A fixed-dose combination oral suspension containing a second-generation fluoroquinolone antibiotic (Ofloxacin) and a 5-nitroimidazole antiprotozoal/antibacterial agent (Ornidazole). It is primarily used for the treatment of mixed aerobic-anaerobic infections, particularly in gastrointestinal and gynecological contexts, where broad-spectrum coverage is required. The combination is synergistic against many pathogens.
Adult: 10 ml (containing Ofloxacin 100mg + Ornidazole 250mg) twice daily. For severe infections: 10 ml thrice daily.
Note: Shake the bottle well before use. Administer orally, preferably 1 hour before or 2 hours after meals for optimal absorption. Maintain adequate hydration. Do not take with dairy products, antacids, or iron supplements; separate by at least 2-3 hours.
Ofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA replication, transcription, repair, and recombination. This leads to rapid bactericidal activity. Ornidazole is a prodrug; its nitro group is reduced by intracellular enzymes in anaerobic bacteria and protozoa, generating cytotoxic radicals that damage DNA and other macromolecules, leading to cell death.
Pregnancy: CONTRANDICATED, especially in first trimester. Ofloxacin: Category C (risk of arthropathy in animal studies). Ornidazole: Category B (but contraindicated due to mutagenic potential). Use only if potential benefit justifies potential fetal risk.
Driving: May cause dizziness, lightheadedness, or visual disturbances. Patients should not drive or operate machinery until their response is known.
| Antacids (Al, Mg), Sucralfate, Iron/Zinc salts | Markedly reduce absorption of Ofloxacin due to chelation | Major |
| Warfarin | Ornidazole may inhibit metabolism, increasing INR and bleeding risk | Major |
| Theophylline | Ofloxacin may inhibit metabolism, increasing theophylline levels and toxicity | Moderate |
| NSAIDs (e.g., Ibuprofen) | May increase risk of CNS stimulation and seizures | Moderate |
| Corticosteroids (systemic) | Increased risk of tendon rupture with Ofloxacin | Moderate |
| Alcohol | Disulfiram-like reaction with Ornidazole (flushing, nausea, vomiting) | Major |
| Other QT-prolonging drugs (e.g., Erythromycin, Amiodarone) | Additive risk of cardiac arrhythmias | Major |
Same composition (Ofloxacin (50mg/5ml) + Ornidazole (125mg/5ml)), different brands: