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Subject:
From:
Kris Rogers <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 7 May 2002 12:41:22 -0500
Content-Type:
text/plain
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Lisa,
    This is from 2002 Hale, Medications and Mother's Milk:
    Avelox (Moxifloxacin) is a new broad spectrum fluoroquinolone antibiotic similar to ciprofloxacin and others.  Fluoroquinolone antibiotics are generally contraindicated in pediatric age patients due to arthropathy, although they are occasionally used in severe infections.  No studies in breastfeeding mothers are available.  In rodents, milk levels were 25 - 40% of maternal plasma levels.  The average adult human concentration over 24 hours is approximately 2 micrograms/mL.  Assuming a low milk/plasma ratio like in rodents (0.4), an infant would likely ingest less than 120 micrograms/kg/day (theoretical).  It is not likely that this would produce a clinical effect in an infant, but changes in colonic flora could occur.  
    Pregnancy Risk Category: C
    Lactation Risk Category: L3
    Adult concerns: Asthenia, moniliasis, pain, malaise, abdominal pain, cardiac palpitations, vasodilation, tachycardia, hypertension, insomnia, nervousness, confusion, dry mouth, constipation, stomatitis, arthralgia, myalgia, etc. have been reported.
    Pediatric concerns: None via milk but observe for diarrhea in infant.
    Drug Interactions: Antacids, sucralfate, metal cations, and multivitamins may reduce absorption.  No clinical interactions have been noted between moxifloxacin and warfarin, theophylline, digoxin, or glyburide.
    Alternatives: Ofloxacin, Norfloxacin, Levofloxacin
    Adult Dosage: 400 mg daily
T1/2 = 12 hours
PK = 1 - 3 hours
MW = 439
Vd = 2.7 
PB = 50%
Oral = 90%
    Hope this helps,
    Kristeen Rogers, RN, IBCLC

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