Marbofloxacin

What it is used for

• For susceptible infections (urinary tract, skin and soft tissue)
• First-line treatment for feline tuberculosis or non-tuberculous mycobacteria (NTM)
• For hemoplasmosis
• Susceptible bacterial infections
• Susceptible infections
• For susceptible infections (urinary tract, skin and soft tissue)
• For susceptible Pseudomonas otitis
• Susceptible bacterial infections
• Otitis externa

How it is given

Possible side effects

• Gastrointestinal distress (vomiting, anorexia, soft stools, diarrhea)
• Decreased activity/lethargy
• Cartilage abnormalities in young, growing animals
• Elevated hepatic enzymes (rare)
• Ataxia, seizures, depression, nervousness (rare)
• Hypersensitivity reactions (rare)
• Crystalluria (rare)
• Potential ocular toxicity/blindness in cats (rare/unproven, but reported)
• Gastrointestinal signs (nausea, vomiting)
• Potential CNS toxicity (seizures)
• Cartilage abnormalities in growing animals
• Potential retinal toxicity/blindness in cats (at high doses)

Cautions & contraindications

• Hypersensitivity to fluoroquinolones
• Small and medium breed dogs up to 8 months of age
• Large breed dogs up to 12 months of age
• Giant breed dogs up to 18 months of age
• Cats under 12 months of age
• Food-producing animals (FDA prohibited)
• Cats (do not use 20 mg and 80 mg tablets)
• Dogs < 12 months of age
• Giant-breed dogs < 18 months of age
• Cats < 16 weeks of age
• > **Warning**: Contraindicated in young, growing animals due to the risk of **articular cartilage lesions** (arthropathy). * **Neurologic**: Can rarely cause CNS stimulation; use with caution in patients with pre-existing seizure disorders. * **Renal/Hepatic**: Use cautiously in patients with severe hepatic or renal insufficiency. * **Hydration**: Ensure adequate hydration to minimize the risk of crystalluria. * **Regulatory**: The FDA strictly prohibits the extra-label use of fluoroquinolones in food-producing animals.

Drug interactions

• Antacids / Dairy Products: Cations (Mg++, Al+++, Ca++) may bind to marbofloxacin and prevent its absorption; separate doses by at least 2 hours
• Antibiotics (aminoglycosides, 3rd-gen cephalosporins, extended-spectrum penicillins): Unpredictable synergism may occur against some bacteria, particularly Pseudomonas aeruginosa
• Cyclosporine: May exacerbate nephrotoxicity and reduce the metabolism of systemically used cyclosporine
• Flunixin: May increase AUC and elimination half-life of the fluoroquinolone, and vice versa (extrapolated from enrofloxacin)
• Glyburide: Severe hypoglycemia possible
• Iron, Zinc (oral): Decreased marbofloxacin absorption; separate doses by at least two hours
• Methotrexate: Increased MTX levels possible with resultant toxicity
• Nitrofurantoin: May antagonize the antimicrobial activity of fluoroquinolones; concomitant use not recommended
• Phenytoin: Marbofloxacin may alter phenytoin levels
• Probenecid: Blocks tubular secretion and may increase blood level and half-life of marbofloxacin
• Quinidine: Increased risk for cardiotoxicity
• Sucralfate: May inhibit absorption of marbofloxacin; separate doses by at least 2 hours
• Theophylline: May increase theophylline blood levels (though less likely than with enrofloxacin)
• Warfarin: Potential for increased warfarin effects
• Antacids (Mg2+, Al3+): Bind fluoroquinolones, preventing GI absorption
• Zinc salts: Inhibits absorption (separate dosing by at least 2 hours)
• Cimetidine: May reduce the clearance of fluoroquinolones
• Ciclosporin: May decrease metabolism and increase nephrotoxicity
• Tacrolimus: May decrease metabolism and increase nephrotoxicity
• Oral anticoagulants: May increase anticoagulant action
• NSAIDs: May potentiate CNS adverse effects (seizures)

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