Tarivid (Ofloxacin)

What is Tarivid?

Tarivid (ofloxacin) is a second-generation fluoroquinolone antibiotic with broad-spectrum antibacterial activity. It is used to treat a range of bacterial infections, including urinary tract infections (UTIs), sexually transmitted infections caused by susceptible bacteria, and epididymo-orchitis.

Ofloxacin has been in clinical use since the 1980s and is recognised in European and WHO clinical guidelines as an effective antibiotic for specific sexual health indications. However, it is generally reserved for situations where first-line antibiotics are not appropriate, due to the class-specific safety considerations associated with fluoroquinolones.

How does Tarivid work?

Ofloxacin belongs to the fluoroquinolone class of antibiotics and kills bacteria through a mechanism that is distinct from other antibiotic classes:

• DNA gyrase and topoisomerase IV inhibition: Ofloxacin inhibits two bacterial enzymes — DNA gyrase (topoisomerase II) and topoisomerase IV — that are essential for bacterial DNA replication, transcription, repair, and recombination.
• DNA strand breaks: Inhibition of these enzymes causes irreversible double-strand breaks in bacterial DNA, leading to disruption of DNA structure and function.
• Bactericidal activity: The resulting DNA damage is lethal to the bacterium, making ofloxacin a bactericidal antibiotic (it kills bacteria rather than merely inhibiting growth).
• Broad gram-negative activity: Ofloxacin has strong activity against gram-negative bacteria (including Escherichia coli, Neisseria gonorrhoeae) and moderate activity against gram-positive organisms. Importantly for sexual health, it is also active against the intracellular pathogen Chlamydia trachomatis.

Levofloxacin: Levofloxacin is the L-isomer of ofloxacin and is essentially the active component. Levofloxacin has largely replaced ofloxacin in many markets due to a twice-daily dosing schedule becoming once-daily.

Who is Tarivid for?

In sexual health practice, ofloxacin is relevant for:

• Uncomplicated UTIs: Lower urinary tract infections caused by susceptible gram-negative organisms (e.g., E. coli), though fluoroquinolones are now reserved for cases where first-line agents are unsuitable due to resistance or allergy concerns
• Non-gonococcal urethritis (NGU): Alternative treatment option
• Chlamydia (Chlamydia trachomatis): 200–300 mg twice daily for 7 days — alternative to doxycycline or azithromycin
• Epididymo-orchitis: European STI guidelines include ofloxacin 200 mg twice daily for 14 days as an option for epididymo-orchitis likely caused by enteric organisms in older men (not suitable if gonorrhoea is suspected)
• Pelvic inflammatory disease (PID): Used in combination regimens including metronidazole

Ofloxacin is not appropriate for:

• Children and adolescents under 18 years (risk of cartilage damage — a fluoroquinolone class restriction)
• Pregnant or breastfeeding women
• Patients with a history of tendon disorders related to fluoroquinolone use
• Patients with QT prolongation or on QT-prolonging medicines
• Gonorrhoea — fluoroquinolone resistance in Neisseria gonorrhoeae is widespread in Europe; ofloxacin should not be used unless susceptibility is confirmed

Dosage

Indication	Dose	Duration
Uncomplicated UTI	200 mg twice daily	3–7 days
Complicated UTI	200 mg twice daily	7–14 days
Chlamydia (alternative)	200–300 mg twice daily	7 days
NGU (alternative)	200 mg twice daily	7 days
Epididymo-orchitis (enteric organisms)	200 mg twice daily	14 days
PID (in combination)	400 mg twice daily	14 days

Tarivid tablets can be taken with or without food. Take with adequate water. Avoid taking with antacids, iron, zinc, or calcium-rich products within 2 hours (reduced absorption).

Side effects

Fluoroquinolones have a specific safety profile that must be considered, including some class-specific risks not seen with other antibiotic classes.

Common side effects

• Nausea
• Diarrhoea
• Headache
• Dizziness
• Insomnia or sleep disturbance
• Photosensitivity (avoid sun exposure; use sunscreen)

Fluoroquinolone class-specific safety concerns

Tendinopathy and tendon rupture: Fluoroquinolones can cause inflammation and rupture of tendons, most commonly the Achilles tendon. Risk is higher in patients over 60 years, those taking systemic corticosteroids, and those with kidney, heart, or lung transplants. Stop treatment immediately if tendon pain, swelling, or inflammation develops.

