Prulifloxacin is a broad-spectrum oral fluoroquinolone antibiotic. It is a prodrug of ulifloxacin, the active metabolite, with enhanced absorption. It is primarily indicated for the treatment of uncomplicated and complicated urinary tract infections (UTIs), including acute cystitis and chronic bacterial prostatitis, and traveler's diarrhea caused by susceptible bacteria. It exhibits bactericidal activity by inhibiting bacterial DNA gyrase and topoisomerase IV.
Adult: 600 mg orally once daily. For uncomplicated cystitis: 600 mg once daily for 3-5 days. For cUTIs and prostatitis: 600 mg once daily for 7-10 days. For traveler's diarrhea: 600 mg as a single dose or once daily for up to 3 days.
Note: Administer orally with a full glass of water. Can be taken with or without food, but taking with food may minimize potential gastrointestinal upset. Do not crush or chew the tablet. Swallow whole. Maintain adequate hydration.
Prulifloxacin is a prodrug. After oral administration, it is metabolized to ulifloxacin, the active antibacterial component. Ulifloxacin inhibits bacterial DNA synthesis by targeting two essential enzymes: DNA gyrase (topoisomerase II) and topoisomerase IV. DNA gyrase is responsible for introducing negative supercoils into DNA, essential for replication and transcription. Topoisomerase IV is crucial for separating daughter DNA strands during cell division. Inhibition of these enzymes leads to double-strand DNA breaks, rapid cessation of bacterial cell division, and cell death.
Pregnancy: Category C (US FDA). Animal studies have shown fetal toxicity (arthropathy in immature animals). There are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus. Generally avoided.
Driving: May cause dizziness, lightheadedness, or visual disturbances. Patients should be cautioned about operating machinery or driving until they are certain the medication does not affect them adversely.
| Antacids (Al, Mg), Sucralfate, Iron, Zinc, Multivitamins with minerals | Form chelation complexes, significantly reducing absorption and bioavailability of prulifloxacin. | Major |
| Theophylline | Prulifloxacin may inhibit metabolism of theophylline, increasing theophylline levels and risk of toxicity (nausea, seizures, arrhythmias). | Major |
| Warfarin and other oral anticoagulants | May potentiate anticoagulant effect, increasing risk of bleeding. Monitor INR closely. | Major |
| NSAIDs (e.g., Ibuprofen, Diclofenac) | May increase the risk of CNS stimulation and seizures. Concomitant use with corticosteroids may increase risk of tendon rupture. | Moderate |
| Drugs that prolong QT interval (e.g., Class IA/III antiarrhythmics, Macrolides, Tricyclic antidepressants, Antipsychotics) | Additive effect on QT prolongation, increasing risk of life-threatening arrhythmias like torsades de pointes. | Major |
| Probenecid | May reduce renal tubular secretion of ulifloxacin, increasing its plasma levels and half-life. | Moderate |
| Cyclosporine | Possible increase in serum creatinine; monitor renal function. | Moderate |