Question:medium
Which fluoroquinolone is contraindicated (dose must be reduced) in liver disease?
Which fluoroquinolone is contraindicated (dose must be reduced) in liver disease?
Show Hint
Find the quinolone that is hepatically cleared and accumulates, unlike the renally excreted rest.
Updated On: Jun 23, 2026
- Levofloxacin
- Pefloxacin
- Ofloxacin
- Lomefloxacin
Show Solution
The Correct Option is B
Solution and Explanation
Memory hook: 'Pefloxacin = hePatic'. Among the fluoroquinolones, it is the one that leans on the liver instead of the kidney for clearance.
Pefloxacin undergoes extensive hepatic metabolism and has the longest half-life of the group, so repeated doses pile up and plasma concentrations roughly double compared with a single dose. In hepatic dysfunction this build-up risks toxicity, so the dose is cut in liver disease while staying unchanged in renal failure.
By contrast, levofloxacin, ofloxacin, and lomefloxacin are excreted predominantly unchanged in urine, so they need renal, not hepatic, dose adjustment. That isolates pefloxacin as the correct answer.
Pefloxacin undergoes extensive hepatic metabolism and has the longest half-life of the group, so repeated doses pile up and plasma concentrations roughly double compared with a single dose. In hepatic dysfunction this build-up risks toxicity, so the dose is cut in liver disease while staying unchanged in renal failure.
By contrast, levofloxacin, ofloxacin, and lomefloxacin are excreted predominantly unchanged in urine, so they need renal, not hepatic, dose adjustment. That isolates pefloxacin as the correct answer.
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