Normally the quinolone class of drugs is used in patients who have failed at least one prior therapy. The
patients tend to be fairly ill and require relatively acute care that often may be the last step before they
are admitted into the hospital. …By the time the physicians get to this classification, they tend to have
a good idea of what bacteria is involved, what antibiotic is the most potent for the bacteria and which
penetrates that particular body side the best. …These drugs are often the last step before admission
into the hospital..." Jim Hoover, for Bayer Corporation, Alaska Pharmacy and Therapeutics Committee
March 19, 2004
 

  Avelox
  Moxifloxacin
  Bayer A. G
  NDA  021085, 021334
  Latest Package Insert
  Avelox 1999, 2003, 2004 2007
  Safety Profile
  Fatal reactions, irreversible peripheral neuropathy, tendon ruptures
  DO NOT USE  (Read More)
 

  Baytril
  Enrofloxacin
  Bayer A. G.

  Latest Package Insert
  No Information Found on the FDA site
  Safety Profile
  Banned by the FDA
  DO NOT USE  (Read More)
 

  Cinobac
  Cinoxacin
  Oclassen Pharmaceuticals, Inc. A Division of Watson Labs, Inc.
  NDA  018067
  Latest Package Insert
  Cinobac 2002
  Safety Profile  Approved for use 1980

  Discontinued, no longer available (read more)


  Brand Name Unknown
  Clinafloxacin
  Manufacturer Unknown

  No Package Insert Available

  Safety Profile Removed from Clinical Use due to adverse reactions
  Severe phototoxicity and hypoglycaemia
  Discontinued, no longer available  (read more)
 

  Cipro
  Ciprofloxacin
  Bayer A. G. as well as Generic Manufacturers
  NDA  019537, 019847, 020780
  Latest Package Insert
  Cipro 2000,  2004
  Safety Profile
  Fatal reactions, irreversible peripheral neuropathy, tendon ruptures
  DO NOT USE  (Read More)
 

  Cipro Extended Release (Cipro XR)
  Ciprofloxacin / Proquin
  Bayer A. G. as well as Generic Manufacturers
  NDA 021744
  Latest Package Insert
  Proquin 2005
  Safety Profile
  Fatal reactions, irreversible peripheral neuropathy, tendon ruptures
  DO NOT USE  (Read More)

  Factive
  Gemifloxacin
  Oscient Pharmaceuticals and Pfizer, S.A. de C.V.
  NDA  021158
  Latest Package Insert
  Factive 2003, 2004, 2006
  Safety Profile
  Severe rashes, irreversible peripheral neuropathy, tendon ruptures
  DO NOT USE  (Read More)


  Floxacin
  Floxacin Ofloxacin Ocuflox 
  Ortho-McNeil Pharmaceuticals
  (NDA) 019735 This NDA is still in use
  Latest Package Insert
  Floxin 2001
  Safety Profile Warning letter 1-18-1997,  5-30-1997,  6-23-1997
  (NDA) 020087 This NDA was discontinued in 1992
  DO NOT USE  (Read More)


  Levaquin
  Levofloxacin
  Ortho McNeil  Johnson and Johnson
  NDA  020634, 020635, 021721
  Latest Package Insert
  Levaquin 2002,  2005  2007
  Safety Profile:  The worse safety profile of all the fluoroquinolones
  Fatal reactions, irreversible peripheral neuropathy, tendon ruptures
  DO NOT USE  (Read More)


  Maxaquin
  Lomefloxacin
  G.D. Searle LLC  A subsidiary of Pharmacia Corporation
  (NDA 020013
  Latest Package Insert
  Lomefloxacin 1999,  2004, 2005
  Safety Profile

  DO NOT USE  (Read More)


  NegGram
  Nalidixic Acid
  Sanofi-Synthelabo Inc.
  NDA  014214
  Latest Package Insert
  Neggram 2004
  Safety Profile

  DO NOT USE  (Read More)


  Noroxin
  Norfloxacin
  Merck & Co., Inc.,
  NDA 019384
  Latest Package Insert
  Noroxin 1999, 2001, 2004,  2006
  Safety Profile
  Rhabdomyolysis may occur.
  DO NOT USE  (Read More)


  Omniflox
  Temafloxacin
  Abbott Laboratories

  No Package Insert Available

  Safety Profile Removed from Clinical Use due to adverse reactions

  Discontinued, no longer available  (Read More)

  Peflacin
  Pefloxacin
  Aventis Pharma

  Latest Package Insert
  Has not received FDA approval
  Safety Profile
  Pefloxacin is not currently available in the United States
  DO NOT USE   (Read More)


  Quinodis
  Fleroxacin
  Gruenenthal / Hoffmann-La Roche

  Latest Package Insert
  No Information found on the FDA site
  Safety Profile: Fleroxacin is not available for clinical use in several
  European countries and the United States.
  DO NOT USE  (Read More)
 

