General: Adequate hydration of patients receiving sparfloxacin should be maintained to prevent the formation of a highly concentrated urine . Administer sparfloxacin with caution in the presence of renal insufficiency. Careful clinical observation and appropriate laboratory studies should be performed prior to and during therapy since elimination of sparfloxacin may be reduced. Adjustment of the dosage regimen is necessary for patients with impaired renal function-creatinine clearance CLINICAL PHARMACOLOGY and DOSAGE AND ADMINISTRATION . ) Avoid the concomitant prescription of medications known to prolong the QT c interval, e.g., erythromycin , terfenadine, astemizole, cisapride, pentamidine, tricyclic antidepressants, some antipsychotics including phenothiazines. (See CONTRAINDICATIONS . ) Sparfloxacin is not recommended for use in patients with pro-arrhythmic conditions (e.g., hypokalemia , significant bradycardia , congestive heart failure , myocardial ischemia , and atrial fibrillation ). Moderate to severe phototoxicity reactions have been observed in patients exposed to direct sunlight while receiving drugs in this class. Excessive exposure to sunlight should be avoided. In clinical trials with sparfloxacin, phototoxicity was observed in approximately 7% of patients. Therapy should be discontinued if phototoxicity (e.g., a skin eruption) occurs. As with other quinolones, sparfloxacin should be used with caution in any patient with a known or suspected CNS disorder tha
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