Moxifloxacin Canon - instructions for use, dose, side effects, contraindications

Excipients: calcium stearate 7 mg, corn starch 50 mg, croscarmellose sodium 21 mg, mannitol 55 mg, povidone K-30 25 mg, cellulose microcrystalline 105.65 mg;

composition of the film shell: Opadrai II yellow 21 mg, including: polyvinyl alcohol 8.4 mg, macrogol (polyethylene glycol) 4.2 mg, talc 3.15 mg, titanium dioxide 3.5 mg, iron oxide yellow 1.75 mg.

Description:Oval biconvex tablets, covered with a film coating of yellow color. In cross section - light yellow color.

Pharmacotherapeutic group:Antimicrobial agent - fluoroquinolone

ATX: & nbsp

J.01.M.A.14 Moxifloxacin

Pharmacodynamics:

Moxifloxacin is a bactericidal antibacterial preparation of a broad spectrum of action of the fluoroquinolone series. The bactericidal effect of the drug is due to the inhibition of bacterial topoisomerases II and IV, which leads to a disruption of the biosynthesis of the DNA of the microbial cell and, as a consequence, to the death of microbial cells.The minimum bactericidal concentrations of the preparation as a whole are comparable to its minimum inhibitory concentrations.

Mechanisms that lead to the development of resistance to penicillins, cephalosporins, aminoglycosides, macrolides and tetracyclines, do not interfere with the antibacterial activity of moxifloxacin. Cross-resistance between these groups of antibacterial drugs and moxifloxacin is not noted. So far, no cases of plasmid resistance have been observed. The overall frequency of development of resistance is very low (10^-7-10^-10). Resistance to moxifloxacin develops slowly by multiple mutations. Multiple effects of moxifloxacin on microorganisms at concentrations below the minimum inhibitory concentration (MIC) are accompanied by only a slight increase in MIC. There are cases of cross-resistance to quinolones. Nevertheless, some gram-positive and anaerobic microorganisms resistant to other quinolones retain sensitivity to moxifloxacin.

It was found that the addition of a methoxyfloxacin methoxy group at the C 8 position increases the activity of moxifloxacin and reduces the formation of resistant mutant strains of Gram-positive bacteria.The addition of a bicyclo-amine group at the C7 position prevents the development of an active efflux, a mechanism of resistance to fluoroquinolones.

Moxifloxacin is in vitro active against a wide range of gram-negative and gram-positive microorganisms, anaerobes, acid-fast bacteria and atypical forms such as Mycoplasma spp., Chlamidia spp., Legionella spp., And bacteria resistant to beta-lactam and macrolide antibiotics.

Influence on human intestinal microflora

In two studies conducted on volunteers, the following changes in the intestinal microflora following oral administration of moxifloxacin were observed: a decrease in the concentrations of Escherichia coli, Bacillus spp., Bacteroides vulgatus, Enterococcus spp., Klebsiella spp., As well as anaerobes Bifidobactericum spp., Eubacterium spp., Peptostreptococcus spp. These changes were reversible within two weeks. There were no toxins of Clostridium dificile.

The spectrum of antibacterial activity of moxifloxacin includes the following microorganisms:

Sensitive

Moderately sensitive

Resistant

Gram-positive

Streptococcus pneumoniae (includinghresistant strains resistant to penicillin and strains with multiple antibiotic resistance, as well as strains resistant to two or more antibiotics, such as penicillinlin (MIC ≥2 μg / ml), cephalosporins II generation (for example, qefuroxime), macrolides, tetracyclines, trimethoprim / sulfamethoxzonel)

Streptococcus pyogenes (group A *)

Streptococcus milleri

Streptococcus mitior

Streptococcus agalactiae

Streptococcus dysgalactiae

Streptococcus anginosus*

Streptococcus constellatus *

Staphylococcus aureus (including strains sensitive to methicillin)

Staphylococcus aureus (including susceptible to methicillin / ofloxacin strains) **

Staphylococcus aureus (strains resistant to methicillin / ofloxacin) *

Staphylococcus cohnii

Staphylococcus epidermidis (including strains sensitive to methicillin)

Staphylococcus epidermidis (including susceptible to methicillin / ofloxacin strains) *

Staphylococcus epidermidis (strains resistant to methicillin / ofloxacin) *

Staphylococcus haemolyticus

Staphylococcus hominis

Staphylococcus saprophyticus

Staphylococcus simulans

Enterococcus faecalis (strains only, sensitivetto vancomycin and gentamicin) *

Gram-negative

Burkholderia cepacia

Haemophilias parainfluenzae (including strains producing and non-producing beta-lactamases) *

