH THE TIP OF THE BOTTLE TO THE EYES, EYELASHES, OR TOUCH IT WITH YOUR HANDS.
CLOSE YOUR EYES AND RINSE IT WITH A DRY Cotton Swab.
WITHOUT OPENING EYES, SLIGHTLY PRESS THE INNER ANGLE FOR 3-5 MINUTES. THIS WILL ALLOW TO INCREASE THE EFFICIENCY OF THE DROPS.

Influence on the ability to drive vehicles and work with mechanisms

Vigamox does not affect or has a slight effect on the ability to drive and work with mechanisms. As with any eye drops, temporary blurred vision or other visual disturbances can affect the ability to drive or operate machinery.If visual impairment occurs after instillation, the patient should wait until vision is restored before driving or operating machinery.

Overdose

The limited capacity of the conjunctival sac practically excludes the possibility of drug overdose.
The amount of moxifloxacin in the vial is too small to cause side effects after accidental ingestion.

Form of issue

5 ml each in a dropper bottle DROPTAINER made of low density polyethylene.1 bottle with instructions for use in a cardboard box.

Storage conditions

At a temperature not exceeding 30 ° C, out of the reach of children.

Expiry date

2 years. Do not use after the expiration date printed on the package.
Use within 4 weeks after opening the bottle.

Terms of dispensing from pharmacies

On prescription.

Buy Vigamox drops gl. 5mg / ml in vial 5ml per pack No. 1 in the pharmacy

Price for Vigamox drops hl.5mg / ml in vial 5ml per pack No. 1

Instructions for use for Vigamox drops, hl. 5mg / ml in vial 5ml per pack No. 1

598 08/22/2016 – ClinLine

MOXA-10/2015 Protocol

Protocol name
An open comparative randomized multicenter clinical study of no less efficacy and safety of the drug Moxyoftan eye drops, 5 mg / ml, 5 ml (manufacturer – YADRAN-GALENSKI LABORATORIES a.O., Croatia.) and the registered reference drug Vigamox eye drops, 5 mg / ml, 5 ml (manufacturer – Alcon Laboratories Inc., USA) in the treatment of patients with bacterial conjunctivitis.

Therapeutic area

Ophthalmology

CI start and end date
22.08.2016 – 15.10.2018

RCT number and date
598 08/22/2016

CI organization
YADRAN-GALENSKI LABORATORIES JSC

Drug name
Moxyoftan (Moxifloxacin)

Dosage form and dosage
eye drops 5 mg / ml.

Cities
Ivanovo, Kazan, Reutov, St. Petersburg, Yaroslavl

Developer country
Croatia

CI phase
III

KI type
KI

The purpose of CI
Comparative study of the efficacy and safety of Moxyoftan and Vigamox drugs in patients with bacterial conjunctivitis

The amount of honey.institutions
5

Number of patients
220

90,000 Clinical Study Bacterial Conjunctivitis: PRO-157, Vigamox, Zymar®, Lagricel Ofteno® – Clinical Trials Registry

A randomized, double-blind, multicenter Phase II trial to evaluate the safety and efficacy of PRO-157 ophthalmic solution in three different dosing regimens, compared with moxifloxacin and gatifloxacin in patients with bacterial conjunctivitis.

Number of participants: 300 eyes, 60 per group.

Evaluation Criteria:

Performance Measurements: The Main Performance Criterion. Efficacy will be determined if there is a decrease in the number or species of bacterial flora when comparing the basal culture versus the final culture among five different patient groups.

Reduction or absence of infection with clinical assessment through signs and symptoms.

Safety measurements: this will be determined by visual acuity and adverse events Patients recruited will be treated for 7, for protocol purposes infected eyes will be taken at baseline, however investigational drugs and procedures will be applied to both eyes to protect the healthy eye.

The study is divided into the following evaluation periods:

Baseline visit 1 (day 1), visit 2 (day 3), final visit (day 8), and phone call (day 23) to assess adverse events.

Subjects will be administered any of the following dosages:

– PRO-157 1 drop 2 times daily.

– PRO-157 1 drop 3 times a day.

– PRO-157 1 drop 4 times a day.

– Moxifloxacin 1 drop 3 times a day.

– Gatifloxacin 1 drop 3 times a day.All dosing regimens are designed for 7 days. preservative-free artificial tears (Lagricel Ofteno®) will also be applied 15 minutes before instillation of the study drug during the study period.

