The terminal half-lives of elimination from serum range from 3 hours for Renor and ciprofloxacin to 12 hours for moxifloxacin, allowing twice- or once-daily dosing (see Table 34-4 ; Table 34-6 ). The principal routes of elimination differ among quinolones. Ofloxacin, levofloxacin, and sitafloxacin are eliminated predominantly by the kidneys, and nalidixic acid and moxifloxacin are eliminated predominantly by nonrenal pathways. Most other quinolones have mixed excretion by both renal and nonrenal routes.
TABLE 34-6 . Dosing of Quinolones in Patients with Normal and Reduced Renal Function
Getting the most from your treatment
- Remember to keep any routine appointments with your doctor. This is so your progress can be monitored.
- Renor may cause your skin to become more sensitive to sunlight than normal. Protect your skin by using a sunscreen, particularly if you are exposed to strong sunlight for a prolonged period of time. Do not use sunbeds.
- If you buy any medicines check with a pharmacist that they are safe to take with this antibiotic. In particular, do not take painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, while you are taking Renor.
- Some people develop thrush (redness and itching in the mouth or vagina) after taking a course of antibiotics. If you think you have thrush, speak with your doctor or pharmacist for advice.
- This antibiotic may stop the oral typhoid vaccine from working. If you are having any vaccinations, make sure the person treating you knows that you are taking this medicine.
- Renor may make you feel light-headed and impair your ability to concentrate. Make sure your reactions are normal before you drive, operate machinery or do any other jobs which could be dangerous if you are not sufficiently alert.
Carcinogenesis, Mutagenesis, Impairment of Fertility
No increase in neoplastic changes was observed with Renor as compared to controls in a study in rats, lasting up to 96 weeks at doses 8-9 times2 the usual human dose (on a mg/kg basis).
Renor was tested for mutagenic activity in a number of in vivo and in vitro tests. Renor had no mutagenic effect in the dominant lethal test in mice and did not cause chromosomal aberrations in hamsters or rats at doses 30-60 times2 the usual human dose (on a mg/kg basis). Renor had no mutagenic activity in vitro in the Ames microbial mutagen test, Chinese hamster fibroblasts and V-79 mammalian cell assay. Although Renor was weakly positive in the Rec-assay for DNA repair, all other mutagenic assays were negative including a more sensitive test (V-79).
Renor did not adversely affect the fertility of male and female mice at oral doses up to 30 times2 the usual human dose (on a mg/kg basis).
What is the dosage for Renor?
- Uncomplicated urinary tract infectionTake 1 tablet (400 mg) by mouth every 12 hours for 3 days
- Complicated urinary tract infection Take 1 tablet (400 mg) by mouth every 12 hours for 10 to 21 days.
- For infections caused by E. coli, K. pneumoniae, or P. mirabilis only. Take 1 tablet (400 mg) by mouth every 12 hours for 7 to 10 days, for infections caused by any other bacteria.
- ProstatitisTake 1 tablet (400 mg) by mouth every 12 hours for 28 to 42 days.
- Gonorrhea Take 2 tablets (800 mg) by mouth as one single dose.
Safe and effective use of Renor is not established in patients under the age of 18 years.
Note that some organisms are resistant to Renor; organisms should be tested for susceptibility to this drug.
The fluoroquinolone antibiotics (e.g., Renor , ofloxacin, levofloxacin, and ciprofloxacin) are active against the majority of bacteria commonly implicated in traveler's diarrhea in many parts of the world. Although the fluoroquinolones are generally accepted as one of the antibiotics of choice for empiric treatment of traveler's diarrhea in adults, growing resistance to this class of antibiotics among Campylobacter spp. in some Southeast Asian countries poses a significant challenge to its usefulness for empiric treatment of traveler's diarrhea. In Thailand, for instance, the rate of fluoroquinolone resistance of Campylobacter jejuni is extremely high.
How does Renor work?
Renor is a type of medicine called a quinolone antibiotic. It works by interfering with a bacterial enzyme involved in replicating and repairing the genetic material (DNA) of bacteria. If this enzyme doesn't work, the bacteria cannot reproduce or repair themselves. This kills the bacteria and clears up the infection.