Haemophillus influenzae*

Moraxella catarrhal is (including

strains producing and non-producing beta-lactamases) *

Bordetella pertussis

Escherichia coli

Klebsiella pneumonia*

Klebsiella oxytoca

Enterobacter aerogenes

Enterobacter agglomerans

Enterobacter cloacae*

Enterobacter intermedius

Enterobacter sakazaki

Pseudomonas aeruginosa

Pseudomonas fluorescens

Burkholderia cepacia

Stenotrophomonas malto-philia

Proteus mirabilis*

Proteus vulgaris

Pseudomonas aeruginosa

Pseudomonas fluorescens

Morganella morganii

Neisseria gonorrhoeae*

Providencia rettgeri

Providencia stuartii

Anaerobes

Bacteroides distasonis

Bacteroides eggerthii

Bacteroides fragilis*

Bacteroides ovatus

Bacteroides thetaiotaomicron*

Bacteroides uniformis

Fusobacterium spp.

Peptostreptococcus spp.

Porphyromonas spp.

Porphyromonas anaerobius

Porphyromonas asaccharolyticus

Porphyromonas magnus

Prevotella spp.

Propionibacterium spp.

Clostridium perfringens

Clostridium ramosum

Neisseria gonorrhoea

Stenotrophomonas

maltophilia

Atypical

Chlamydia pneumoniae*

Chlamydia trachomatis*

Mycoplasma pneumoniae*

Mycoplasma hominis

Mycoplasma genitalium

Legionella pneumophila*

Coxiella burnetti

* Sensitivity to moxifloxacin is confirmed by clinical data.

** When identifying strains of Staphylococcus containing MesA genes, the use of moxifloxacin is not recommended.

For certain strains, the spread of acquired resistance may vary depending on the geographical region and over time. In this regard, when testing the sensitivity of a strain, it is desirable to have local information on resistance, especially when treating severe infections.

If the patients undergoing treatment in the hospital, the value of AUC /MIC₉₀ exceeds 125, and C_max/ MIC₉₀ is within the range of 8-10, this implies a clinical improvement. In outpatients, the value of these parameters is usually less: AUC /MIC₉₀ >30-40.

Parameter (average)	AUC	C_max/ MIC₉₀
MIC₉₀ 0,125 mg / l	279	23,6
MIC₉₀ 0.25 mg / l	140	11,8
MIC₉₀ 0.5 mg / l	70	5,9

Pharmacokinetics:

Absorption and bioavailability

When taken orally moxifloxacin absorbed quickly and almost completely. Absolute bioavailability is about 91%. The pharmacokinetics of moxifloxacin when administered at a dose of 50 to 1200 mg once, and also at 600 mg / day for 10 days is linear. The equilibrium state is reached within 3 days.

After a single administration of 400 mg of moxifloxacin, the maximum concentration (C_max) in the blood is reached within 0.5-4 hours and is 3.2 mg / l.

When moxifloxacin is taken with food, there is a slight increase in the time to reach C_max (for 2 hours) and a slight decrease in C_max (approximately 16%), while the duration of absorption does not change. However, these data have no clinical significance, and the drug can be used regardless of food intake.

Distribution

Moxifloxacin is rapidly distributed in tissues and organs and binds to blood proteins (mainly albumins) by about 45%. The distribution volume is approximately 2 l / kg.

High concentrations of the drug, exceeding those in the plasma, are created in the lung tissue (including alveolar macrophages), in bronchial mucosa, in nasal sinuses, in exudate from the focus of skin inflammation. In the interstitial fluid and in saliva, the drug is determined in a free, non-protein-binding form at a concentration higher than in the plasma. In addition, high concentrations of the drug are determined in the organs of the abdominal cavity and peritoneal fluid, as well as in the tissues of the female genital organs.

Metabolism

After passing the second phase of biotransformation moxifloxacin is excreted from the body by the kidneys and the gastrointestinal tract (GIT) both in unmodified form and in the form of inactive sulfo compounds and glucuronides. Moxifloxacin does not undergo biotransformation by the microsomal system of cytochrome P450.

Excretion

The half-life of the drug is approximately 12 hours. The average total clearance after taking in a dose of 400 mg is from 179 to 246 ml / min. About 19% of a single dose (400 mg) is excreted unchanged by the kidneys, about 25% by the gastrointestinal tract.

Pharmacokinetics in different patient groups

Age, gender and ethnicity.

Age, sex and ethnic clinically significant differences in the pharmacokinetics of moxifloxacin have not been established.

Children. The pharmacokinetics of moxifloxacin in children have not been studied.

Renal failure. There were no significant changes in the pharmacokinetics of moxifloxacin in patients with impaired renal function (including patients with creatinine clearance <30 mL / min / 1.73 m²) and in those on continuous hemodialysis and long-term outpatient peritoneal dialysis.

Violation of the function of the liver. In patients with minor and moderate impairment of liver function (stage A and B according to the Child-Pugh classification), the pharmacokinetics of moxifloxacin does not change.In patients with severe impairment of liver function (Child-Pugh, Stage C), there is no data on the pharmacokinetics of moxifloxacin.

Indications:

Moxifloxacin Canon is indicated for the treatment in adults of the following infections caused by drug-susceptible microorganisms:

- Acute sinusitis;

- Community-acquired pneumonia, including CAP which pathogens are microbial strains with multiple resistance to antibiotics *;

- Exacerbation of chronic bronchitis;

- Uncomplicated skin and soft tissue infections;

- Complicated infections of the skin and subcutaneous structures (including an infected diabetic foot);

- Complicated intra-abdominal infections, including polymicrobial infections, including intraperitoneal abscesses;

- Uncomplicated inflammatory diseases of the pelvic organs (including salpingitis and endometritis).

* - Streptococcus pneumoniae with multiple resistance to antibiotics, including strains resistant to penicillin and strains resistant to two or more antibiotics from the groups such as the penicillins (minimum inhibitory activity at ≥ 2 mg / ml) 2nd generation cephalosporins (cefuroxime), macrolides, tetracyclines and trimethoprim / sulfamethoxazole.

Contraindications:

- Hypersensitivity to moxifloxacin, other quinolones or any of the components of the drug;

- Age to 18 years;

- Pregnancy and lactation;

- Presence in the anamnesis of diseases of tendons, associated with the intake of quinolones;

- Elongation of the QT interval on a cardiogram (congenital or acquired);

- Disorders of electrolyte metabolism, especially uncompensated hypokalemia;

- Clinically significant bradycardia;

- Clinically significant heart failure with a reduced fraction of ejection from the left ventricle;

- The presence in the history of arrhythmias, accompanied by clinical symptoms;

- Simultaneous use with other drugs that can cause prolongation of the QT interval;

- In the absence of sufficient information moxifloxacin contraindicated in patients with impaired liver function (Child-Pugh, Stage C) and patients with elevated liver transaminases more than 5 times the upper limit of the norm.

Carefully:

- Among women;

- In elderly patients;

- In diseases of the central nervous system (CNS) (incl.diseases suspected of involvement of the central nervous system), predisposing to the occurrence of seizures and reducing the threshold of convulsive activity;

- In patients with potentially proarrhythmic conditions, such as acute myocardial ischemia, especially in women and elderly patients;

- With Myasthenia gravis;

- With cirrhosis of the liver;

- With simultaneous reception with drugs that reduce the concentration of potassium in the blood plasma;

- With deficiency of glucose-6-phosphate dehydrogenase.

Pregnancy and lactation:

Safety of moxifloxacin during pregnancy is not established, therefore the use of the drug Moxifloxacin Canon during pregnancy is contraindicated.

A small amount of moxifloxacin is excreted in breast milk. Data on the use of moxifloxacin in women during lactation are absent, so the use of the drug Moxifloxacin Canon during breastfeeding is contraindicated.

Dosing and Administration:

Inside, not liquid, squeezed enough water, regardless of food intake.

Recommended dosage regimen: one tablet (400 mg) once a day for any of the infections listed above.

Duration of therapy

The duration of treatment is determined by the severity of the infection and the clinical effect. Exacerbation of chronic bronchitis - 5 days.

Community-acquired pneumonia - 7-14 days.

Acute sinusitis - 7 days.

Uncomplicated skin and soft tissue infections - 7 days.

Complicated infections of the skin and subcutaneous structures - the total duration of stepwise therapy with moxifloxacin is 7-21 days.

Complicated intra-abdominal infections - the total duration of the stepwise therapy is 5-14 days.

Uncomplicated inflammatory diseases of the pelvic organs - 14 days.

According to clinical studies, the duration of treatment with moxifloxacin in tablets can reach 21 days.

Older patients: changing the dosing regimen is not required.

Children: efficacy and safety of moxifloxacin in children and adolescents is not established.

Impaired liver function: patients with minor disturbances of liver function do not need to change the dosage regimen.

Renal insufficiency: in patients with impaired renal function (including with severe renal failure with creatinine clearance <30 mL / min / 1.73 m2), as well as in patients,patients on continuous hemodialysis and long-term outpatient peritoneal dialysis, a change in the dosage regimen is not required.

The use of different ethnic groups in patients: changing the dosing regimen is not required.

Side effects:

Data on the side effects of moxifloxacin at a dosage of 400 mg (for oral administration and stepwise therapy) are obtained from clinical studies and post-marketing reports.

Classification of WHO frequency of development of side effects:

very often - ≥ 1/10 of appointments (> 10%)

often from ≥1 / 100 to <1/10 of appointments (> 1% and <10%)

infrequently - from ≥ 1/1000 to <1/100 of prescriptions (> 0.1% and <1%)

rarely from ≥ 1/10000 to <1/1000 appointments (> 0.01% and <0.1%)

very rarely - from <1/10000 appointments (<0.01%), including individual messages.

Allergic reactions

Infrequent - hives, itching, rash, eosinophilia; rarely anaphylactic / anaphylactoid reactions, angioedema, including laryngeal edema (potentially life-threatening); very rarely - anaphylactic shock (including life-threatening).

Disorders of the psyche

Infrequently - a sense of anxiety, psychomotor activity, agitation; rarely - emotional lability, depression (in very rare cases, behavior with a tendency to self-injury,such as suicidal thoughts or suicidal attempts), hallucinations; very rarely - depersonalization, psychotic reactions (potentially manifested in behavior with a tendency to self-harm, such as suicidal thoughts or suicidal attempts).

Disturbances from the nervous system

Often - dizziness, headache; rarely - peripheral sensory or sensorimotor neuropathy; infrequently - confusion, disorientation, vertigo, drowsiness, tremor, paresthesia / dysesthesia, sleep disorders, taste disorders; rarely - hypodesis, pathological dreams, impaired coordination (including gait disturbance due to dizziness, very rarely leading to trauma from falling, especially in elderly patients), seizures with various clinical manifestations (including "grand mal" seizures), disorders attention, speech disorder, amnesia, impaired sense of smell, including anosmia; very rarely - hyperesthesia, loss of taste sensitivity.

Disturbances on the part of the organ of sight

Infrequent - vision disorders - blurred vision, decreased visual acuity, diplopia, especially in combination with dizziness and confusion; very rarely - transient loss of vision (especially against the background of reactions from the central nervous system).

Hearing disorders and labyrinthine disorders

Rarely, noise in the ears, hearing impairment up to deafness (usually reversible).

Heart Disease

Elongation of the QT interval (often in patients with concomitant hypokalemia, infrequently in the remaining patients); infrequent - a feeling of palpitation, tachycardia, vasodilation; rarely - lowering blood pressure, increasing blood pressure, fainting, ventricular tachyarrhythmias; very rarely - nonspecific arrhythmias (polymorphic ventricular tachycardia (Torsade de Pointes), cardiac arrest (mainly in persons with predisposing to arrhythmias, such as clinically significant bradycardia, acute myocardial ischemia).

Disturbances from the respiratory system, chest and mediastinal organs

Infrequent - shortness of breath (including asthmatic condition).

Disorders from the gastrointestinal tract

Often - nausea, vomiting, abdominal pain, diarrhea, transient increase in transaminase activity; infrequently - anorexia, constipation, indigestion, flatulence, gastroenteritis (except erosive gastroenteritis); rarely - dysphagia, stomatitis, pseudomembranous colitis (in very rare cases associated with life-threatening complications).

Disturbances from the liver and bile ducts

Infrequent - increased concentrations of amylase, bilirubin, impaired liver function (including increased lactate dehydrogenase concentration), increased concentration of γ-glutamyltransferase and alkaline phosphatase; rarely - jaundice, hepatitis (mostly cholestatic); very rarely - fulminant hepatitis, potentially leading to life-threatening liver failure.

Disturbances from the skin and subcutaneous tissues

Very rarely - bullous skin reactions, for example, Stevens-Johnson syndrome or toxic epidermal necrolysis (potentially life-threatening).

Disturbances from musculoskeletal and connective tissue

Infrequent - arthralgia, myalgia; rarely - tendonitis, increased muscle tone and cramps, muscle weakness; very rarely - increased symptoms of myasthenia gravis, tendon ruptures, arthritis, gait disorders due to damage to the musculoskeletal system.