  Brand Names Unknown
  Rosoxacin
  Manufacturers unknown
  Use restricted to treating gonorrhea
  Latest Package Insert
  None available
  Safety Profile
  High incident of CNS events / Restricted useage
  DO NOT USE  (Read More)
 

  Raxar / Vaxar
  Grepafloxacin
  Glaxo Wellcome
  NDA 020695 1997
  No Package Insert Available

  Safety Profile Removed from Clinical Use due to fatal reactions
 
  Discontinued, no longer available  (Read More)


  Sigma
  Flumequine
  Sigma / Aldrich

  No Package Insert Available

  Safety Profile:  Direct acting genotoxic carcinogen

  DO NOT USE (Read More)

  Tequin
  Gatifloxacin
  Bristol Meyers
  NDA  021061, 021062, 021404, 021405, 021678
  Package Insert
  Tequin 1999, 2001, 2002, 2004, 2005  Warning Letter 2006
  Safety Profile  No longer manufactured / fatal adverse reactions
  but is still in clinical use today.  Irreversible peripheral neuropathy,
  tendon ruptures   DISCONTINUED  DO NOT USE  (Read More)
 

  Tosuxacin
  Tosufloxacin
  Daianabot / Abbott Laboratories
 
  Latest Package Insert
  None available
  Safety Profile: Associated with chronic interstitial nephritis
  Marketed on in Japan
  DO NOT USE  (Read More)
 

  Trovan
  Trovafloxacin
  Pfizer
  NDA 020759
  Package Insert
  Trovan / Zithromax 1998
  Safety Profile  Restricted use due to fatal adverse reactions
  Trovan Warning 1998 (1 of 2) Trovan Warning Letter 1998 ( 2 of 2)
  DO NOT USE  (Read More)


  Zagam
  Sparfloxacin
  Pharhome
  NDA 020677
  Package Insert
  Sparfloxain_2003
  Safety Profile
  Associated with rhabdomyolysis
  DO NOT USE  (Read More)


This is not a complete list of all the fluoroquinolones currently in use today.  The number of fluoroquinolones including generic equivalents is well into the thousands, with various manufacturers using their own trademark names for the very same drug.  The following is a list of the various chemical names that make up this chemotherapeutic class of drugs.  Again this is far from being an exhaustive list of such agents as new drugs are being developed all over the world:

Fluoroquinolones are a group of synthetic antibiotics that are derived from basic structure of nalidixic acid and have substituents at N-1, C-5, C-7, position 8 and a fluorine atom at position 6. There are also polycyclic derivatives. Quinolone antibiotics have a ketone at position 4 and a carboxylic group at position 3. Fluoroquinolones inhibit the bacterial DNA gyrase or the topoisomerase IV enzyme, resulting the inhibition of DNA replication and transcription. Fluorine at position 6 enhances gyrase inhibition and cell penetration. Piperaziny substituents provide activity against Gram-negative bacteria and pyrrolidinyl moiety is active against Gram-positive cocci. They improve water solubility needed oral application. The function substituted at position 8 IS to control anaerobe activity.


Fluoroquinolone Substituted at N-1

    Norfloxacin
    Enoxacin   
    Lomefloxacin  Still in use in spite of irreversible peripheral neuropathy / tendon ruptures
    Fleroxacin  Not available for clinical use in several European countries and the USA.
    Difloxacin         
   Temafloxacin  Removed from Clinical Use
   Trovafloxacin  Removed from Clinical Use due to fatal liver failures
    Amifloxacin      
    Ciprofloxacin  Still in use in spite of fatal reactions, peripheral neuropathy / tendon ruptures
    Grepafloxacin  Removed from Clinical Use due to heart problems
    Alumofloxacin  
    Gemifloxacin  Still in use in spite of disfiguring rashes
    Moxifloxacin  Still in use in spite of fatal reactions, peripheral neuropathy / tendon ruptures
    Ecenofloxacin  
    Balofloxacin     

Substituted at C-5

    Sparfloxacin  Associated with rhabdomyolysis
    Grepafloxacin  Removed from Clinical Use due to heart problems

Substituted at C-7

    Trovafloxacin  Removed from Clinical Use due to fatal liver problems
    Moxifloxacin  Still in use in spite of fatal reactions, peripheral neuropathy / tendon ruptures
    Danafloxacin   
    Garenoxacin   
    Ciprofloxacin  Still in use in spite of fatal reactions, peripheral neuropathy / tendon ruptures
    Lomefloxacin  Still in use in spite of irreversible peripheral neuropathy / tendon ruptures
    Norfloxacin
    Fleroxacin  Not available for clinical use in several European countries and the USA.
    Ofloxacin  Discontinued no reason given
    Sparfloxacin  Associated with rhabdomyolysis
    Grepafloxacin  Removed from Clinical Use due to fatal reactions, heart problems
    Gatafloxacin   
    Levofloxacin  Still in use in spite of fatal reactions, peripheral neuropathy / tendon ruptures
    Clinafloxacin  Removed from Clinical Use due to severe phototoxicity and hypoglycemia
    Nadifloxacin   
    Sitafloxacin    
    Irloxacin        
    Balofloxacin   
    Piperidinyl     