Data analysis: data will be analyzed by intent to treat (ITT) and by protocol (PP) each variable is described, the ITT population will consist of all recruited subjects who have received at least one study dose, the PP population will be a subset of the ITT consisting of of all subjects without any major protocol deviations and in this group, bivariate analysis will be performed.

Continuous quantitative variables are expressed and represented by measures of the central trend. and variance (mean, standard deviation, and ranges). Qualitative nominal and ordinal variables are presented in the form of frequencies and proportions. The significance level was alpha 0.05 or less.

Vigamox (eye drops) – instructions for use, description, drug analogues

Vigamox eye drops are contraindicated in patients with existing hypersensitivity to the active substance, other quinolones or to any of the excipients listed in the “Composition” section.

Special warnings and special precautions

In patients using systemic drugs of the quinolone series, severe and in some cases fatal hypersensitivity reactions (anaphylaxis) were observed, sometimes immediately after taking the first dose. Some reactions were accompanied by acute vascular insufficiency, loss of consciousness, Quincke’s edema (including edema of the larynx, pharynx, or face), airway obstruction, shortness of breath, urticaria, and pruritus.

If you experience an allergic reaction to Vigamox, you must stop using the drug. In the event of an acute hypersensitivity reaction to moxifloxacin or other components, resuscitation may be required. When clinically indicated, oxygen and airway restoration are used.

As with other antibiotics, prolonged use can lead to overgrowth of resistant microorganisms, including fungi.In case of superinfection, it is necessary to discontinue the drug and prescribe an alternative therapy.

With the systemic administration of fluoroquinolones, including moxifloxacin, inflammation and tendon rupture are possible, especially in elderly patients and patients receiving concomitant corticosteroids. The plasma concentration of moxifloxacin after ophthalmic administration of Vigamox is much lower than after therapeutic oral administration of moxifloxacin (see.Sections “Interaction with drugs and other forms of interaction” and “Pharmacokinetics”), however, care must be taken and treatment with Vigamox should be discontinued at the first signs of tendon inflammation.

There are limited data on the efficacy and safety of Vigamox in the treatment of conjunctivitis in newborns. Therefore, the drug is not recommended for the treatment of conjunctivitis in newborns.

Vigamox eye drops should not be prescribed for prophylaxis or as an empirical therapy for gonoblenorrhea in newborns, due to the possibility of developing resistance of Neisseria gonorrhoeae to fluoroquinolones.Patients with Neisseria gonorrhoeae eye infections should receive appropriate systemic treatment.

It is not recommended to use the drug in the treatment of Chlamydia trachomatis in patients under two years of age, since the use of the drug in this case has not been studied. Patients over 2 years of age with eye infections caused by Chlamydia trachomatis are prescribed appropriate systemic treatment.

With conjunctivitis of newborns, treatment is prescribed corresponding to the condition, that is, systemic treatment of diseases caused by Chlamydia trachomatis and Neisseria gonorrhoeae.

Patients should be advised not to wear contact lenses if signs and symptoms of a bacterial ocular infection are present.

Interaction with medicinal products and other forms of interaction

The interaction of Vigamox eye drops 5 mg / ml with other drugs has not been studied. Taking into account the low systemic concentration of moxifloxacin after topical application of the drug (see.section “Pharmacokinetics”), development of interaction with other drugs is unlikely.

Pregnancy and breastfeeding

Pregnancy

There is no sufficient data on the use of Vigamox during pregnancy. However, the effect of the drug on the body during pregnancy is not expected, since the systemic effect of moxifloxacin is insignificant. The drug can be used during pregnancy.

Lactation

It is not known whether moxifloxacin passes into breast milk. Animal studies have shown a negligible degree of penetration into breast milk after oral administration of moxifloxacin. However, when using therapeutic doses, the effect of the drug on infants is not expected. The drug can be used while breastfeeding.

Side effects

Security Profile Overview

During clinical trials, in which 2252 people took part, Vigamox was used up to 8 times a day, of which 1900 patients took the drug 3 times a day.The safety assessment involved 1,389 patients from the United States and Canada, 586 patients from Japan, and 277 patients from India. Clinical trials have not shown any serious ophthalmic or systemic adverse effects associated with the use of the drug. The most frequent undesirable effects from the use of the drug are eye irritation and eye pain, observed in 1-2% of cases. Adverse effects were mild in 96% of patients in whom they manifested; treatment was discontinued in only 1 patient.

The following side effects caused by the use of Vigamox have been classified according to the following principle: very frequent (≥1 / 10), frequent (≥1 / 100 to <1/10), infrequent (≥1 / 1000 to <1/100) , rare (≥1 / 10,000 to <1/1000), very rare (<1/10000), or unknown (cannot be estimated from the available data). Within each group, the frequency of adverse effects is presented in decreasing order of severity.

System organ classification Frequency Adverse Reactions
Disturbances from the hematopoietic and lymphatic systems Rarely Decreased hemoglobin
Immune system disorders Unknown Increased sensitivity
CNS disorders Uncommon Rarely Unknown Headache Paresthesia Dizziness
Ophthalmic disorders Often Uncommon Rarely Unknown Eye pain, eye irritation Pinpoint keratitis, dry eyes, conjunctival hemorrhages, eye flushing, ocular itching, eyelid edema, ocular discomfort Corneal epithelial damage, corneal damage, conjunctivitis, blepharitis, eye edema, conjunctival edema, blurred vision, blurred vision asthenopia, erythema of the eyelids Endophthalmitis, ulcerative keratitis, corneal erosion, thinning of the cornea, increased intraocular pressure, opacity of the cornea, corneal infiltrate, corneal deposits, eye allergies, keratitis, corneal edema, sensation of photophobia, edema of the eyelids, increased lacrimation body in the eye.
Heart disorders Unknown Cardiopalmus
Respiratory, Chest and Mediastinal Disorders Rarely Unknown Nasal discomfort, laryngeal pain, foreign body sensation (in the throat) Shortness of breath
Gastrointestinal disorders Uncommon Rarely Unknown Taste disorders Vomiting Nausea
Liver and biliary tract disorders Rarely Increased levels of ALT, gamma glutamyl transferase
Skin and subcutaneous tissue disorders Unknown Redness, rash, itching, urticaria

Description of some side effects

In patients using systemic drugs of the quinolone series, severe and in some cases fatal hypersensitivity reactions (anaphylaxis) were observed, sometimes immediately after taking the first dose.Some reactions were accompanied by acute vascular collapse, loss of consciousness, Quincke’s edema (including edema of the larynx, pharynx or face), airway obstruction, shortness of breath, urticaria, and pruritus (see section “Special warnings and special precautions”).

There have been reports of ruptured tendons of the shoulder, arm, Achilles tendon, and other tendons that required surgical repair and resulted from long-term disability in patients receiving systemic fluoroquinolones.Studies and post-marketing data on the systemic administration of quinolones indicate that the risk of these ruptures may be increased in patients receiving corticosteroids, especially in elderly patients and for tendons that are exposed to high stress, including the Achilles tendon (see section “Special warnings and special precautions” ).

Application in children

Clinical studies have shown that Vigamox is safe for pediatric patients, including newborns.In patients under the age of 18, the most common two adverse reactions were eye irritation and eye pain, occurring in 0.9% of cases.

Based on data obtained from clinical studies involving pediatric patients, including infants (see section “Pharmacodynamics”), the type and severity of adverse reactions in children were the same as in adults.

Reporting suspected adverse reactions

It is important to report suspected adverse reactions after registration of the medicinal product, i.e.This allows monitoring the benefit / risk ratio of the medicinal product. Healthcare professionals should report all adverse reactions in accordance with local regulations.

Method of application and dosage

For topical use in ophthalmology only. Not for injection. Vigamox eye drops 5 mg / ml should not be injected under the conjunctiva or directly into the anterior chamber of the eye.

Dosage

Adults, including the elderly (over 65)

Instill one drop into the affected eye 3 times a day.Improvement, as a rule, occurs after 5 days, the treatment should be continued in the next 2-3 days. If no improvement is observed within 5 days, the diagnosis and / or treatment should be reviewed. The duration of treatment depends on the severity of the condition, as well as the clinical and bacteriological course of the disease.

Use in children

Dose selection is not required.

Application for hepatic and renal failure

No dose selection required

Mode of application

To prevent microbial contamination of the dropper and solution, be careful not to touch the eyelids, eye contour, or other surfaces with the dropper.

To prevent the absorption of drops through the nasal mucosa, especially in newborns or children, it is necessary to close the nasolacrimal canals for 2-3 minutes after using the drops. After removing the cap, remove the protective ring that controls the first tampering.

When prescribing several ophthalmic medicinal products, the interval between their use should be at least 5 minutes. Eye ointments should be applied last.

Compliance with the following recommendations will help when instilling the drug:

WASH HANDS CAREFULLY BEFORE INSERTION.

REMOVE THE HEAD BACK. PULL THE LOWER LID DOWN AND LOOK UP. ADD 1 DROP INTO THE SPACE BETWEEN THE EYEBLUE AND THE EYEBALL BY PRESSING THE BOTTOM OF THE BOTTLE.

DO NOT TOUCH THE TIP OF THE BOTTLE TO THE EYES, EYELASHES, OR TOUCH IT WITH YOUR HANDS.

CLOSE YOUR EYES AND RINSE IT WITH A DRY Cotton Swab.

WITHOUT OPENING EYES, SLIGHTLY PRESS THE INNER ANGLE FOR 3-5 MINUTES. THIS WILL ALLOW TO INCREASE THE EFFICIENCY OF THE DROPS.

Influence on the ability to drive vehicles and work with mechanisms

Vigamox does not affect or has little effect on the ability to drive and operate machinery. As with any eye drops, temporary blurred vision or other visual disturbances can affect the ability to drive or operate machinery. If visual impairment occurs after instillation, the patient should wait until vision is restored before driving or operating machinery.

90,000 The first experience of clinical use of Vigamox eye drops in pediatric patients

Zubareva L.N., Gavrilyuk A.S., Artamonova A.V.

Federal State Budgetary Institution “Clinical Hospital”

E-mail: [email protected]

FIRST EXPERIENCE OF CLINICAL APPLICATION OF VIGAMOX EYE DROPS IN CHILD PATIENTS

The article is devoted to the first experience of the clinical use of Vigamox eye drops in 37 children aged 3 weeks to 17 years, of which 16 had inflammatory diseases of the anterior segment of the eyeball.In 21 children, Vigamox was prescribed to prevent infectious complications after surgery. The high therapeutic and prophylactic efficacy of Vigamox drops, good tolerance and the absence of side effects in all children, including infants, were noted.

Keywords: Vigamox, inflammation, infection, treatment, prevention, children

Relevance of work

Inflammatory diseases of the anterior segment of the eye account for about a third of diseases among children seeking ophthalmological help.In some cases, with an unfavorable course, they can lead to irreversible consequences.

Despite the fact that antibiotic therapy has achieved great success, the treatment of inflammatory diseases presents significant difficulties associated primarily with the wide spread of resistant forms of microorganisms, which necessitates the search for new drugs.

Fluoroquinolones are antibiotics that have been widely used since the sixties for the treatment and prevention of bacterial infections.Their frequent appointment, especially systemic, has led to an increase in the development of resistant forms of bacteria. The mechanism of action of fluoroquinolones is inhibition of the synthesis of DNA topoisomerase II and topoisomerase IV of a bacterial cell. Fluoroquinolones of the first three generations act only on DNA gyrase of many gram-negative bacteria or topoisomerase IV of many gram-positive bacteria. This selectivity of action leads to a decrease in sensitivity to drugs and increases the risk of mutations, which leads to an increase in resistance to their effects.

The IV generation drug moxifloxacin (in ophthalmology, the drug moxif-loxacin is used – Vigamox eye drops 0.5%) has a methoxy group (OCH2) in its structure, due to which it has the ability to bind to both types of enzymes. In addition, the side bicyclic chain provides high impact efficiency and suppresses

development of resistant forms of bacteria.The presence of this chain increases the period of residence of the active substance inside the cell.

A distinctive feature of Vigamox is the ability to penetrate deeply into the tissues and structures of the eye, creating high concentrations in them. So in the conjunctiva when instilling Vigamox drops, its concentration is 7 times higher compared to Oftaquix (levofloxacin) and 15 times higher compared to Floxal (ofloxacin) [3,4,7].

Vigamox, in contrast to the fluoro-quinalone preparations of previous generations, has an extended range of effects on gram-positive, gram-negative, atypical and anaerobic flora.

