Moxifloxacin
Pronunciation: (mox-ee-FLOX-a-sin).
- Generic name
- Moxifloxacin
- Brand names
- Moxicip, Moxigram, Moxeza, Moxiford, Avelox, Vigamox
- Drug class
- Antibiotic (Fluoroquinolone)
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What Moxifloxacin is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Moxifloxacin works
Moxifloxacin is a fourth-generation fluoroquinolone antibiotic that inhibits bacterial DNA gyrase and topoisomerase IV, enzymes essential for DNA replication, transcription, repair, and recombination. This leads to rapid bacterial cell death. It is bactericidal against a broad spectrum of Gram-positive, Gram-negative, and atypical bacteria. (1)
What Moxifloxacin is used for
Acute bacterial sinusitis — reserved for patients who have no alternative treatment options, because of the serious risks of fluoroquinolone antibiotics.
Acute bacterial sinusitis — reserved for patients who have no alternative treatment options, because of the serious risks of fluoroquinolone antibiotics. (2)
Acute bacterial exacerbation of chronic bronchitis — also reserved for patients with no alternative treatment options.
Acute bacterial exacerbation of chronic bronchitis — also reserved for patients with no alternative treatment options. (2)
Community-acquired pneumonia.
Community-acquired pneumonia. (2)
Uncomplicated and complicated skin/skin-structure infections.
Uncomplicated and complicated skin/skin-structure infections. (2)
Complicated intra-abdominal infections.
Moxifloxacin is NOT approved or effective for urinary tract infections, unlike several other fluoroquinolones, because it reaches low concentrations in urine. (2)
Certain bacterial eye infections (ophthalmic/eye-drop form only) — a separate, topical use from the oral/IV indications above.
Certain bacterial eye infections (ophthalmic/eye-drop form only) — a separate, topical use from the oral/IV indications above. (2)
Before taking Moxifloxacin
Do not take / not appropriate for
- Contraindicated in patients with hypersensitivity to moxifloxacin or other quinolones, history of tendon disorders related to quinolone use, and known QT prolongation. (Contraindication) (2)
Tell your clinician about
(2)How to take Moxifloxacin
- General Instructions: Take moxifloxacin exactly as prescribed by your healthcare provider. Do not skip doses or stop early, even if you feel better.. Adult Dosing: 400 mg once daily (oral or IV); duration depends on the infection — 10 days for acute bacterial sinusitis, 5 days for acute bronchitis flare-ups, 7-14 days for community-acquired pneumonia, 7 days for uncomplicated skin infections, 7-21 days for complicated skin infections, and 5-14 days for complicated intra-abdominal infections.. Pediatric Dosing: Safety and effectiveness in children under 18 years have not been established for systemic (oral/IV) use. Ophthalmic use may be considered for certain eye infections.. Administration: Take tablets with or without food, at least 4 hours before or 8 hours after antacids or mineral supplements. Swallow whole with water. For the intravenous form, administration is by a healthcare professional as a 60-minute infusion. For eye drops, follow the instructions for instillation.. When To Stop: Complete the full course unless your doctor tells you otherwise. Seek medical advice immediately if you develop tendon pain, nerve symptoms, mood/mental changes, an allergic reaction, or severe diarrhea; let the clinician you see advise on whether to continue or stop moxifloxacin.. Storage: Store tablets at room temperature, away from moisture and heat. Store eye drops as directed on the packaging. Keep out of reach of children.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not take an extra dose to make up for the one you missed.