Substituted at position 8

    Sparfloxacin  Associated with rhabdomyolysis
    Lomefloxacin  Still in use in spite of irreversible peripheral neuropathy / tendon ruptures
    Fleroxacin  Not available for clinical use in several European countries and the USA.
    Ciprofloxacin  Still in use in spite of fatal reactions, peripheral neuropathy / tendon ruptures
    Temafloxacin  Removed from Clinical Use
    Pefloxacin      Not available in USA, Not FDA approved     
    Norfloxacin
    Grepafloxacin  Removed from Clinical Use due to heart problems
    Clinafloxacin  Removed from Clinical Use due to severe phototoxicity and hypoglycemia
    Sitafloxacin    
    Enoxacin       
    Tosufloxacin   Associated with chronic interstitial nephritis 
    Gemifloxacin  Still in use in spite of disfiguring rashes
    Trovafloxacin  Removed from Clinical Use due to fatal liver problems
    Ecenofloxacin  
    Alatrofloxacin (TROVAN) Still in use in spite of fatal liver problems
    Gatifloxacin  No longer being manufactured due to severe and fatal hypo/hyperglycemia
    Pazufloxacin   
    Balofloxacin    
    Moxifloxacin  Still in use in spite of fatal reactions, peripheral neuropathy / tendon ruptures
    Garenoxacin   

Tricyclic derivatives

    Abufloxacin     
    Droxacin         
    Flumequine  Still in use in spite of being direct acting genotoxic carcinogen
    Levofloxacin  Still in use in spite of fatal reactions, peripheral neuropathy / tendon ruptures
    Marbofloxacin
    Miloxacin 
    Ofloxacin  Discontinued no reason given
    Oxolinic acid   
    Pazufloxacin   
    Prulifloxacin    
    Rufloxacin      
    Verbafloxacin 
 

QUINOLONES (Non-fluorinated)

    Nalidixic acid 389-08-2  Discontinued cancer causing agent
    Nalidixate sodium anhydrous 3374-05-8
    Nalidixate sodium 15769-77-4             
    Oxolinic acid 14698-29-4             
    Pipemidic acid 51940-44-4         
    Piromidic acid 19562-30-2        
    Cinoxacin 28657-80-9  Discontinued no reason given
    Miloxacin 37065-29-5         
    Mictral 79449-95-9                       
    Rosoxacin 40034-42-2   Usage restricted to gonorrhea        
   
FLUOROQUINOLONES (fluorinated)

    Flumequine 42835-25-6  Still in use in spite of being direct acting genotoxic carcinogen        
    Ciprofloxacin 85721-33-1 Still in use in spite of fatal reactions, peripheral neuropathy / tendon ruptures
    Enoxacin 74011-58-8                 
    Fleroxacin 79660-72-3  Not available for clinical use in several European countries and the USA. 
    Levofloxacin 100986-85-4  Still in use: fatal reactions, peripheral neuropathy / tendon ruptures
    Lomefloxacin 98079-51-7   Still in use in spite of peripheral neuropathy / tendon ruptures
    Nadifloxacin 124858-35-1          
    Norfloxacin 70458-96-7 
    Ofloxacin 82419-36-1  No longer being manufactured no reason given
    Pefloxacin 70458-92-3      Not available in USA, Not FDA approved           
    Amifloxacin  86393-37-5          
    Rufloxacin 101363-10-4           
    Balofloxacin 127294-70-6          
    Gatifloxacin 112811-59-3   No longer being manufactured due to severe and fatal hypo/hyperglycemia
    Grepafloxacin 119914-60-2  Removed from Clinical Use due to fatal heart problems
    Pazufloxacin 127045-41-4      
    Sparfloxacin 110871-86-8  Associated with rhabdomyolysis
    Temafloxacin 108319-06-8  Removed from Clinical Use 
    Tosufloxacin 100490-36-6   Associated with chronic interstitial nephritis    
    Clinafloxacin 105956-97-6  Removed from Clinical Use due to severe phototoxicity and hypoglycemia
    Gemifloxacin 175463-14-6  Still in use in spite of disfiguring rashes   
    Moxifloxacin 151096-09-2  Still in use: fatal reactions, peripheral neuropathy / tendon ruptures
    Sitafloxacin 127254-12-0         
    Alatrofloxacin 157182-32-6     
    Trovafloxacin 147059-72-1  Removed from Clinical Use due to fatal liver problems
    Ecenofloxacin 162301-05-5     
    Prulifloxacin 123447-62-1         
    Danofloxacin 112398-08-0        
    Difloxacin 98106-17-3             
    Enrofloxacin 93106-60-6  Banned by the FDA    
    Marbofloxacin 115550-35-1
    Orbifloxacin 113617-63-3         
    Sarafloxacin 98105-99-8         

** Note:  Lack of information found on the FDA site may be for several reasons including
   the drug being removed from clinical practice, different name, or veterinarian use.