Garena Uses, Dosage, Side Effects and more
Garena is a synthetic broad spectrum, flouroquinolone derivative antibacterial agent. Garena has in vitro activity against a wide range of Gram-positive and Gram-negative microorganisms. The bactericidal action of Garena results from inhibition of the topoisomerase II (DNA gyrase) and topoisomerase IV required for bacterial DNA replication, transcription, repair and recombination.
Garena is a quinolone/fluoroquinolone antibiotic. Garena can be used to treat infections caused by the following bacteria: Aerobic Gram-positive microorganisms: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumoniae, and Streptococcus viridans group. Aerobic Gram-negative microorganisms: Acinetobacter lwoffii, Haemophilus influenzae, and Haemophilus parainfluenzae. Other microorganisms: Chlamydia trachomatis.Garena is bactericidal and its mode of action depends on blocking of bacterial DNA replication by binding itself to an enzyme called DNA gyrase, which allows the untwisting required to replicate one DNA double helix into two. Notably the drug has 100 times higher affinity for bacterial DNA gyrase than for mammalian. Garena is a broad-spectrum antibiotic that is active against both Gram-positive and Gram-negative bacteria.
Trade Name | Garena |
Availability | Prescription only |
Generic | Moxifloxacin |
Moxifloxacin Other Names | Moxifloxacin, Moxifloxacino |
Related Drugs | amoxicillin, prednisone, doxycycline, ciprofloxacin, cephalexin, metronidazole, azithromycin, clindamycin, ceftriaxone, levofloxacin |
Weight | 400mg/250ml |
Type | Infusion |
Formula | C21H24FN3O4 |
Weight | Average: 401.4314 Monoisotopic: 401.175084476 |
Protein binding | 50% bound to serum proteins, independent of drug concentration. |
Groups | Approved, Investigational |
Therapeutic Class | 4-Quinolone preparations |
Manufacturer | Pratapa Nirmala |
Available Country | Indonesia |
Last Updated: | January 7, 2025 at 1:49 am |
Uses
Garena is used for the treatment of adults (>18 years of age) with infections caused by susceptible strains of the designated microorganisms in the conditions listed below-
- Acute Bacterial Sinusitis caused by Streptococcus pneumoniae, Haemophilus infuenzae or Moraxella catarrhalis.
- Acute Bacterial Exacerbation of Chronic Bronchitis caused by Streptococcus pneumoniae, Haemophilus infuenzae, Haemophilus parainfuenzae, Klebsiella pneumoniae, methicillin-susceptible Staphylococcus aureus or Moraxella catarrhalis
- Community Acquired Pneumonia caused by Streptococcus pneumoniae (including multi-drug resistant strains), Haemophilus infuenzae, Moraxella catarrhalis, methicillin-susceptible Staphylococcus aureus, Klebsiella pneumoniae, Mycoplasma pneumoniae or Chlamydophilia pneumoniae.
- Uncomplicated Skin and Skin Structure Infections caused by methicillin-susceptible Staphylococcus aureus or Streptococcus pyogen.
- Complicated Skin and Skin Structure Infections caused by methicillin-susceptible Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae or Enterobacter cloacae.
- Complicated Intra-Abdominal Infections including polymicrobial infections such as abscess caused by Escherichia coli, Bacteroides fragilis, Streptococcus anginosus, Streptococcus constellatus, Enterococcus faecalis, Proteus mirabilis, Clostridium perfringens, Bacteroides thetaiotaomicron or Peptostreptococcus species.
Garena is also used to associated treatment for these conditions: Acute Exacerbation of Chronic Bronchitis (AECB), Bacterial Conjunctivitis, Community Acquired Pneumonia (CAP), Plague, Postoperative Inflammatory Response, Sinusitis, Skin Infections, Ocular bacterial infections, Post-operative infection
How Garena works
The bactericidal action of moxifloxacin results from inhibition of the enzymes topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.