Overdose
In case of overdose, seek emergency medical attention or contact a poison control center immediately. Symptoms may include confusion, dizziness, seizures, or irregular heartbeat. Supportive care is the mainstay of treatment. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Nausea
Incidence: Common (about 6.9%)
Diarrhea
Incidence: Common (about 6.0%)
Headache
Incidence: Common (about 4.2%)
Dizziness
Incidence: Common (about 3.0%)
Tendon pain, swelling, or weakness (possible tendinitis or tendon rupture)
Incidence: Uncommon but can be serious; higher risk over age 60 or with corticosteroid use
Numbness, tingling, burning pain, or weakness in the arms, hands, legs, or feet (possible peripheral neuropathy)
Incidence: Rare but can be permanent
New confusion, agitation, hallucinations, seizures, or thoughts of self-harm
Incidence: Rare but serious
Severe or persistent diarrhea, which could signal C. difficile infection
Incidence: Uncommon
Sudden, severe, constant pain in the stomach, chest, or back (possible aortic aneurysm/dissection)
Incidence: Rare — this is a medical emergency
Hives, swelling, or difficulty breathing (possible anaphylaxis)
Incidence: Rare
Serious warnings
BOXED WARNING — serious
Symptoms: BOXED WARNING: fluoroquinolone antibiotics, including moxifloxacin, are associated with disabling and potentially irreversible serious reactions that can occur together in the same person: (1) tendinitis and tendon rupture, at any age — most often the Achilles tendon, but also the shoulder, hand, biceps, thumb, or other tendons; onset can range from hours after the first dose to months after finishing treatment; risk is higher over age 60, with corticosteroid use, and in kidney/heart/lung transplant recipients; (2) peripheral neuropathy — nerve damage causing pain, burning, tingling, numbness, weakness, or altered sensation, which can be permanent; (3) central nervous system effects — seizures, increased pressure around the brain, psychosis, and reactions such as agitation, insomnia, anxiety, confusion, tremors, hallucinations, depression, or suicidal thoughts. Seek medical advice immediately if any of these symptoms develop; let the clinician you see advise on whether to continue or stop moxifloxacin.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
SEPARATE BOXED WARNING — serious
Symptoms: SEPARATE BOXED WARNING: fluoroquinolones, including moxifloxacin, may worsen muscle weakness in people with myasthenia gravis; moxifloxacin is avoided in anyone with a known history of myasthenia gravis.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Because of these risks, and because acute bacterial sinusitis and acute bronchitis flares are often self-limiting, moxifloxacin is reserved for those two indications only in patients who have no alternative treatment options — serious
Symptoms: Because of these risks, and because acute bacterial sinusitis and acute bronchitis flares are often self-limiting, moxifloxacin is reserved for those two indications only in patients who have no alternative treatment options.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Can prolong the QT interval and increase the risk of serious heart rhythm disturbances — serious
Symptoms: Can prolong the QT interval and increase the risk of serious heart rhythm disturbances; avoided with a known prolonged QT interval, uncorrected low potassium, or certain antiarrhythmic medicines. May cause severe allergic reactions, including anaphylaxis, sometimes after just the first dose. Risk of Clostridioides difficile-associated diarrhea, which can occur during treatment or up to months afterward. Rare risk of liver injury (hepatitis, jaundice, or acute liver failure). Can increase sun sensitivity (photosensitivity). May increase the risk of aortic aneurysm or aortic dissection, particularly in older adults or those with a history of aneurysm, hardened arteries, high blood pressure, or a connective-tissue condition such as Marfan or Ehlers-Danlos syndrome — seek immediate medical attention for sudden, severe, constant pain in the stomach, chest, or back. Can alter blood sugar levels, including severe low blood sugar, especially in people with diabetes taking insulin or an oral antidiabetic medicine.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications on the current FDA label — serious
Symptoms: Contraindications on the current FDA label: known hypersensitivity to moxifloxacin or other quinolone antibiotics. Precautions recorded in the clinician database: extra caution with a history of tendon disorders related to quinolone use, known QT prolongation, cardiac disease, electrolyte disturbances, CNS disorders (seizure risk), or hepatic impairment.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Antacids, sucralfate, and supplements containing magnesium, aluminum, iron, or zinc, and didanosine (ddI) | Reduce moxifloxacin absorption. Take moxifloxacin at least 4 hours before, or 8 hours after, these products. | (2) |
| Class IA or Class III antiarrhythmic medicines (e.g., quinidine, procainamide, amiodarone, sotalol), and other QT-prolonging medicines (some antipsychotics, some tricyclic antidepressants) | Additive risk of QT-interval prolongation and serious heart rhythm disturbances. | (2) |
| NSAIDs (e.g., ibuprofen, naproxen) | May increase the risk of central nervous system stimulation and seizures when combined with a fluoroquinolone. | (2) |
| Warfarin | May enhance the anticoagulant effect; prothrombin time/INR is monitored and any signs of bleeding are reported to the prescriber. | (2) |
| Insulin or oral antidiabetic medicines (e.g., glyburide) | Moxifloxacin can alter blood glucose control, including causing low blood sugar; blood glucose is monitored closely when used together. | (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Historic FDA Pregnancy Category C. Moxifloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies showed decreased fetal body weight and delayed skeletal development at high doses, but no teratogenic (birth-defect-causing) effects. (2)
Breastfeeding
Moxifloxacin may pass into human breast milk. The decision to continue breastfeeding or continue the medicine is made together with the prescriber, weighing the infant's potential exposure against the benefit of treatment. (2)
Children
Safety and effectiveness of oral/IV (systemic) moxifloxacin have not been established in patients under 18 years old; moxifloxacin has been shown to cause joint/cartilage damage (arthropathy) in juvenile animals, which is the basis for this restriction. The ophthalmic (eye drop) form may be considered for certain eye infections under a clinician's guidance. (2)
Renal_impairment
No renal or hepatic dose adjustment is specified on the current label; extra caution and clinical judgment are used in people with hepatic impairment because of the rare risk of liver injury associated with this medicine. (2)
Hepatic_impairment
No renal or hepatic dose adjustment is specified on the current label; extra caution and clinical judgment are used in people with hepatic impairment because of the rare risk of liver injury associated with this medicine. (2)
Monitoring
(2)Storage
Store tablets at room temperature (about 20-25 degC / 68-77 degF), away from moisture and heat. Store eye drops as directed on the packaging. Keep out of reach of children.
