Description and Composition of Zarlox 

Zarlox is a fluoroquinolone antibiotic which contains levofloxacin hemihydrate as its active pharmaceutical ingredient and other excipients or inactive pharmaceutical ingredients. Excipients used in drugs formulation vary across brands and these are what usually differentiate a particular brand from the other.

Pharmacology and Mechanism of Action of Zarlox

Zarlox is a broad-spectrum antibiotic active against both Gram positive and Gram-negative bacteria. It functions by inhibiting DNA gyrase, a type II topoisomerase, and topoisomerase IV, enzymes necessary to separate bacterial DNA, thereby inhibiting cell division.

Pharmacokinetics of Zarlox

Zarlox oral tablet is rapidly and well absorbed from the gastrointestinal tract after oral administration. The absolute bioavailability is approximately 99% with no substantial loss by first pass metabolism. The peak serum time is between 1 to 2 hours.

Indications and Uses of Zarlox

Antibiotics usage including zarlox should be guided by Microscopy, Culture and Sensitivity test result or standard treatment guidelines of a particular country or region where MCS test is not possible. Zarlox is used in the treatment of susceptible bacterial infections including:

• Acute bacterial sinusitis
• Acute bacterial exacerbations of chronic bronchitis
• Urinary tract infections
• Bacterial Gastroenteritis
• Typhoid
• Bone and soft tissue infections
• Gynaecological and wound infections
• Respiratory infections (nosocomial or Community acquired pneumonia)
• Acute pyelonephritis
• Chronic bacterial prostatitis
• Gram negative septicaemia
• Meningitis Prophylaxis and Conjunctivitis
• Skin and skin structure infections

Contraindications of Zarlox

Zarlox is contraindicated in persons with a history of hypersensitivity to zarlox, any member of the quinolone class of antimicrobial agents, or any of the product components.

Dosage of Zarlox

Zarlox should be administered as per the directions given by the physician. Zarlox tablet should be swallowed without crushing and with sufficient amount of liquid. The tablets can be taken with or without food.

Acute bacterial sinusitis

Adult: 500mg daily for 10 to 14 or 750mg daily for 5 days.

Acute bacterial exacerbation of chronic bronchitis

Adult: 500 mg daily for 5 days

Urinary tract infections

Complicated or acute pyelonephritis: 750 mg daily for 5 days Uncomplicated: 250 mg daily for 10 days Uncomplicated: 250 mg daily for 3 days

Nosocomial pneumonia

750 mg daily for 7 to 10 days

Community acquired pneumonia

750 mg daily for 5 days 500 mg daily 7 to 10 days

Skin and skin structure infections

Complicated: 750 mg daily for 7 to 10 days Uncomplicated: 500 mg daily for 7 to 10 days

Chronic bacterial prostatitis

500 mg daily for a month (28 days)

Plague

Adult and Children weighing 50 kg and above: 500 mg daily for 10 to 14 days Children: (30 kg to 50 kg): 250 mg 12 hourly for 10 to 14 days

Post exposure therapy for inhalational anthrax

Adult and Children weighing up to 50 kg: 500 mg daily for 2 months (60 days) Paediatric patients: 30 kg to 50 kg: 250 mg 12 hourly for 60 days

Acne vulgaris (Off label)

100 mg PO tds for a month (28 days)

Epididymitis (off label)

500 mg PO daily for 10 days

Overdosage of Zarlox

In the event of acute overdosage of zarlox, reversible renal toxicity has been reported in some cases. The stomach should be emptied by inducing vomiting or by gastric lavage. The patient should be carefully observed and given supportive treatment, including monitoring of renal function, urinary pH and acidify, if required, to prevent crystalluria and administration of magnesium, aluminum, or calcium containing antacids, which can reduce the absorption of zarlox. Adequate hydration must be maintained.

Side Effects of Zarlox

Some side effects associated with the use of Zarlox may include:

• Nausea
• Vomiting
• Headache
• Diarrhoea or constipation
• Stomach upset
• Dizziness
• Insomnia

Drug Interactions with Zarlox

Zarlox is known to interact with other drugs and should not be co-administered or caution observed when doing so. Some are entirely contraindicated (C), have serious interaction, and minor. This list is not exhaustive and you’re advised to confirm with your Pharmacist or doctor for a comprehensive list.

• BCG vaccine live,
• Typhoid vaccine live
• Strontium ranelate
• Aluminium hydroxide
• Cholera vaccine
• Caffeine
• Chloramphenicol
• Clozapine
• Cyclosporin A
• Multivitamins with minerals
• Pentostatin,
• Phenytoin Na
• Probenecid
• Rifampicin
• Sucralfate
• Theophylline
• Warfarin Na.

Zarlox Disease Interactions

Zarlox interacts with the following disease conditions

• Diabetes
• CNS disorders
• Colitis
• Myasthenia gravis
• Peripheral neuropathy
• Renal dysfunction
• Tendonitis
• Hemodialysis
• QT interval prolongation
• Crystalluria

Use of Zarlox in Pregnancy and Lactation

Zarlox is in Pregnancy category C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well controlled studies in humans but potential benefits may warrant use of the drug in pregnant women despite potential risks. Lactation Studies in breastfeeding mothers have demonstrated that there is significant and documented risk to the infant based on human experience. The drug is contraindicated in breastfeeding mothers

Storage of Zarlox

Zarlox tablets, injection, and other dosage forms available should be stored  below 30°C in a cool & dry place. Keep all medicines out of reach of children.