The drug has a quick bactericidal effect, is non-toxic at the systemic and tissue levels, is well tolerated and, importantly, is free from preservatives, since it has the property of self-preservation. Convenient dosing regimen – 1 drop 3 times a day [8].

Considering the advantages of the new antibiotic moxifloxacin described in the literature, it is of great interest to test it in the practice of pediatric ophthalmology.

The aim of the study was to study the efficacy and safety of using Vigamox in pediatric and adolescent patients.

Materials and methods

We have tested Viga-mox eye drops in the treatment of 37 patients aged 3 weeks to 17 years with inflammatory diseases of the anterior part of the eyeball: acute bacterial conjunctivitis – 10 children aged 2 to 12 years, with dacryocystitis novo-

born – 4 children aged 3 to 6 weeks, with traumatic keratitis in the form of corneal infiltration after removal of a foreign body – 2 children aged 7 and 12 years

Instillation regimen 1 drop 3 times a day for 4 days.In order to prevent infectious complications, Vigamox was prescribed in the postoperative period to 6 children aged 4-6 years after surgical correction of strabismus and 5 children aged 11-14 years after scleroplasty.

Prevention of infectious complications in abdominal surgery is especially important. For prophylactic purposes, Vigamox was prescribed 1 drop 3 times a day the day before the operation, 3 times every 15 minutes on the day of the operation, and 3 times a day for 4 days after the operation.

According to this scheme, Vigamox was prescribed to 8 children aged 1.5-6 years with cataract phacoaspiration with IOL implantation and 2 children aged 2 and 5 years with antiglaucomatous surgery.

Results and discussion

In patients with inflammatory diseases, it was possible to arrest the inflammatory process in all cases. In children with conjunctivitis, the subjective condition improved the very next day.Decreased edema, hyperemia of the eyelids and conjunctiva, separated from the conjunctival cavity. The complete disappearance of symptoms, depending on the severity, was observed on days 2-4.

In infants with neonatal dacryocystitis, the discharge disappeared in 2-3 days. The lacrimal sac massage was continued for 1-2 weeks. Pro-

washing, probing of the lacrimal ducts in this group of children was not required.

In traumatic keratitis, the infiltrate resolved on days 4 and 6.No recurrence of symptoms was observed in any patient with inflammatory diseases of the anterior segment of the eyeball.

In patients after surgical correction of strabismus and scleroplasty, the local conjunctival injection in the manipulation zone disappeared in 3-4 days. In children after abdominal operations, the postoperative period was uneventful. The inflammatory response corresponded to the volume and complexity of the operations performed.

The drug was well tolerated in all children, including infants.The results of our observations coincide with the literature data on the safety and efficacy of Vigamox drops in children from infancy [1,6].

Conclusion

Thus, the results obtained indicate a high therapeutic and prophylactic efficacy of Vigamox eye drops. In the course of its use, no side effects were noted. Vigamox is well tolerated by children, including infants.

Based on our experience, we can recommend the use of Vigamox in children with inflammatory diseases of the anterior segment of the eyeball, as well as in preparing children for intraocular surgery and in the postoperative period for the prevention of infectious complications.

13.10.2011

References:

1.Gross R.D., Silas P., Oshman S. et al. A Comparison of the Safety and Efficacy of Moxifloxacin and Ciprofloxacin in the Treatment of Presumed Bacterial Conjunctivitis in Neonatal Patients // Invest. Ophthalmol. Vis. Sci. 2003. V. 44. P. 1465

2. Hwang G. Fluoroquinolone resistance in ophthalmology and the potential role for newer ophthalmic fluoroquinolones // Survey of Ophthalmology. 2004. V. 49 Suppl 2. Issue March. P. 79-83

3.Katz R., Mesket S., Lane S.S. et al. Absorption of Topical Moxifloxacin Ophthalmic Solution Into Human Aqueous Humor // Cornea. 2005. V. 24. P. 955-958

4. Kim H, Stark J, O’Brien P; Dick J.D. Aqueous penetration and biological activity of moxifloxacin 0.5% ophthalmic solution and gatifloxacin 0.3% solution in cataract surgery patients // Ophthalmology 2005. V. 112. P. 1992-6.

