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Home >> Healthcare Professionals > Safty > Special warnings and precautions

Special warnings and precautions

General Precautions for Use

It is recommended that susceptibility of bacteria to FACTIVE should be tested prior to use and FACTIVE should be administered for minimum duration required for effective treatment in order to avoid development of resistance to FACTIVE.

Adequate hydration should be maintained to prevent the formation of highly concentrated urine.

Photosensitivity reaction has been rarely reported with the use of FACTIVE. Patients taking FACTIVE should be avoided unnecessary exposure to strong sunlight or artificial UV rays eg., Sunlamps, solarium, to prevent photosensitivity reaction. FACTIVE should be discontinued if photosensitivity reaction e.g., skin eruption, is suspected.

CNS side effects have been reported rarely in clinical trials with FACTIVE. However, as with other drugs, patients should be observed for reaction to FACTIVE and, if affected, should not drive or operate machinery.

Special Warnings and Precautions for Use

Quinolones may prolong the QTc internal in some patients. FACTIVE should be avoided in patients with a history of prolongation of the QTc interval, patients with uncorrected electrolytic disorders (hypokalemia or hypomagnesemia), and patients receiving Class ⅠA (e.g., quinidine, procinamide) or Class Ⅲ (e.g., amiodarone, sotalol) antiarrhythmic agents.

FACTIVE should be used with caution in patients with epilepsy or patients with a history of convulsions (risk of convulsion) and Patients with severe renal impairment

FACTIVE should be used with caution in patients with existing or family history of glucose-6-phosphate dehydrogenase deficiency (rarely hemolytic reactions may be developed during therapy)

Special Populations

Elderly
No dosage adjustment is required in the elderly.

Children
Safety and effectiveness in children and adolescents less than 18 years of age have not been established.

Hepatic impairment
No dosage adjustment is recommended in patients with mild (Child-Pugh Class A), moderate (Child-Pugh Class B) or severe (Child-Pugh Class C) hepatic impairment.

Renal impairment
In the pharmacokinetic studies, FACTIVE Cmax was not significantly altered in subjects with renal insufficiency.

Creatinine clearance (mL/min) Dose
>40 Usual dosage (320mg every 24 hours)
≤40 160mg every 24 hours

Contraindications

FACTIVE is contraindicated in patients with a history of hypersensitivity to FACTIVE, fluoroquinolone antibiotic agents, or any of the product components.

References

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Important Safety Information

THE SAFETY AND EFFECTIVENESS OF FACTIVE IN CHILDREN, ADOLESCENTS (<18 YEARS OF AGE), PREGNANT WOMEN, AND LACTATING WOMEN HAVE NOT BEEN ESTABLISHED.

FACTIVE is contraindicated in patients with a history of hypersensitivity to gemifloxacin, fluoroquinolone antibiotic agents, or any of the product components. Serious hypersensitivity and/or anaphylactic reactions have been reported in patients receiving fluoroquinolone therapy, including FACTIVE. Hypersensitivity reactions reported in patients receiving fluoroquinolone therapy have occasionally been fatal. These reactions may include serious, sometimes fatal skin reactions such as toxic epidermal necrolysis or Stevens-Johnson Syndrome; effects on the liver, including hepatitis, jaundice, and acute hepatic necrosis or failure; renal toxicities including interstitial nephritis and/or acute renal insufficiency or failure; and hematologic effects, including agranulocytosis, thrombocytopenia, and other hematologic abnormalities. These reactions may occur following the first dose or multiple doses. FACTIVE should be discontinued immediately at the first sign of an immediate type I hypersensitivity skin rash or any other manifestation of hypersensitivity reaction.

Fluoroquinolones, including FACTIVE, are associated with an increased risk of tendinitis and tendon rupture in all ages. This risk is further increased in older patients usually over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart, or lung transplants. Call your healthcare professional right away at the first sign of tendon pain, swelling, or inflammation. You should stop taking FACTIVE until tendinitis or tendon rupture have been ruled out, and avoid exercise and using the affected area.

Fluoroquinolones may prolong the QT interval in some patients. FACTIVE should be avoided in patients with a history of prolongation of the QTc interval, patients with uncorrected electrolyte disorders (hypokalemia or hypomagnesemia), and patients receiving Class IA or Class III antiarrhythmic agents.

Rare cases of peripheral neuropathy have been reported in patients receiving quinolones.

In clinical studies with FACTIVE, central nervous system (CNS) effects have been reported infrequently. As with other fluoroquinolones, FACTIVE should be used with caution in patients with known or suspected CNS diseases. If CNS reactions occur, FACTIVE should be discontinued and appropriate measures instituted.

Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibiotic agents, including FACTIVE. If diarrhea occurs, evaluate for CDAD and treat appropriately.

In clinical trials, rash occurred more often with FACTIVE than therapy with comparator agents (2.8% vs. 0.6%). Increasing incidence of rash was associated with younger age (especially below 40), female gender, use of hormone replacement therapy, and longer duration of therapy.

Moderate to severe photosensitivity/phototoxicity reactions can be associated with the use of quinolones after sun or UV light exposure. Excessive exposure to the sun or UV light should be avoided.

Magnesium- and/or aluminum-containing antacids, products containing ferrous sulfate (iron), multivitamin preparations containing zinc or other cations, or Videx® (didanosine) chewable/buffered tablets or the pediatric powder for oral solution should not be taken within 3 hours before or 2 hours after FACTIVE. Sucralfate should not be taken within 2 hours of FACTIVE.

In clinical trials, the most common adverse drug reactions (≥2%) were diarrhea, rash, nausea, headache, abdominal pain, vomiting, and dizziness.

This product is available by prescription only.

* Videx® is a registered trademark of Bristol-Myers Squibb Company.

For US residents,
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

For Non-US residents,
You are encouraged to report negative side effects of prescription drugs, please click here or call 82-2-6924-3620.

Please note that the information contained on this site is intended for international health care providers and may not be appropriate for your country of origin. Please see the full FACTIVE prescribing information for your country for approved product indications, dosing, and important safety considerations. Click on the "Global Countries" tab above to learn how to obtain country-specific prescribing information.

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