FLUOROQUINOLONES (Systemic)

Some commonly used brand names are:

In the U.S.?

• Avelox ⁶
• Cipro ¹
• Cipro I.V. ¹
• Floxin ⁸
• Floxin I.V. ⁸
• Levaquin ⁴
• Maxaquin ⁵
• Noroxin ⁷
• Tequin ³

In Canada?

• Cipro ¹
• Cipro I.V. ¹
• Floxin ⁸
• Levaquin ⁴
• Noroxin ⁷

Category

• Antibacterial, systemic?Ciprofloxacin; enoxacin; gatifloxacin; levofloxacin; lomefloxacin; moxifloxacin; norfloxacin; ofloxacin; sparfloxacin

Description

Fluoroquinolones (flu-roe-KWIN-a-lones) are usedto treat bacterial infections in many different parts of the body. They workby killing bacteria or preventing their growth. However, these medicines willnot work for colds, flu, or other virus infections. Fluoroquinolones may alsobe used for other problems as determined by your doctor.

Fluoroquinolones are available only with your doctor's prescription, inthe following dosage forms:

Oral
• Ciprofloxacin
  • Extended-release tablets (U.S. and Canada)
  • Oral suspension (U.S.)
  • Tablets (U.S. and Canada)
• Enoxacin
  • Tablets (U.S.)
• Gatifloxacin
  • Oral suspension (U.S.)
  • Tablets (U.S.)
• Levofloxacin
  • Oral solution (U.S.)
  • Tablets (U.S. and Canada)
• Lomefloxacin
  • Tablets (U.S.)
• Moxifloxacin
  • Tablets (U.S.)
• Norfloxacin
  • Tablets (U.S. and Canada)
• Ofloxacin
  • Tablets (U.S. and Canada)
• Sparfloxacin
  • Tablets (U.S.)

Parenteral
• Ciprofloxacin
  • Injection (U.S. and Canada)
• Gatifloxacin
  • Injection (U.S.)
• Levofloxacin
  • Injection (U.S. and Canada)
• Moxifloxacin
  • Injection (U.S.)
• Ofloxacin
  • Injection (U.S.)

Before Using This Medicine

In deciding to use a medicine,the risks of taking the medicine must be weighed against the good it willdo. This is a decision you and your doctor will make. For the fluoroquinolones,the following should be considered:

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to any of the fluoroquinolones or to any related medicinessuch as cinoxacin (e.g., Cinobac) or nalidixic acid (e.g., NegGram). Alsotell your health care professional if you are allergic to any other substances,such as foods, preservatives, or dyes.

Pregnancy?Studies have not been done in humans. However, useis not recommended during pregnancy since fluoroquinolones have been reportedto cause bone development problems in young animals.

Breast-feeding?Some of the fluoroquinolones are known to passinto human breast milk. Since fluoroquinolones have been reported to causebone development problems in young animals, breast-feeding is not recommendedduring treatment with these medicines.

Children?Use is not recommended for infants or children youngerthan 18 years of age since fluoroquinolones have been shown to cause bonedevelopment problems in young animals. However, your doctor may choose touse one of these medicines if other medicines cannot be used.

Older adults?These medicines have been tested and,in effective doses, have not been shown to cause different side effects orproblems in older people than they do in younger adults.

Other medicines?Althoughcertain medicines should not be used together at all, in other cases two differentmedicines may be used together even if an interaction might occur. In thesecases, your doctor may want to change the dose, or other precautions may benecessary. When you are taking a fluoroquinolone, it is especially importantthat your health care professional know if you are taking any of the following:

• Aminophylline or
• Oxtriphylline (e.g., Choledyl) or
• Theophylline (e.g., Elixophyllin, Theo-Dur)?Ciprofloxacin,enoxacin, and norfloxacin may increase the chance of side effects of aminophylline,oxtriphylline, or theophylline

• Amiodarone (e.g., Cordarone) or
• Astemizole (e.g., Hismanal) or
• Bepridil (e.g., Vascor) or
• Cisapride (e.g., Propulsid) or
• Disopyramide (e.g., Norpace) or
• Erythromycin (e.g., E-Mycin) or
• Pentamidine (e.g., NebuPent) or
• Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g.,Ormazine, Thorazine Spansule, Thor-Prom], fluphenazine [e.g., Permitil, Prolixin],mesoridazine [e.g., Serentil], methotrimeprazine [e.g., Nozinan], pericyazine[e.g., Neuleptil], perphenazine [e.g., Trilafon], prochlorperazine [e.g.,Compazine], promazine [e.g., Primazine, Sparine], thioridazine [e.g., Mellaril],trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin]) or
• Procainamide (e.g., Pronestyl) or
• Quinidine (e.g., Quinidex) or
• Sotalol (e.g., Sotacor) or
• Terfenadine (e.g., Seldane) or
• Tricyclic antidepressants (amitriptyline [e.g., Elavil, Endep], amoxapine[e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Norpramin],doxepin [e.g., Sinequan], imipramine [e.g., Norfranil, Tipramine, Tofranil],nortriptyline [e.g., Aventyl, Pamelor], protriptyline [e.g., Vivactil], trimipramine[e.g., Surmontil])?Use of these medicines with gatifloxacin, levofloxacin,moxifloxacin or sparfloxacin may cause heart problems, such as an irregularheartbeat

• Antacids, aluminum-, calcium-, and/or magnesium-containing, or
• Didanosine (e.g., Videx, ddI) or
• Iron supplements or
• Sucralfate (e.g., Carafate)?Antacids, didanosine, iron, orsucralfate may keep any of the fluoroquinolones from working properly. Ciprofloxacinmay be taken 2 hours before or 6 hours after these medicines. Levofloxacinor norfloxacin may be taken 2 hours before or 2 hours after these medicines.Moxifloxacin may be taken 4 hours before or 8 hours after these medicines.

• Caffeine?Ciprofloxacin, enoxacin, and norfloxacin may increasethe chance of side effects of caffeine; caffeine should not be taken during treatment with enoxacin

• Phenytoin (e.g., Dilantin)?Ciprofloxacin may keep phenytoinfrom working properly

• Warfarin (e.g., Coumadin)?Ciprofloxacin, levofloxacin, andnorfloxacin may increase the effect of warfarin, increasing the chance ofbleeding

Other medical problems?The presence of other medical problems may affect the use of fluoroquinolones.Make sure you tell your doctor if you have any other medical problems, especially:

• Brain or spinal cord disease, including hardening of the arteriesin the brain or epilepsy or other seizures?Fluoroquinolones may causenervous system side effects

• Diabetes mellitus (sugar diabetes)?Levofloxacin may cause changesin blood sugar, which could lead to problems in controlling blood sugar

• Diarrhea?May be a sign of colon problems and taking fluoroquinolonescould make this problem worse. Your doctor will want to check you before youbegin taking your medicine.

• Glucose-6-phosphate dehydrogenase activity defect (problem with anenzyme that your body makes)?If you have this condition and you takea fluoroquinolone, you could have problems with anemia.

• Heart disease?Gatifloxacin, lomefloxacin, moxifloxacin or sparfloxacinmay make this problem worse

• Kidney disease or
• Liver disease?Patients with kidney disease or liver diseasemay have an increased chance of side effects with any of the fluoroquinolones

• Myasthenia gravis (muscle disease)?This condition may becomeworse when taking a fluoroquinolone and cause your respiratory muscles tobecome weak which is life-threatening. Be sure and tell your doctor if youhave this condition.

• Sensitivity of the skin to sunlight (previous)?Patients takingsparfloxacin or any of the other fluoroquinolones may have an increased riskof severe reactions to sunlight

• Tendinitis (previous)?Fluoroquinolones may increase the riskof tendon injury

Proper Use of This Medicine

Do not take fluoroquinolones ifyou are pregnant. Do not give fluoroquinolones to infants, children, or teenagers unless otherwise directed by your doctor. These medicines have beenshown to cause bone development problems in young animals.