Disorders from the kidneys and urinary tract

Rarely, renal dysfunction, renal failure (as a result of dehydration, which can lead to kidney damage, especially in elderly patients with concomitant renal dysfunction).

Violations of the genitals and mammary gland

Often - candidal superinfection, vaginitis; infrequently - dehydration (caused by diarrhea or decreased fluid intake).

General disorders and disorders at the site of administration

Infrequent - general malaise (including symptoms of poor health, nonspecific pain and sweating); rarely - swelling.

Laboratory and instrumental data

Infrequent anemia, leukopenia (including neutropenia), thrombocytopenia, thrombocytosis, prolongation of prothrombin time and an increase in the international normalized ratio (INR); rarely - change in the concentration of thromboplastin; very rarely - an increase in the concentration of prothrombin and a decrease in INR, a change in the concentration of prothrombin, hyperlipidemia, hyperglycemia, hyperuricemia.

Overdose:There are limited data on the overdose of moxifloxacin. In case of an overdose, one should be guided by the clinical picture and carry out symptomatic maintenance therapy with ECG monitoring. Acceptance of activated carbon at an early stage of absorption prevents further systemic exposure of moxifloxacin, which should be considered in the event of an overdose of the drug.

Interaction:

Correction of the dose is not required when combined with atenolol, ranitidine, calcium-containing additives, theophylline, oral contraceptives, glibenclamide, itraconazole, digoxin, morphine, probenicide (no clinically significant interaction with moxifloxacin was confirmed). Antacids, sucralfate. multivitamins and other preparations containing salts of magnesium, aluminum, iron and zinc

The use of moxifloxacin concomitantly with antacids, multivitamins and minerals can lead to impaired absorption of moxifloxacin after ingestion due to the formation of chelate complexes with polyvalent cations contained in these preparations. As a result, the concentration of moxifloxacin in plasma can be significantly lower than desired. Consequently, antacids, antiretroviral drugs (eg, didanosine) and other preparations containing magnesium or aluminum, sucralfate and other preparations containing iron or zinc, should be prescribed at least 4 hours before or 4 hours after taking moxifloxacin inside.

Warfarin

When combined with warfarin prothrombin time and other parameters of blood coagulation do not change.

Changing the MHO value. In patients who received anticoagulants in combination with antibiotics, including moxifloxacin, there are cases of increased anticoagulant activity of anticoagulants. Risk factors are the presence of an infectious disease (and concomitant inflammatory process), the age and general condition of the patient. Despite the fact that the interaction between moxifloxacin and warfarin is not detected, in patients receiving concomitant treatment with these drugs, it is necessary to monitor the INR and, if necessary, adjust the dose of oral anticoagulants.

Digoxin

Moxifloxacin and digoxin do not significantly affect the pharmacokinetic parameters of each other. With the appointment of repeated doses of moxifloxacin, the maximum digoxin concentration increased by approximately 30%, while the values of the area under the concentration-time curve (AUC) and the minimum digoxin concentration did not change.

Drugs that extend the QT interval

Potential interactions of moxifloxacin, resulting in the risk of developing an additive effect, to an increase in the QT interval: with drugs that extend the QT interval (including antiarrhythmic drugs of class IA, III, tricyclic and tetracyclic antidepressants, neuroleptics, macrolides, antimicrobials, derivatives imidazole, cisapride).

Activated carbon

With the simultaneous use of activated carbon and moxifloxacin inside at a dose of 400 mg, the systemic bioavailability of the drug is reduced by more than 80% as a result of inhibition of its absorption. In the case of an overdose, the use of activated carbon at an early stage of absorption inhibits further increase in systemic exposure.

Food and Dairy Products

Absorption of moxifloxacin does not change with simultaneous intake of food (including dairy products). Moxifloxacin can be taken regardless of food intake.

Special instructions:

In some cases, after the first use of the drug may develop hypersensitivity and allergic reactions, which should immediately inform the doctor. Very rarely, even after the first use of the drug, anaphylactic reactions can progress to a life-threatening anaphylactic shock.In these cases, treatment with moxifloxacin should be discontinued and necessary medical measures (including anti-shock) should be carried out.

