SIDE EFFECTS
The following is a compilation of the data for ofloxacin based on clinical
experience with both the oral and intravenous formulations. The incidence of
drug-related adverse reactions in patients during Phase 2 and 3 clinical trials
was 11%. Among patients receiving multiple-dose therapy, 4% discontinued ofloxacin
due to adverse experiences.
In clinical trials, the following events were considered likely to be drug-related
in patients receiving multiple doses of ofloxacin:
nausea 3%, insomnia 3%, headache 1%, dizziness 1%, diarrhea 1%, vomiting 1%,
rash 1%, pruritus 1%, external genital pruritus in women 1%, vaginitis 1%, dysgeusia
1%.
In clinical trials, the most frequently reported adverse events, regardless
of relationship to drug, were:
nausea 10%, headache 9%, insomnia 7%, external genital pruritus in women 6%,
dizziness 5%, vaginitis 5%, diarrhea 4%, vomiting 4%.
In clinical trials, the following events, regardless of relationship to drug,
occurred in 1 to 3% of patients:
Abdominal pain and cramps, chest pain, decreased appetite, dry mouth, dysgeusia,
fatigue, flatulence, gastrointestinal distress, nervousness, pharyngitis, pruritus,
fever, rash, sleep disorders, somnolence, trunk pain, vaginal discharge, visual
disturbances, and constipation.
Additional events, occurring in clinical trials at a rate of less than 1%,
regardless of relationship to drug, were:
Body as a whole: asthenia, chills, malaise, extremity pain, pain, epistaxis
Cardiovascular System: cardiac arrest, edema, hypertension, hypotension,
palpitations, vasodilation
Gastrointestinal System: Dyspepsia
Genital/Reproductive System: burning, irritation, pain and rash of the
female genitalia; dysmenorrhea; menorrhagia; metrorrhagia
Musculoskeletal System: arthralgia, myalgia
Nervous System: seizures, anxiety, cognitive change, depression, dream
abnormality, euphoria, hallucinations, paresthesia, syncope, vertigo, tremor,
confusion
Nutritional/Metabolic: thirst, weight loss
Respiratory System: respiratory arrest, cough, rhinorrhea
Skin/Hypersensitivity: angioedema, diaphoresis, urticaria, vasculitis
Special Senses: decreased hearing acuity, tinnitus, photophobia
Urinary System: dysuria, urinary frequency, urinary retention
The following laboratory abnormalities appeared in ≥ 1.0% of patients receiving
multiple doses of ofloxacin. It is not known whether these abnormalities were
caused by the drug or the underlying conditions being treated.
Hematopoietic: anemia, leukopenia, leukocytosis, neutropenia, neutrophilia,
increased band forms, lymphocytopenia, eosinophilia, lymphocytosis, thrombocytopenia,
thrombocytosis, elevated ESR
Hepatic: elevated: alkaline phosphatase, AST (SGOT), ALT (SGPT) Serum
chemistry: hyperglycemia, hypoglycemia, elevated creatinine, elevated BUN Urinary:
glucosuria, proteinuria, alkalinuria, hyposthenuria, hematuria, pyuria
Post-Marketing Adverse Events
Additional adverse events, regardless of relationship to drug, reported from
worldwide marketing experience with quinolones, including ofloxacin:
Clinical
Cardiovascular System: cerebral thrombosis, pulmonary edema, tachycardia,
hypotension/shock, syncope, torsades de pointes
Endocrine/Metabolic: hyper-or hypoglycemia, especially in diabetic patients
on insulin or oral hypoglycemic agents (See PRECAUTIONS: General
and DRUG INTERACTIONS.)
Gastrointestinal System: hepatic dysfunction including: hepatic necrosis,
jaundice (cholestatic or hepatocellular), hepatitis; intestinal perforation;
hepatic failure (including fatal cases); pseudomembranous colitis (the onset
of pseudomembranous colitis symptoms may occur during or after antimicrobial
treatment), GI hemorrhage; hiccough, painful oral mucosa, pyrosis (See WARNINGS.)
Genital/Reproductive System: vaginal candidiasis
Hematopoietic: anemia, including hemolytic and aplastic; hemorrhage,
pancytopenia, agranulocytosis, leukopenia, reversible bone marrow depression,
thrombocytopenia, thrombotic thrombocytopenic purpura, petechiae, ecchymosis/bruising
(See WARNINGS.)
Musculoskeletal: tendinitis/rupture; weakness; rhabdomyolysis(See WARNINGS.)
Nervous System: nightmares; suicidal thoughts or acts, disorientation,
psychotic reactions, paranoia; phobia, agitation, restlessness, aggressiveness/hostility,
manic reaction, emotional lability; peripheral neuropathy, ataxia, incoordination;
exacerbation of: myasthenia gravis and extrapyramidal disorders; dysphasia,
lightheadedness (See WARNINGS and PRECAUTIONS.)
Respiratory System: dyspnea, bronchospasm, allergic pneumonitis, stridor
(See WARNINGS.)
Skin/Hypersensitivity: anaphylactic (-toid) reactions/shock; purpura,
serum sickness, erythema multiforme/Stevens-Johnson Syndrome, erythema nodosum,
exfoliative dermatitis, hyperpigmentation, toxic epidermal necrolysis, conjunctivitis,
photosensitivity/phototoxicity reaction, vesiculobullous eruption (See WARNINGS and PRECAUTIONS.)
Special Senses: diplopia, nystagmus, blurred vision, disturbances of:
taste, smell, hearing and equilibrium, usually reversible following discontinuation
Urinary System: anuria, polyuria, renal calculi, renal failure, interstitial
nephritis, hematuria (See WARNINGS and PRECAUTIONS.)
Laboratory
Hematopoietic: prolongation of prothrombin time
Serum chemistry: acidosis, elevation of: serum triglycerides, serum
cholesterol, serum potassium, liver function tests including: GGTP, LDH, bilirubin
Urinary: albuminuria, candiduria
In clinical trials using multiple-dose therapy, ophthalmologic abnormalities,
including cataracts and multiple punctate lenticular opacities, have been noted
in patients undergoing treatment with other quinolones. The relationship of
the drugs to these events is not presently established.
CRYSTALLURIA and CYLINDRURIA HAVE BEEN REPORTED with other quinolones.