5.Mather R., Karenchak L.M., Romanowski E.G., Kowalski R.P. Fourth generation fluoroquinolones: new weapons in the arsenal of ophthalmic antibiotics. // Am. J. Ophthalmol. 2002. V. 133. Issue 4, P.463-466

6. Silver L. H., Burkey R., Montgomery D. et al. Safety of Ophthalmic Moxifloxacin in the Treatment of Newborns, Infants and Toddlers, Children, and Adolescents With Bacterial Conjunctivitis // Invest. Ophthalmol. Vis. Sci. 2003. V. 44. P.804

7. Solomon R., Donnenfeld E. D., Perry H. D. et al. Penetration of topically applied gatifloxacin 0.3%, moxifloxacin 0.5%, and ciprofloxacin 0.3% into the aqueous humor // Ophthalmology. 2005. V. 112. P.466-469

8. Wagner R.S., D’Arienzo P.A., et al. A Comparative Study In a Normal Pediatric Population of the Relative Comfort of Moxifloxacin

0.5% Ophthalmic Solution versus a Tear Substitute // Invest. Ophthalmol. Vis. Sci. 2004. V. 45. P. 4936

9. Ong-Tone L. Aqueous humor penetration of gatifloxacin and moxifloxacin eyedrops given by different methods before cataract surgery // J. Cataract Refract. Surg. 2007.V. 33, Issue: 1, P. 59-62

UDC 615.33-053.2-08

Zubareva L.N., Gavrilyuk A.S., Artamonova A.V.

FIRST EXPERIENCE OF EYE DROPS VIGAMOKS CLINICAL APPLICATION IN CHILDREN

Article is devoted to the first experience of clinical application of eye drops of Vigamox at 37 children at the age from 3 weeks till 17 years, from them 16 had inflammatory diseases of an anterior part of an eye. At 21 children Vigamox was administered for the purpose of prophylactic of infectious complications after surgical interventions.High medical and prophilactic efficiency of Vigamox, good toleration and absence of adverse events at all children, including infants was revealed.

Keywords: Vigamox, inflammation, infection, treatment, prophylactic, children

Bibliography:

1. Gross R.D., Silas P, Oshman S. et al. A Comparison of the Safety and Efficacy of Moxifloxacin and Ciprofloxacin in the Treatment of Presumed Bacterial Conjunctivitis in Neonatal Patients // Invest.Ophthalmol. Vis. Sci. 2003. V. 44. P 1465

2. Hwang G. Fluoroquinolone resistance in ophthalmology and the potential role for newer ophthalmic fluoroquinolones // Survey of Ophthalmology. 2004. V. 49 Suppl 2. Issue March. P 79-83

3. Katz R., Mesket S., Lane S.S. et al. Absorption of Topical Moxifloxacin Ophthalmic Solution Into Human Aqueous Humor // Cornea. 2005. V. 24. P. 955-958

4.Kim H, Stark J, O’Brien P; Dick J.D. Aqueous penetration and biological activity of moxifloxacin 0.5% ophthalmic solution and gatifloxacin 0.3% solution in cataract surgery patients // Ophthalmology 2005. V. 112. P. 1992-6.

5. Mather R., Karenchak L.M., Romanowski E.G., Kowalski R.P Fourth generation fluoroquinolones: new weapons in the arsenal of ophthalmic antibiotics. // Am. J. Ophthalmol. 2002. V. 133. Issue 4, P463-466

6.Silver L. H., Burkey R., Montgomery D. et al. Safety of Ophthalmic Moxifloxacin in the Treatment of Newborns, Infants and Toddlers, Children, and Adolescents With Bacterial Conjunctivitis // Invest. Ophthalmol. Vis. Sci. 2003. V. 44. P. 804

7. Solomon R., Donnenfeld E. D., Perry H. D. et al. Penetration of topically applied gatifloxacin 0.3%, moxifloxacin 0.5%, and ciprofloxacin 0.3% into the aqueous humor // Ophthalmology. 2005. V. 112. P466-469

8.Wagner R.S., D’Arienzo PA., Et al. A Comparative Study In a Normal Pediatric Population of the Relative Comfort of Moxifloxacin 0.5% Ophthalmic Solution versus a Tear Substitute // Invest. Ophthalmol. Vis. Sci. 2004. V. 45. P. 4936

9. Ong-Tone L. Aqueous humor penetration of gatifloxacin and moxifloxacin eyedrops given by different methods before cataract surgery // J. Cataract Refract. Surg. 2007.V. 33, Issue: 1, P. 59-62

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