Leogem

Indications

Gemifloxacin is a fluoroquinolone antibiotic used in adults to treat bacterial chest infections: sudden worsening of chronic bronchitis caused by bacteria (acute bacterial exacerbation of chronic bronchitis) and mild to moderate community acquired pneumonia. Because of the risk of serious side effects, it is generally kept for cases where other suitable antibiotics cannot be used.

How It Works

Gemifloxacin blocks two bacterial enzymes, DNA gyrase and topoisomerase IV, that bacteria need to copy and repair their DNA. Without them the bacteria cannot multiply and die. It is active against common chest infection germs such as Streptococcus pneumoniae (including some resistant strains), Haemophilus influenzae and atypical bacteria.

Dosage and Administration

The usual adult dose is 320 mg once a day by mouth. For bacterial worsening of chronic bronchitis it is usually taken for 5 days; for pneumonia usually for 5 or 7 days, as prescribed. Swallow the tablet whole with water, with or without food, and drink plenty of fluids. People with reduced kidney function may need a lower dose. Complete the course unless the doctor says otherwise.

Interactions

• Antacids containing magnesium or aluminium, Sucralfate, and supplements with Iron, Zinc or Calcium reduce absorption: take gemifloxacin at least 2 hours before or 3 hours after them.
• Medicines that prolong the QT interval, such as Amiodarone, Sotalol, some antipsychotics, Erythromycin and some antidepressants, increase the risk of heart rhythm problems.
• It may increase the effect of Warfarin; INR should be monitored.
• Non steroidal anti inflammatory drugs may increase the risk of seizures; corticosteroids such as Prednisolone increase the risk of tendon damage.
• It can disturb blood sugar control in people taking diabetes medicines.

Contraindications

• Allergy to gemifloxacin or any other quinolone, such as Ciprofloxacin or Levofloxacin.
• History of tendon problems with a quinolone.
• Known QT prolongation or uncorrected low potassium or magnesium.
• Myasthenia gravis (it can make muscle weakness worse).
• Children and adolescents under 18 years.

Side Effects

Common: rash, diarrhoea, nausea, headache, stomach pain and dizziness. Rash is more likely in women and in people under 40, and with courses longer than 7 days. Less common but serious: inflammation or rupture of tendons (especially the Achilles tendon), nerve damage causing pain, burning or numbness, mood changes, confusion or seizures, low or high blood sugar, heart rhythm changes, severe diarrhoea from Clostridioides difficile, liver injury, sensitivity to sunlight, and damage to the aorta.

Get urgent medical help for sudden tendon pain or swelling, a widespread or blistering rash, swelling of the face or throat, fainting or a fast or irregular heartbeat, sudden severe chest, stomach or back pain, seizures, severe watery or bloody diarrhoea, yellowing of the skin or eyes, or numbness and weakness in the limbs.

Pregnancy and Lactation

It is not recommended in pregnancy or while breastfeeding because of possible effects on the baby's growing joints, unless the doctor decides there is no better option.

Precautions and Warnings

Stop taking it and contact a doctor at the first sign of tendon pain, nerve symptoms, a rash or mental changes. Use with care in older people, those taking steroids, people with kidney, liver or heart disease, epilepsy, diabetes, or a history of aortic aneurysm. Avoid strong sunlight. It can cause dizziness, so do not drive if affected.

Overdose

Overdose may cause nausea, vomiting, dizziness, confusion, seizures and heart rhythm problems. Seek emergency medical care; heart monitoring and supportive treatment are given in hospital.

Therapeutic Class

Antibacterial, fluoroquinolone

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.