Fluoroquinolones should be used only to treat bacterialinfections and not viral infections like the common cold.

To help clear up your infection completely, keep takingyour medicine for the full time of treatment, even if you begin tofeel better after a few days. If you stop taking this medicine too soon, yoursymptoms may return.

Fluoroquinolones are best taken with a full glass (8ounces) of water. Several additional glasses of water should be taken everyday, unless you are otherwise directed by your doctor. Drinking extrawater will help to prevent some unwanted effects of ciprofloxacin and norfloxacin.

Enoxacin or norfloxacin should be taken on an emptystomach.

Ciprofloxacin, gatifloxacin, levofloxacin, lomefloxacin,moxifloxacin, ofloxacin, or sparfloxacin may be taken with meals or on anempty stomach. Ciprofloxacin should NOT be taken with dairy products or calcium-fortifiedjuices alone, but may be taken with a meal that contains these products

This medicine works best when there is a constant amount in the blood orurine. To help keep the amount constant, do not missany doses. Also, it is best to take the doses at evenly spaced times, dayand night. For example, if you are to take two doses a day, the dosesshould be spaced about 12 hours apart. If this interferes with your sleepor other daily activities, or if you need help in planning the best timesto take your medicine, check with your health care professional.

If you need to take this medicine for anthrax, your doctor will want youto begin taking it as soon as possible after you are exposed to anthrax.

Dosing?The dose offluoroquinolones will be different for different patients. Follow your doctor's orders or the directions on the label. The followinginformation includes only the average doses of fluoroquinolones. Your dosemay be different if you have kidney disease. If yourdose is different, do not change it unless your doctor tells you todo so.

The number of tablets or amount of oral suspension that you take dependson the strength of the medicine. Also, the number ofdoses you take each day, the time allowed between doses, and the length oftime you take the medicine depend on the medical problem for which you areusing a fluoroquinolone.

For ciprofloxacin
• For oral dosage form (extended-releasetablets):
  • Adults: 500 to 1000 milligrams (mg) every twenty-four hours for threeto fourteen days, depending on the medical problem being treated.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.
• For oral dosage form (oral suspensionor tablets):
  • Adults: 100 to 750 milligrams (mg) every twelve hours for three totwenty-eight days, depending on the medical problem being treated. Bone andjoint infections are usually treated for at least four to six weeks. Gonorrheais usually treated with a single oral dose of 250 mg. Inhalational anthraxis usually treated for sixty days with 500 mg every twelve hours.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers, except in the case of inhalationalanthrax. Inhalational anthrax is usually treated for sixty days with 15 mgper kilogram (kg) (6.8 mg per pound) of body weight every twelve hours.
• For injection dosage form:
  • Adults: 200 to 400 mg every eight to twelve hours.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers, except in the case of inhalationalanthrax. Inhalational anthrax is usually treated for sixty days with 10 mgper kg (4.5 mg per pound) of body weight every twelve hours.

For enoxacin
• For oral dosage form (tablets):
  • Adults: 200 to 400 mg every twelve hours for seven to fourteen days,depending on the medical problem being treated. Gonorrhea is usually treatedwith a single oral dose of 400 mg.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.

For gatifloxacin
• For oral dosage form (oral suspensionor tablets):
  • Adult: 200 to 400 mg every twenty four hours for seven to fourteendays, depending on the medical problems being treated. Gonorrhea and certainbladder infection are usually treated with a single oral dose of 400 mg.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.
• For injection dosage form:
  • Adults: 200 to 400 mg every twenty four hours for seven to fourteendays, depending on the medical problems being treated. Gonorrhea and certainbladder infection are usually treated with a single oral dose of 400 mg.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.

For levofloxacin
• For oral dosage form (tablets):
  • Adults: 250 to 750 mg once a day for three to twenty-eight days,depending on the medical problem being treated.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.
• For injection dosage form:
  • Adults: 250 to 750 mg, injected slowly into a vein, once a day forthree to twenty-eight days, depending on the medical problem being treated.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.

