Nor Super Oral Solution

Indications

Norfloxacin is a fluoroquinolone antibiotic. In people it is used mainly for urinary tract infections (cystitis and other bladder and kidney infections caused by sensitive bacteria), and sometimes for bacterial diarrhoea and prostate infection. Norfloxacin is also made as oral solutions and powders for animals, especially poultry, to treat bacterial infections of the gut and airways; these veterinary products are not for human use.

How It Works

Norfloxacin blocks two bacterial enzymes, DNA gyrase and topoisomerase IV, that bacteria need to copy their DNA and divide. This kills the bacteria. It is concentrated in the urine, which makes it useful for urinary infections. It does not work against viruses.

Dosage and Administration

• Adults, uncomplicated cystitis: usually 400 mg twice daily for 3 days (women), or as prescribed.
• Adults, other urinary tract infections: usually 400 mg twice daily for 7 to 10 days, or as prescribed.
• Take on an empty stomach, at least 1 hour before or 2 hours after meals or milk, with a full glass of water. Finish the full course.
• Not normally used in children or growing adolescents.
• Veterinary products: dose in drinking water or feed only as directed on the label or by a veterinarian, and observe the stated withdrawal period before meat or eggs from treated birds or animals are used for food.

Interactions

• Antacids, Calcium, Iron, Zinc, Magnesium, Sucralfate and dairy products reduce absorption: take Norfloxacin at least 2 hours before them.
• Theophylline and Caffeine: levels may rise.
• Warfarin: bleeding risk may increase.
• NSAIDs such as Ibuprofen: higher risk of fits.
• Corticosteroids: higher risk of tendon damage.
• Medicines that prolong the QT interval (such as Amiodarone and some antipsychotics): heart rhythm risk.

Contraindications

• Allergy to Norfloxacin or any other quinolone antibiotic.
• Past tendon problems with a quinolone.
• Children and growing adolescents, unless a specialist decides otherwise.
• Pregnancy and breastfeeding.

Side Effects

Common effects include nausea, stomach upset, headache, dizziness and rash. Less common but serious effects include tendon pain, swelling or rupture (especially the Achilles tendon), nerve damage with tingling or numbness, mood changes or confusion, fits, sensitivity to sunlight, severe diarrhoea caused by Clostridioides difficile, irregular heartbeat and low blood sugar.

Get urgent medical help if you have sudden tendon pain or cannot bear weight, swelling of the face or throat, difficulty breathing, a blistering rash, severe watery or bloody diarrhoea, fainting or palpitations, fits, or confusion.

Pregnancy and Lactation

Avoid during pregnancy and breastfeeding, as quinolones may affect developing joints. Your doctor will choose a safer antibiotic.

Precautions and Warnings

• Stop treatment and contact your doctor at the first sign of tendon pain, numbness or burning pain in the hands or feet.
• Use with care in people over 60, those with epilepsy, myasthenia gravis, kidney problems, heart rhythm problems or diabetes.
• Avoid strong sunlight and sunbeds.
• Drink plenty of fluids. It may cause dizziness: take care when driving.
• Veterinary products must not be used in people, and treated animals must not enter the food chain before the withdrawal period ends.

Overdose

Overdose may cause nausea, vomiting, dizziness, confusion and fits. Seek emergency medical help.

Therapeutic Class

Fluoroquinolone antibiotic.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep veterinary products separate from human medicines and food.