Peripheral neuropathy: Fluoroquinolones can cause peripheral sensory neuropathy — tingling, burning, or numbness in the extremities. This may be long-lasting. Discontinue immediately if these symptoms develop.

Central nervous system effects: Dizziness, confusion, anxiety, tremors, and rarely seizures. Caution in patients with a history of seizures or CNS conditions.

QT prolongation: Ofloxacin can prolong the QT interval, increasing the risk of cardiac arrhythmias. Avoid in patients with known QT prolongation or on other QT-prolonging medicines.

Aortic aneurysm and dissection: An association between fluoroquinolone use and aortic aneurysm or dissection has been identified by the EMA. Avoid in patients with known aortic aneurysm or risk factors.

Hypoglycaemia and hyperglycaemia: Disturbances in blood sugar have been reported, particularly in diabetic patients taking antidiabetic medicines.

Tarivid vs alternative antibiotics for STI treatment

Antibiotic	Chlamydia	UTI	NGU	Epididymo-orchitis	Notes
Doxycycline (1st line)	Yes	No	Yes	Yes	Preferred for chlamydia
Azithromycin (1st line)	Yes	No	Yes	No	Preferred for chlamydia
Ofloxacin (Tarivid)	Alternative	Yes	Alternative	Yes (enteric)	Fluoroquinolone cautions
Amoxicillin	Limited	Yes	No	No	Penicillin; limited STI role

How to access Tarivid online in Europe

Tarivid (ofloxacin) is a prescription-only medicine (POM) in all EU member states. It cannot legally be dispensed without a valid prescription from a licensed medical professional.

Prescrivia operates as a technology intermediary: we do not prescribe medicines, employ doctors, or sell medicines. Our platform connects patients with independent EU-registered doctors who can conduct confidential online health assessments.

The process:

1. Complete a health assessment: Provide details of your symptoms, current medications, and any relevant medical history including tendon disorders or cardiac conditions.
2. Doctor review: An independent EU-registered doctor reviews your assessment and determines whether ofloxacin is appropriate.
3. Pharmacy fulfilment: The prescription is sent to a licensed EU pharmacy partner for dispensing and direct delivery.

Important: Prescrivia does not guarantee that a prescription will be issued. All prescribing decisions are made independently by qualified medical professionals.

Important safety information

Do not take Tarivid if you:

• Are under 18 years of age
• Are pregnant or breastfeeding
• Have previously had a tendon disorder caused by a fluoroquinolone antibiotic
• Have myasthenia gravis (risk of worsening)
• Have QT prolongation or are taking other QT-prolonging medicines
• Are allergic to ofloxacin or other fluoroquinolone antibiotics

Tell your doctor if you:

• Have epilepsy or a history of seizures
• Have kidney disease (dose adjustment may be required)
• Have diabetes and are taking antidiabetic medicines
• Have a history of aortic aneurysm, Marfan syndrome, or Ehlers-Danlos syndrome
• Are taking non-steroidal anti-inflammatory drugs (NSAIDs) concurrently (lowers seizure threshold)
• Are taking warfarin (ofloxacin increases anticoagulant effect)

EMA regulatory note: The EMA has issued guidance restricting the use of fluoroquinolone antibiotics to situations where other antibiotics cannot be used, given the serious disabling and potentially permanent side effects (tendon, muscle, joint, and nervous system effects). A doctor will weigh these considerations when prescribing.

Sources

Medical information on this page is based on the following sources:

• European Medicines Agency (EMA). Fluoroquinolone antibiotics: updated restrictions on use. EMA/795349/2018. Available at: ema.europa.eu
• European STI Guidelines Editorial Board. 2017 European guideline on the management of epididymo-orchitis. Journal of the European Academy of Dermatology and Venereology.
• World Health Organization (WHO). WHO Guidelines for the Treatment of Chlamydia trachomatis. 2016. who.int

This content is reviewed periodically to reflect updated clinical guidance. It is provided for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for advice relevant to your individual health circumstances.