Dosage
The dose of Garena is 400 mg once every 24 hours. The duration of therapy depends on the type of infection as described bellow-
- In Acute Bacterial Sinusitis: Garena 400 mg is given once daily for 10 days.
- In Acute Bacterial Exacerbation of Chronic Bronchitis: Garena 400 mg is given once daily for 5 days.
- In Community Acquired Pneumonia: Garena 400 mg is given once daily for 7-14 days.
- In Uncomplicated Skin & Skin Structure infections: Garena 400 mg is given once daily for 7 days.
- In Complicated Skin & Skin Structure infections: Garena 400 mg is given once daily for 7-21 days.
- In Complicated Intra-Abdominal infections: Garena 400 mg is given once daily for 5-14 days.
Garena 400 mg IV infusion can be administered intravenously for the entire treatment duration. Alternatively, therapy may be initial intravenous administration, followed by oral administration when clinically indicated. The recommended duration of treatment for the indication being treated should not be exceeded. The solution for infusion should be infused intravenously over 60 minutes.
Side Effects
The following one or more side effects may be observed: tendinopathy and tendon rupture, QT prolongation, hypersensitivity reactions, Clostridium difficile-associated diarrhea, peripheral neuropathy, photosensitivity, phototoxicity etc.
Toxicity
Symptoms of overdose include CNS and gastrointestinal effects such as decreased activity, somnolence, tremor, convulsions, vomiting, and diarrhea. The minimal lethal intravenous dose in mice and rats is 100 mg/kg.
Precaution
Garena should be discontinued at the first appearance of a skin rash or any other sign of hypersensitivity. Garena should be discontinued if the patient experiences pain, swelling, inflammation or rupture of a tendon.
Interaction
No quinolone should be co-administered with any solution containing multivalent cations (e.g. magnesium) through the same intravenous line. Antacids, iron and adsorbents reduce absorption of Garena. NSAID may increase the risk of CNS stimulation. Warfarin may increase the risk of bleeding.
Food Interaction
- Drink plenty of fluids.
- Take with or without food.
Garena multivitamins interaction
[Moderate] ADJUST DOSING INTERVAL: Oral preparations that contain magnesium, aluminum, or calcium may significantly decrease the gastrointestinal absorption of quinolone antibiotics.
Absorption may also be reduced by sucralfate, which contains aluminum, as well as other polyvalent cations such as iron and zinc.
The mechanism is chelation of quinolones by polyvalent cations, forming a complex that is poorly absorbed from the gastrointestinal tract.
The bioavailability of ciprofloxacin has been reported to decrease by as much as 90% when administered with antacids containing aluminum or magnesium hydroxide.
When coadministration cannot be avoided, quinolone antibiotics should be dosed either 2 to 4 hours before or 4 to 6 hours after polyvalent cation-containing products to minimize the potential for interaction.
When coadministered with Suprep Bowel Prep (magnesium Please consult individual product labeling for specific recommendations. Moderate: aspirin, aspirin, aspirin, celecoxib, albuterol / ipratropium, budesonide / formoterolUnknown: amoxicillin / clavulanate, diphenhydramine, ubiquinone, duloxetine, omega-3 polyunsaturated fatty acids, furosemide, atorvastatin, metoprolol, acetaminophen, acetaminophen, cyanocobalamin, pyridoxine, ascorbic acid, cholecalciferol Major: colitis, liver disease, CNS disorders, myasthenia gravis, peripheral neuropathy, QT interval prolongation, tendonitisModerate: crystalluria, diabetes Well absorbed from the gastrointestinal tract. Absolute oral bioavailability is approximately 90%. Food has little effect on absorption. 11.5-15.6 hours (single dose, oral) Approximately 45% of an oral or intravenous dose of moxifloxacin is excreted as unchanged drug (~20% in urine and ~25% in feces). Pregnancy Category C. Garena is not recommended during pregnancy & lactation. Garena is contraindicated in persons with a history of hypersensitivity to Garena or any member of the quinolone class of antimicrobial agents and any component of this formulation. Elderly: No adjustment of dosage is required in the elderly. Children: Efficacy and safety of Garena IV infusion in children and adolescent have not been established. In the events of an acute overdose, the stomach should be emptied. The patient should be kept under observation and appropriate hydration should be maintained. Store between 15 to 30° C. Protect from light and moisture. Keep away from reach of children.