When moxifloxacin is used, prolongation of the QT interval may be noted in some patients. When analyzing the ECG, obtained during clinical trials, the QT interval was +/- 6 msec, 1.4% compared to the initial one. Since women have a longer QT interval than men, they may be more sensitive to drugs that extend the QT interval. Elderly patients are also more prone to drugs that affect the QT interval. The degree of elongation of the QT interval may increase with increasing drug concentration, therefore, do not exceed the recommended dose. However, in patients with pneumonia, there was no correlation between the concentration of moxifloxacin in the blood plasma and the prolongation of the QT interval. The prolongation of the QT interval is associated with an increased risk of ventricular arrhythmias, including polymorphic ventricular tachycardia. None of the 9,000 patients who received moxifloxacin, there were no cardiovascular complications and lethal cases associated with prolongation of the QT interval.However, in patients with predisposing arrhythmias, the risk of developing ventricular arrhythmias may increase with moxifloxacin. Concerning moxifloxacin can not be administered to patients with established QT interval elongation, patients with unadjusted hypokalemia, and also to patients who receive antiarrhythmic drugs IA (quinidine, procainamide) or class III (amiodarone, sotalol, ibutilide).

Because of the risk of developing an additive effect on the QT interval moxifloxacin It should not be administered simultaneously with drugs that extend the QT interval (cisapride, erythromycin, antipsychotics, tricyclic antidepressants), patients with arrhythmia predisposing states such as clinically significant bradycardia, acute myocardial ischemia, and those patients with cirrhosis who can not rule out the risk of developing QT interval prolongation, especially for women and elderly patients how these categories of patients are more sensitive to drugs that extend the QT interval).

When moxifloxacin was taken, cases of fulminant hepatitis, potentially leading to liver failure (including fatal cases), were reported.The patient should be informed that if symptoms of hepatic insufficiency occur, the doctor should be consulted before continuing with moxifloxacin.

Reported cases of bullous skin lesions (Stevens-Johnson syndrome, toxic epidermal necrolysis). The patient should be informed that in case of symptoms of skin or mucous membrane damage, the doctor should be consulted before continuing with moxifloxacin therapy. The use of drugs quinolone series is associated with a possible risk of seizures. Moxifloxacin should be used with caution in patients with CNS diseases and in conditions suspicious of CNS involvement predisposing to the occurrence of seizures or reducing the threshold of seizure activity.

Against the background of therapy with fluoroquinolones, including moxifloxacin, especially in elderly patients receiving glucocorticosteroids, tendonitis and tendon rupture may develop. At the first symptoms of pain or inflammation at the site of damage, taking the drug should stop and unload the affected limb.

The use of broad-spectrum antibacterial drugs, including moxifloxacin, is associated with a risk of developing antibiotic-associated colitis (including pseudomembranous colitis). This diagnosis should be kept in mind in patients who have severe diarrhea with moxifloxacin. In this case, immediate therapy should be prescribed. Preparations that inhibit the intestinal peristalsis are contraindicated in the development of severe diarrhea. Moxifloxacin should be used with caution in patients with myasthenia gravis due to possible exacerbation of the disease.

When applying quinolones, photosensitivity reactions are noted. However, during pre-clinical, clinical trials, as well as with the use of moxifloxacin, no photosensitivity reactions were observed in practice. Nevertheless, patients receiving moxifloxacin, should avoid direct sunlight and ultraviolet irradiation.

The use of the drug is not recommended in patients with complicated inflammatory diseases of the pelvic organs (for example, associated with tubo-ovarian or pelvic abscesses).

Effect on the ability to drive transp. cf.and fur:Fluoroquinolones, including Moxifloxacin Canon, may impair the ability of patients to drive vehicles and engage in other potentially hazardous activities requiring increased attention and speed of psychomotor reactions, due to influence on the central nervous system.

Form release / dosage:

Tablets, film-coated, 400 mg.

Packaging:

For 5, 7 or 10 tablets in a contour mesh box made of polyvinylchloride film and aluminum foil printed lacquered.

By 1, 3, 6 contour cell packs of 5 or 10 tablets or 1, 2, 4. contour cell packs of 7 tablets together with instructions for use are placed in a pack of cardboard.

Storage conditions:

At a temperature of no higher than 25 ° C in the manufacturer's packaging.

Keep out of the reach of children.

Shelf life:3 years. Do not use after the expiration date.

Terms of leave from pharmacies:On prescription

Registration number:LP-002193

Date of registration:22.08.2013 / 16.03.2018

Expiration Date:22.08.2018

The owner of the registration certificate:CANONFARMA PRODUCTION, CJSC CANONFARMA PRODUCTION, CJSC Russia

Manufacturer: & nbsp

CANONFARMA PRODUCTION, CJSC Russia

Information update date: & nbsp12.06.2018

Illustrated instructions

Instructions

Moxifloxacin Canon (Moxifloxacine Canon)