For lomefloxacin
• For oral dosage form (tablets):
  • Adults: 400 mg once a day for three to fourteen days, depending onthe medical problem being treated.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.

For moxifloxacin
• For oral dosage form (tablets):
  • Adult: 400 mg once a day for five to fourteen days, depending onthe medical problem being treated.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.
• For injection dosage form:
  • Adult: 400 mg injected in a vein once a day for five to fourteendays, depending on the medical problem being treated.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.

For norfloxacin
• For oral dosage form (tablets):
  • Adults: 400 mg every twelve hours for three to twenty-eight days,depending on the medical problem being treated. Gonorrhea is usually treatedwith a single oral dose of 800 mg.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.

For ofloxacin
• For oral dosage form (tablets):
  • Adults: 200 to 400 mg every twelve hours for three to fourteen days,depending on the medical problem being treated. Prostatitis is usually treatedfor six weeks. Gonorrhea is usually treated with a single oral dose of 400mg.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.
• For injection dosage form:
  • Adults: 200 to 400 mg, injected slowly into a vein, every twelvehours for three to fourteen days, depending on the medical problem being treated.Prostatitis is usually treated for six weeks. Gonorrhea is usually treatedwith a single dose of 400 mg.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.

For sparfloxacin
• For oral dosage form (tablets):
  • Adults: 400 mg on the first day, then 200 mg once a day for an additionalnine days.
  • Children up to 18 years of age: This medicine is not recommendedfor use in infants, children, or teenagers.

Missed dose?If you miss a dose of this medicine, take it assoon as possible. This will help to keep a constant amount of medicine inthe blood or urine. However, if it is almost time for your next dose, skipthe missed dose and go back to your regular dosing schedule. Do not doubledoses.

Storage?To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Ciprofloxacin oral suspension may be refrigerated. However, keepthis medicine from freezing.
• Gatifloxacin oral suspension may be stored in the tightly closedbottle in a refrigerator for 14 days. Shake thoroughly prior to each use.
• Do not store in the bathroom, near the kitchen sink, or in otherdamp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

If yoursymptoms do not improve within a few days, or if they become worse, checkwith your doctor.

If you are taking aluminum- or magnesium-containingantacids, didanosine, or sucralfate, do not take them at the same time thatyou take this medicine. It is best to take these medicines at least6 hours before or 2 hours after taking ciprofloxacin; at least 8 hours beforeor 2 hours after taking enoxacin; at least 4 hours after taking gatifloxacin;at least 4 hours before or 4 hours after taking sparfloxacin; at least 2 hoursbefore or 2 hours after taking levofloxacin, norfloxacin, or ofloxacin; atleast 4 hours before or 2 hours after taking lomefloxacin, and at least 8hours before and 4 hours after taking moxifloxacin. These medicines may keepfluoroquinolones from working properly.

If you are taking metal cations such as iron, and multivitaminpreparations with zinc, or didanosine (Videx[reg ]) chewable/buffered tabletsor the pediatric powder for oral solution take moxifloxacin at least4 hours before or 8 hours after and take ciprofloxacin at least 2 hours beforeor 6 hours after taking these medicines.

If you are taking levofloxacin or lomefloxacin, youshould not take certain medications which correct a fast, slow or irregularheartbeat. Check with your physician to determine whether you aretaking one of these medications.

If you are taking enoxacin, you should not take anycaffeine-containing products (e.g., coffee, tea, chocolate, certain carbonatedbeverages). Taking any of these caffeine-containing products whileyou are taking enoxacin may increase the effects of caffeine.

Some people who take fluoroquinolones, especially sparfloxacin, may becomemore sensitive to sunlight than they are normally. Exposure to sunlight, evenfor brief periods of time, may cause severe sunburn, or skin rash, redness,itching, or discoloration. When you begin taking this medicine:

• Stay out of direct sunlight, especially between the hours of 10:00a.m. and 3:00 p.m., if possible.
• Wear protective clothing, including a hat and sunglasses.
• Apply a sun block product that has a skin protection factor (SPF)of at least 15. Some patients may require a product with a higher SPF number,especially if they have a fair complexion. If you have any questions aboutthis, check with your health care professional.
• Do not use a sunlamp or tanning bed or booth.