Garena
contains
Moxifloxacin
see full prescribing information from innovator
Monograph,
MSDS,
FDA label
Garena is used to treat certain infections caused by bacteria such as pneumonia, and skin, and abdominal (stomach area) infections.Garena is also used to prevent and treat plague a serious infection that may be spread on purpose as part of a bioterror attack.
Garena may cause problems with bones, joints, and tissues around joints in children.Garena should not be given to children younger than 18 years old.Garena may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
Garena works by killing the bacteria that cause infections. Antibiotics such as Garena will not work for colds, flu, or other viral infections.
The common side effects of Garena are include:
Use is considered acceptable; according to some experts,this drug should be used during pregnancy only if the benefit outweighs the risk to the fetus.
Use of Garena is acceptable in nursing mothers with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis..Garena is preferable to use an alternate drug for which safety information is available.
Do not drink alcohol. Drinking alcohol can increase the chance of liver problems while you are taking Garena. Avoid hard physical activity. Although not common, Garena can make it easier to get tendon injuries.
Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
Garena is usually taken with or without food once a day for 5 to 21 days. The length of treatment depends on the type of infection being treated. Your doctor will tell you how long to take Garena. Take Garena at around the same time every day.
Take Garena exactly as your doctor tells you to. You will be prescribed a dose of one tablet a day. Try to take the tablets at the same time of day each day, as this will help you to remember to take Garena regularly.
Normally, Garenais not a dangerous antibiotic for most people, but in rare cases, it can cause serious side effects such as heart rhythm problems, liver damage, and tendon rupture.
Garena may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally.
Garena ophthalmic may cause blurred vision and may impair your reactions. Avoid driving or hazardous activity until you know how this medicine will affect you.
Garena causes increase heart rate greater than 10 bpm.
Garena is usually used three times a day for 7 days. Try to use at around the same times every day.
An overdose of Garena ophthalmic is not expected to be dangerous. Seek emergency medical attention if anyone has accidentally swallowed the medication. Do not use other eye medications unless your doctor tells you to.
Garena can cause long-lasting, disabling and potentially permanent side effects involving tendons, muscles, joints and the nervous system.
The elimination half-life of Garena is 11.5 to 15.6 hours .About 45% of an oral or intravenous dose of Garena is excreted as unchanged drug.
Garena oral tablet is used for short-term treatment.
Garena comes as tablet to take by mouth.Garena is usually taken with or without food once a day for 5 to 21 days. The length of treatment depends on the type of infection being treated.
Stop using Garena and call your doctor at once if you have symptoms such as:headache, hunger, irritability, numbness, tingling, burning pain, confusion, agitation, paranoia, problems with memory or concentration, thoughts of suicide, or sudden pain or movement problems in any of your joints.Drug Interaction
Disease Interaction
Volume of Distribution
Elimination Route
Half Life
Clearance
Elimination Route
Pregnancy & Breastfeeding use
Contraindication
Special Warning
Acute Overdose
Storage Condition
Innovators Monograph
FAQ
What is Garena used for?
How safe is Garena?
How does Garena work?
What are the common side effects of Garena?
Is Garena safe during pregnancy?
Is Garena safe during breastfeeding?
Can I drink alcohol with Garena?
Can I drive after taking Garena?
What is the best time to take Garena?
Can I take Garena at night?
Is Garena a good antibiotic?
Does Garena make me sleepy?
Can Garena cause blurry vision?
Can Garena increase heart rate?
How often can I use Garena?
Can I overdose on Garena?
Can Garena cause permanent damage?
How long does btrand stay in my body?
Can I take Garena for a long time?
How long can I take Garena?
Who should Garena take Garena?