Study the drug class: Fluoroquinolones
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General (US label)
Indication: Sinusitis / bronchitis flare / pneumonia / skin infections / intra-abdominal infections
Dose summary: 400 mg once daily (oral or IV), with duration set by indication: sinusitis 10 days; bronchitis flare 5 days; pneumonia 7-14 days; uncomplicated skin infection 7 days; complicated skin infection 7-21 days; complicated intra-abdominal infection 5-14 days.
Renal context: No renal or hepatic dose adjustment is specified on the current label. (1) (2)
Frequently asked questions
What infections does moxifloxacin treat?
Moxifloxacin is FDA-approved to treat acute bacterial sinusitis and acute bronchitis flare-ups (both reserved for patients with no alternative treatment options), community-acquired pneumonia, skin and soft tissue infections, complicated intra-abdominal infections, and certain eye infections (eye-drop form). It is not effective against viral infections, and it is not approved for urinary tract infections.
How quickly does moxifloxacin work?
Most people start to feel better within a few days of starting moxifloxacin, but it is important to complete the full course as prescribed.
Can I drink alcohol while taking moxifloxacin?
There are no direct interactions between moxifloxacin and alcohol, but it is best to avoid excessive alcohol as it may worsen side effects like dizziness.
Is moxifloxacin safe in pregnancy or breastfeeding?
Moxifloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus; animal studies showed reduced fetal weight and delayed skeletal development at high doses, without birth defects. It may also pass into breast milk. Consult your doctor to weigh the risks and benefits for your situation.
What should I do if I develop tendon pain while taking moxifloxacin?
Seek medical advice immediately if you experience tendon pain, swelling, or weakness — this is one of the boxed-warning risks of moxifloxacin. Let the clinician you see advise on whether to continue or stop the medicine and rest the affected area in the meantime.
Can children take moxifloxacin?
Systemic use of moxifloxacin is not recommended in children under 18 years due to the risk of joint and tendon problems. Ophthalmic use may be permitted for certain eye infections.
What should I avoid while using moxifloxacin eye drops?
Avoid wearing contact lenses during treatment for an eye infection and do not touch the dropper tip to any surface to prevent contamination.
What happens if I take too much Moxifloxacin?
Taking too much Moxifloxacin can lead to severe side effects such as central nervous system disturbances (e.g., seizures), kidney problems, and cardiac arrhythmias. If an overdose is suspected, it is crucial to seek immediate emergency medical attention. Do not attempt to induce vomiting or self-treat. Prompt professional intervention is necessary to manage potential complications.
Is Moxifloxacin safe during pregnancy?
Moxifloxacin is generally not recommended during pregnancy unless the potential benefits outweigh the risks. It falls under Pregnancy Category C, meaning animal studies have shown an adverse effect on the fetus, but there are no adequate and well-controlled studies in humans. Always consult your doctor if you are pregnant or planning to become pregnant to discuss the safest treatment options for your specific condition.
What is the mechanism of action of Moxifloxacin?
Moxifloxacin is a fourth-generation fluoroquinolone antibiotic that inhibits bacterial DNA gyrase and topoisomerase IV, enzymes essential for DNA replication, transcription, repair, and recombination. This leads to rapid bacterial cell death. It is bactericidal against a broad spectrum of Gram-positive, Gram-negative, and atypical bacteria. (1)
What is the generic name of Moxifloxacin?
The generic name is Moxifloxacin. It is sold under brand names including Moxicip, Moxigram, Moxeza, Moxiford, Avelox, Vigamox.
What class of drug is Moxifloxacin?
Moxifloxacin is classed as: Antibiotic (Fluoroquinolone).
References
- Moxifloxacin clinician-authored medicine recordMedGuideGlobal · Global · accessed 2026-08-06 · source 1
- AVELOX (moxifloxacin hydrochloride) tablet — prescribing informationU.S. Food and Drug Administration · United States · accessed 2026-08-06 · source 2
- MOXIFLOXACIN SOLUTION/ DROPS [A-S MEDICATION SOLUTIONS] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Moxifloxacin — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- MOXIFLOXACIN HYDROCHLORIDE — FDA approval record (Drugs@FDA ANDA202632)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- Moxifloxacin — RxNorm normalized drug concept (RXCUI 139462)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient Moxifloxacin names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- VIGAMOX5 mg/mL · harrow eye, llc
Canada
- AVELOX
- AVELOX I.V.
- VIGAMOX