How does this medication work? What will it do for me?
Norfloxacin is an antibiotic that belongs to the class of medications called quinolones. It is used to treat infections caused by certain types of bacteria. It is most commonly used to treat urinary tract (bladder) infections. Norfloxacin works by killing some types of bacteria that can cause these infections.
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 taking this medication, speak to your doctor. Do not stop taking 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 take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each white, oval, biconvex, film-coated tablet, scored and engraved "APO 400" on one side and plain on the other, contains norfloxacin 400 mg. Nonmedicinal ingredients: crospovidone, magnesium stearate, colloidal silicon dioxide, hydroxypropyl cellulose, hydroxypropyl methylcellulose, polyethylene glycol, and titanium dioxide.
How should I use this medication?
The usual recommended adult dose is 400 mg twice daily, taken with a glass of water at least one hour before or 2 hours after a meal or milk. You should drink plenty of liquids (water or juice) every day unless your doctor has told you otherwise. Norfloxacin should not be taken within 2 hours of taking iron, zinc supplements, or multivitamins containing them. The dose of norfloxacin can vary depending on the circumstances and the condition being treated.
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 one above, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. Finish all this medication, even if you have started to feel better. If you miss a dose, take it as soon as possible and continue on with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue on with your regular dosing schedule. Do not take 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, protect it from light and moisture, 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 take norfloxacin if you are allergic to norfloxacin, other quinolones (e.g., ciprofloxacin, nalidixic acid), or any other ingredients of the medication.
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 takes 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 taking 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.
- diarrhea (mild)
- dizziness or lightheadedness
- increased skin sensitivity to the sun
- loss of appetite
- trouble sleeping
Check with your doctor as soon as possible if any of the following side effects occur:
- blistering of skin
- increasing muscle weakness
- joint or muscle pain
- mood changes such as anxiety or depression
- pain, swelling, or rupture of a tendon
- sensation of skin burning
- skin itching, rash, redness, or swelling
- symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
- symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heart beat, weakness)
- vision changes
Stop taking the medication and seek immediate medical attention if any of the following occur:
- diarrhea (watery and severe or bloody)
- signs of a serious allergic reaction (swelling of face or throat, hives, or difficulty breathing)
- signs of a severe skin reaction (e.g., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)
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.
HEALTH CANADA ADVISORY
January 23, 2017
Health Canada has issued new restrictions concerning the use of norfloxacin. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Blood sugar levels: Norfloxacin may cause a loss of control of blood sugar levels and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication. People without diabetes have also been known to experience high or low blood sugars while taking norfloxacin.
If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience signs of high blood sugar (fruity breath odour, weight loss, increased thirst, or increased need to urinate) or low blood sugar (cold sweat, cool pale skin, headache, or weakness) contact your doctor.
Diarrhea: People taking this medication may develop diarrhea caused by an infection with the bacteria C. difficile. If you have loose, watery and bloody bowel movements, with or without fever or stomach cramps, after taking norfloxacin, get medical attention as soon as possible. Diarrhea caused by C. difficile infection can lead to serious health problems if it is not properly treated.
Kidney: Norfloxacin is passed from the body mostly by the kidney. If you have reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Neuromuscular disorders: Norfloxacin may cause increased muscle weakness for people with myasthenia gravis (an autoimmune disorder that causes muscle weakness). If you have myasthenia gravis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Seizures: Rarely, seizures have been reported with this medication. If you have a history of epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you have a seizure while taking this medication, stop taking it and get immediate medical attention.
Sunburn: People who take norfloxacin are more likely to suffer from sunburn. Avoid exposure to excessive sunlight, including sunlamps and tanning beds, and use sunblock with minimum SPF 15. Stop taking the medication if sun sensitivity occurs.
Tendons: Rarely, people taking norfloxacin have experienced tendonitis and/or tendon rupture, especially if they were also taking corticosteroids. If you experience any joint or tendon pain or swelling, contact your doctor as soon as possible.
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: Norfloxacin may pass 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 under 16 years of age.
What other drugs could interact with this medication?
There may be an interaction between norfloxacin and any of the following:
- antacids containing aluminum, calcium or magnesium (do not take within 2 hours of norfloxacin)
- antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- calcium supplements and multivitamins containing calcium (do not take within 2 hours of norfloxacin)
- corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
- diabetes medications (e.g., chlorpropamide, glipizide, glyburide, insulin, metformin, nateglinide, rosiglitazone)
- didanosine (do not take within 2 hours of norfloxacin)
- iron supplements, such as ferrous sulfate, or multivitamins containing iron (do not take within 2 hours of norfloxacin)
- macrolide antibiotics (e.g., clarithromycin, erythromycin)
- multivitamins with minerals
- nonsteroidal anti-inflammatory medications (e.g., diclofenac, ibuprofen, ketoprofen, naproxen)
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
- serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
- sodium picosulfate
- sucralfate (do not take within 2 hours of norfloxacin)
- typhoid vaccine
- zinc supplements or multivitamins containing zinc (do not take within 2 hours of norfloxacin)
If you are taking any of these medications, speak with your doctor or pharmacist. 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.
Medications other than those listed above may 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.