Stay out of direct sunlight and artificial light (e.g., sunlamp, tanningbed or booth) for the next 5 days or until the reaction has stopped.

If you get a skin rash or other signs of an allergicreaction, stop taking the fluoroquinolone and check with your doctor.

Fluoroquinolones may also cause some people to become dizzy, lightheaded,drowsy, or less alert than they are normally. Make sureyou know how you react to this medicine before you drive, use machines, ordo anything else that can be dangerous if you are dizzy or are not alert.If these reactions are especially bothersome, check with your doctor.

Fluoroquinolones may rarely cause inflammation or even tearing of a tendon(the cord that attaches muscles to bones). If you getsudden pain in a tendon after exercise (for example, in your ankle, back ofthe knee or leg, shoulder, elbow, or wrist), stop taking the fluoroquinoloneand check with your doctor. Rest and do not exercise until the doctorhas made sure that you have not injured or torn the tendon.

If you have pain, burning, tingling, numbness and/or weakness, stop takingthe fluoroquinolone and check with your doctor.

For patients with diabetes taking insulin or diabetes medicine by mouth:Levofloxacin may cause hypoglycemia (low blood sugar) in some patients. Symptoms of low blood sugar must be treated before they leadto unconsciousness (passing out). Different people may feel differentsymptoms of low blood sugar. If you experience symptomsof low blood sugar, stop taking levofloxacin and check with your doctor rightaway:

• Symptoms of low blood sugar can include: Anxious feeling, behaviorchange similar to being drunk, blurred vision, cold sweats, confusion, coolpale skin, difficulty in concentrating, drowsiness, excessive hunger, headache,nausea, nervousness, rapid heartbeat, shakiness, unusual tiredness or weakness.

For patients with low potassium levels: levofloxacin may increase yourrisk of experiencing a fast, slow or irregular heartbeat.

Side Effects of This Medicine

Along with its needed effects, a medicine maycause some unwanted effects. Although not all of these side effects may occur,if they do occur they may need medical attention.

Check with your doctor immediately if any ofthe following side effects occur:

More common?For sparfloxacin, lomefloxacin (rare),and moxifloxacin (less common)

Fainting; irregular or slow heart rate

Less common?More common for lomefloxacin and sparfloxacin

Bloating or swelling of face, arms, hands,lower legs, or feet; blistering of skin; blurred vision; dizziness; headache; nervousness; pounding in the ears; rapid weight gain; sensation of skin burning; slow or fast heartbeat; skin itching, rash, redness,or swelling; tingling of hands or feet; unusual weight gain or loss

Rare

Abdominal or stomach cramps and pain (severe); abdominal pain; abdominal tenderness; agitation; area rash; black, tarry stools; bleeding; blisters on mucous membranes, with fever; blistering,itching, loosening, peeling, or redness of skin; bloody or cloudy urine; coldness; burning, crawling, itching, numbness, prickling, "pins and needles" , or tinglingfeelings; chills; chestpain; clay-colored stools; confusion; cough; dark oramber urine; diarrhea (watery and severe, which mayalso be bloody); difficulty breathing; difficulty swallowing; discolorationof skin; dizziness; drymouth; excessive muscle tone; fainting; faintness, dizziness, or lightheadednesswhen getting up from a lying or sitting position suddenly; fast, pounding, or irregular heartbeat or pulse; fatigue; flushed, dry skin; feeling of pressure; feeling of unreality; feeling of warmth or heat; fever; flushing or redness of skin especially on face and neck; fruit-like breath odor; hallucinations(seeing, hearing, or feeling things that are not there); hives or welts; incoordination; increased hunger; increased thirst; increased urination; inflammation; infection; irregular or fast heart rate; itching; joint pain; lack or loss of strength; large amountof fat in the blood; loss of appetite; loss of memory; lower back, side, orstomach pain; lumps; musclestiffness; muscle tension or tightness; nausea; noisy breathing; numbness; pain; pain at site of injection?for ciprofloxacin or ofloxacin injection; pain in calves, radiating to heels; pain, warmth, or burning in fingers, toes and legs; painful or difficult urination; pale stools; palpitations; peeling of the skin; problems with memory; problems withspeech or speaking; problems with vision or hearing; rash; rash with flatlesions or small raised lesions on the skin; redness; redness of skin; redness,swelling, or soreness of tongue; scarring; seizures; sense of detachment from selfor body; shakiness or tremors; shortness of breath skin rash; sore throat; sores, ulcers, or white spots on lips or in mouth; soreness; stomach pain; stinging; sweating; swelling; swelling of face or neck; swelling of calves, feet, or lower legs; swelling or inflammation of the mouth; swelling orpuffiness of face; tenderness; tightness in chest; tingling; troubled breathing; ulceration; unpleasant breath odor; unusual tiredness or weakness; vomiting; vomiting ofblood; warmth; wheezing; yellow eyes or skin

