Moxifloxacin Tablet Dosing
Moxifloxacin tablets are dosed at 400 mg orally once daily, with treatment duration ranging from 5 to 21 days depending on the specific infection being treated. 1
Standard Dosing Regimen
- The universal dose is 400 mg once every 24 hours for adults, regardless of the indication 1
- Tablets can be taken with or without food, though patients should drink fluids liberally 1
- No dosage adjustment is required for renal or hepatic impairment 2, 3
Duration by Indication
The treatment duration varies significantly based on infection type:
Respiratory Tract Infections:
- Acute bacterial sinusitis: 10 days 1
- Acute bacterial exacerbation of chronic bronchitis: 5 days 1
- Community-acquired pneumonia: 7-14 days 1
Skin and Soft Tissue Infections:
- Uncomplicated skin and skin structure infections: 7 days 1
- Complicated skin and skin structure infections: 7-21 days 1
Other Indications:
- Complicated intra-abdominal infections: 5-14 days 1
- Plague (Yersinia pestis): 10-14 days, with administration beginning as soon as possible after suspected or confirmed exposure 1
Pathogen-Specific Pneumonia Treatment:
- Mycoplasma pneumoniae or Chlamydophila pneumoniae: 7-14 days 4
- Legionella species: Standard duration applies 4
Critical Administration Considerations
Timing with multivalent cations is essential: Administer moxifloxacin at least 4 hours before or 8 hours after products containing magnesium, aluminum, iron, or zinc, including antacids, sucralfate, multivitamins, and didanosine buffered preparations 1. This separation is critical because these divalent cations markedly decrease fluoroquinolone absorption 4.
Special Populations
Renal impairment: No dosage adjustment necessary, as the drug has a balanced excretion system 2, 3
Hepatic impairment: No dosage adjustment required for mild to moderate dysfunction 2
Tuberculosis treatment: When used for drug-resistant tuberculosis, moxifloxacin 400 mg daily is administered as part of combination therapy, though long-term safety data at higher doses are limited 4. For the novel 4-month rifapentine-moxifloxacin regimen for drug-susceptible pulmonary TB, moxifloxacin 400 mg daily is given for 119 total doses (8 weeks intensive phase with 4 drugs, followed by 9 weeks continuation phase with 3 drugs) 4.
Common Pitfalls
Cardiac considerations: Moxifloxacin prolongs the QT interval by approximately 6 milliseconds and should be used with caution in patients with proarrhythmic conditions; avoid concurrent use with antiarrhythmic agents like quinidine, procainamide, amiodarone, or sotalol 2
Pediatric use: Moxifloxacin is not approved for systemic use in children due to concerns about effects on bone and cartilage growth, though topical ophthalmic formulations are used for conjunctivitis in children ≥12 months 4
Drug interactions: Unlike some fluoroquinolones, moxifloxacin does not interact with theophylline or warfarin and is not a substrate or inhibitor of cytochrome P-450 enzymes 2, 5