Agent | Bioavailability | Clearance | Metabolism | Inhibition or induction of metabolism | Elimination half-life | Notes |
Ciprofloxacin | 70% (range 50 to 85%). Avoid taking with most antacids, mineral supplements, and certain oral medications: Decreased bioavailability in some cases by >90%.* May be taken with most foods or on an empty stomach. However, avoid taking with milk or dairy products: Decreased bioavailability up to 40%.[1] | Oral administration:
| Hepatic metabolism is poorly characterized; some metabolites are active. | Inhibitor of CYP1A2. Can increase blood levels of CYP1A2 substrate drugs (eg, clozapine, erlotinib, ibrutinib, ropinirole, theophylline, tizanidine); refer to Lexicomp drug interactions program for detail. | 3 to 5 hours. Prolonged in older adults and in renal impairment (up to 8 hours in advanced chronic kidney disease). | Some drug interactions require dose adjustment or avoidance of certain combinations; refer to Lexicomp drug interactions program for detail. |
Delafloxacin | 59%. Avoid taking with most antacids, mineral supplements, and certain oral medications: Decreased bioavailability in some cases by >90%.* May be taken with or without food. | Oral administration:
| Does not undergo CYP450 metabolism. Minimally metabolized via glucuronidation. | Does not inhibit or induce hepatic CYP450 enzymes to a clinically relevant extent. | IV: 3.7 hours; oral: 4.2 to 8.5 hours. Prolonged in renal impairment. | IV formulation contains cyclodextrin vehicle, which accumulates in renal impairment. IV form is not recommended in patients with eGFR of <15 mL/minute/1.73 m2. |
GemifloxacinΔ (oral only) | 71%. Avoid taking with most antacids, mineral supplements, and certain oral medications: Decreased bioavailability in some cases by >90%.* May be taken with or without food. | Oral administration:
| Does not undergo CYP450 metabolism. Metabolized via glucuronidation. | Does not inhibit or induce hepatic CYP450 enzymes. | 7 hours (range 4 to 12 hours). Prolonged in renal impairment. | |
Levofloxacin | 99%. Avoid taking with most antacids, mineral supplements, and certain oral medications: Decreased bioavailability in some cases by >90%.* May be taken with or without food. | Oral/IV administration:
| Does not undergo CYP450 metabolism. Minimally metabolized via glucuronidation. | Does not inhibit or induce hepatic CYP450 enzymes. | 6 to 8 hours. Prolonged up to 35 hours in advanced chronic kidney disease. | |
Moxifloxacin | 90%. Avoid taking with most antacids, mineral supplements, and certain oral medications: Decreased bioavailability in some cases by >90%.* May be taken with or without food. | Oral/IV administration:
| Does not undergo CYP450 metabolism. Metabolized via glucuronidation and sulfate conjugation. | Does not inhibit or induce hepatic CYP450 enzymes. | 10 to 14 hours. | |
NorfloxacinΔ (oral only) | 30 to 40%. Avoid taking with most antacids, mineral supplements, and certain oral medications: Decreased bioavailability in some cases by >90%.* May be taken with most foods or on an empty stomach, but food may delay absorption. However, avoid taking with milk or dairy products: decreased bioavailability up to 40%.[2] | Oral administration:
| Undergoes modest hepatic metabolism; however, its metabolism has not been well characterized. | Can increase blood levels of theophylline.[3] May alter cyclosporine levels; monitoring suggested.[4] Refer to Lexicomp drug interactions program for detail. | 3 to 4 hours. Prolonged up to 6.5 hours in advanced chronic kidney disease. | Some drug interactions require dose adjustment or avoidance of certain combinations; refer to Lexicomp drug interactions program for detail. |
Ofloxacin | >90%. Avoid taking with most antacids, mineral supplements, and certain oral medications: Decreased bioavailability in some cases by >90%.* May be taken with or without food. | Oral/IV administration:
| Does not undergo CYP450 metabolism. Metabolized via glucuronidation. | Does not inhibit or induce hepatic CYP450 enzymes. | 5 to 7.5 hours. Prolonged in renal impairment. |