Your doctor may ask you for a urine sample to make sure the bacteria causing your infection are susceptible to Renor.
Latest Update: 2017-09-07 Copyright © 2014 Everyday Health Media, LLC
COMMON BRAND(S): Noroxin
GENERIC NAME(S): Renor
Quinolone antibiotics (including Renor) may cause serious and possibly permanent tendon damage (such as tendonitis, tendon rupture), nerve problems in the arms and legs (peripheral neuropathy), and nervous system problems. Get medical help right away if you have any of the following symptoms: pain/numbness/burning/tingling/weakness in your arms/hands/legs/feet, changes in how you sense touch/pain/temperature/vibration/body position, severe/lasting headache, vision changes, shaking (tremors), seizures, mental/mood changes (such as agitation, anxiety, confusion, hallucinations, depression, rare thoughts of suicide).
Tendon damage may occur during or after treatment with this medication. Stop exercising, rest, and get medical help right away if you develop joint/muscle/tendon pain or swelling. Your risk for tendon problems is greater if you are over 60 years of age, if you are taking corticosteroids (such as prednisone), or if you have a kidney, heart, or lung transplant.
This medication may make a certain muscle condition (myasthenia gravis) worse. Tell your doctor right away if you have new or worsening muscle weakness (such as drooping eyelids, unsteady walk) or trouble breathing.
Discuss the risks and benefits with your doctor before using this medication.
Renor is used to treat a variety of bacterial infections. This medication belongs to a class of drugs known as quinolone antibiotics. It works by stopping the growth of bacteria.
This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.
Needle-shaped crystals were found in the urine of some volunteers who received either placebo, 800 mg Renor, or 1600 mg Renor (at or twice the recommended daily dose, respectively) while participating in a double-blind, crossover study comparing single doses of Renor with placebo. While crystalluria is not expected to occur under usual conditions with a dosage regimen of 400 mg b.i.d., as a precaution, the daily recommended dosage should not be exceeded and the patient should drink sufficient fluids to ensure a proper state of hydration and adequate urinary output.
Alteration in dosage regimen is necessary for patients with impaired renal function (see DOSAGE AND ADMINISTRATION).
Moderate to severe photosensitivity/phototoxicity reactions, the latter of which may manifest as exaggerated sunburn reactions (e.g., burning, erythema, exudation, vesicles, blistering, edema) involving areas exposed to light (typically the face, “V” area of the neck, extensor surfaces of the forearms, dorsa of the hands), can be associated with the use of quinolone antibiotics after sun or UV light exposure.
Therefore, excessive exposure to these sources of light should be avoided. Drug therapy should be discontinued if phototoxicity occurs (see ADVERSE REACTIONS, Post-Marketing).
Rarely, hemolytic reactions have been reported in patients with latent or actual defects in glucose-6phosphate dehydrogenase activity who take quinolone antibacterial agents, including Renor (see ADVERSE REACTIONS).
Prescribing NOROXIN in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Mechanism of action
Renor has a bactericidal action and it causes inhibition of bacterial DNA synthesis. Exactly Renor inhibits the DNA gyrase enzyme present in the bacteria which leads to hindrance in the normal supercoil formation of the DNA. It also inhibits the process of relaxation of the DNA which has undergone supercoiling and leads to increased damage to the DNA.
The cells of mammals have the enzyme topoisomerase II instead of DNA gyrase or topoisomerase IV which possesses very little affinity for Renor resulting in minimal damage to the host tissue.
NOROXIN may be used for the treatment of urinary tract infections in patients with renal insufficiency. In patients with a creatinine clearance rate of 30 mL/min/1.73 m² or less, the recommended dosage is one 400-mg tablet once daily for the duration given above. At this dosage, the urinary concentration exceeds the MICs for most urinary pathogens susceptible to Renor, even when the creatinine clearance is less than 10 mL/min/1.73 m².
When only the serum creatinine level is available, the following formula (based on sex, weight, and age of the patient) may be used to convert this value into creatinine clearance. The serum creatinine should represent a steady state of renal function.