Incidence not determined??Observed during clinical practice with levofloxacin;estimates of frequency cannot be determined

Abnormal brain wave patterns; black, tarry stools; bleeding gums; blurredvision; coma; confusion; difficult breathing; failure of the heart, lungs, kidneys and/or liver; fatigue; general body swelling; hives; inability to move arms and legs; increased bleeding time; irregular readingon a electrocardiogram (heart test); joint or musclepain; sharp drop in blood pressure; sore throat; sudden numbness and weaknessin the arms and legs; swollen glands; unsteadiness or awkwardness; unusualbleeding or bruising; weakness in arms, hands, legs,or feet

Other side effects may occur that usually do not need medicalattention. These side effects may go away during treatment as your body adjuststo the medicine. However, check with your doctor if any of the following sideeffects continue or are bothersome:

More common

Abdominal or stomach pain or discomfort (mild); diarrhea (mild); drowsiness; lightheadedness; nervousness; trouble in sleeping; vaginal pain anddischarge

Less frequent or rare

Abnormal dream; acid or sour stomach; back pain; bad, unusualor unpleasant (after) taste; belching; bloated full feeling; burning, crawling,itching, numbness, prickling, "pins and needles" , or tingling feelings; burning feeling in chest or stomach; change in sense of taste; change in sense of smell; change in taste; changein vision; constipation; continuing ringing or buzzing or other unexplained noise in ears; crying; depersonalization; depression; difficulty in moving; difficulty in sleeping; difficulty inspeaking; difficulty in urination; dysphoria; euphoria; excessair or gas in stomach or intestines; fear; feeling of constant movement of self or surroundings; general feeling of discomfort or illness; hearing loss; heartburn; impaired vision; increased sensitivity of skin tosunlight; indigestion; mental depression; muscle pain; pain, swelling, or redness in joints; paranoia; passing gas; pelvic pain; pinpoint red or purple spots on skin; puffiness or swelling of the eyelids or around the eyes, face, lips or tongue; quick to react or overreact emotionally; rapidly changing moods; sensation ofspinning; shortness of breath; sleeplessness; sleepiness or unusual drowsiness; sore mouth or tongue, or white patches in mouth and/or on tongue; spots on skin resembling a blister or pimple; stomach discomfort, upset or pain; tenderness in stomach area; thinking, abnormal; tongue discoloration; unable to sleep; vaginal yeast infection; vision problems; weight loss

Other side effects not listed above may also occur insome patients. If you notice any other effects, check with your doctor.

Additional Information

Once a medicine has been approvedfor marketing for a certain use, experience may show that it is also usefulfor other medical problems. Although these uses are not included in productlabeling, fluoroquinolones are used in certain patients with the followingmedical conditions:

• Chancroid
• Pulmonary exacerbations (airway infections) in cystic fibrosis

Other than the above information, there is no additional information relatingto proper use, precautions, or side effects for these uses.