When Ofloxacin Isn't Available, These Are Your Options

If you've been prescribed Ofloxacin and your pharmacy can't fill it, you might be wondering: what else can I take? You're not alone — Ofloxacin has been difficult to find for many patients, especially the eye drop and ear drop formulations.

The good news is that there are several effective alternatives in the same drug class. This post will walk you through what Ofloxacin is, how it works, and the most common alternatives your doctor might consider.

Important: Never switch medications on your own. Always talk to your doctor or pharmacist before changing your antibiotic. Different antibiotics cover different bacteria, and your provider will know which one is right for your specific infection.

What Is Ofloxacin?

Ofloxacin is a fluoroquinolone antibiotic used to treat a wide range of bacterial infections. It was first approved by the FDA in 1990 and is available in three formulations:

• Oral tablets (200 mg, 300 mg, 400 mg) — for UTIs, respiratory infections, skin infections, prostatitis, and pelvic inflammatory disease
• Ophthalmic solution 0.3% — for bacterial conjunctivitis and corneal ulcers
• Otic solution 0.3% — for ear infections including otitis externa and chronic suppurative otitis media

The original brand names were Floxin (oral), Ocuflox (eye drops), and Floxin Otic (ear drops). Today, only generic versions are available. For a complete overview, see our post on what Ofloxacin is and how to use it.

How Does Ofloxacin Work?

Ofloxacin kills bacteria by blocking DNA gyrase and topoisomerase IV — two enzymes that bacteria need to copy and repair their DNA. Without these enzymes, the bacteria can't reproduce and they die off. This mechanism is shared by all fluoroquinolone antibiotics, which is why drugs in this same class can often be used as substitutes.

For a more detailed explanation, check out our post on how Ofloxacin works.

Alternative #1: Levofloxacin (Levaquin)

Levofloxacin is actually the active L-isomer of Ofloxacin, which means it's chemically related and works the same way — but it's roughly twice as potent. This makes it the closest alternative to Ofloxacin.

Key facts about Levofloxacin:

• Available as oral tablets (250 mg, 500 mg, 750 mg), IV solution, and ophthalmic solution
• Once-daily dosing for most infections (compared to twice-daily for Ofloxacin)
• Treats similar infections: UTIs, respiratory infections, skin infections, prostatitis, sinusitis
• Generic versions widely available — typically $4 to $20 with a discount coupon
• Carries the same FDA boxed warning as all fluoroquinolones

Levofloxacin is generally more readily available than Ofloxacin because more manufacturers produce it and it's prescribed much more frequently.

Alternative #2: Ciprofloxacin (Cipro)

Ciprofloxacin is the most widely prescribed fluoroquinolone in the United States. It has strong activity against gram-negative bacteria and is a go-to choice for UTIs, certain types of diarrhea, bone and joint infections, and anthrax exposure.

Key facts about Ciprofloxacin:

• Available as oral tablets (250 mg, 500 mg, 750 mg), oral suspension, IV solution, ophthalmic solution, and otic solution
• Usually taken twice daily
• Very affordable — as low as $3 to $10 with a GoodRx or SingleCare coupon
• Available in both ophthalmic and otic formulations, making it a direct substitute for Ofloxacin eye or ear drops
• One of the most commonly stocked antibiotics at every pharmacy in the country

If your doctor prescribed Ofloxacin ear or eye drops and they're not available, Ciprofloxacin drops are often the most practical swap because they're so widely stocked.

Alternative #3: Moxifloxacin (Avelox / Vigamox)

Moxifloxacin is a newer-generation fluoroquinolone with enhanced activity against gram-positive bacteria and anaerobes. It's particularly useful for respiratory tract infections and eye infections.

Key facts about Moxifloxacin:

• Available as oral tablets (400 mg) and ophthalmic solution (Vigamox)
• Once-daily dosing
• Better coverage for pneumonia and sinus infections compared to older fluoroquinolones
• Vigamox ophthalmic solution is a popular choice for bacterial conjunctivitis and post-surgical eye infection prevention
• Slightly more expensive — generic oral tablets run about $10 to $30 with coupons
• Not available as an otic (ear) formulation

Alternative #4: Trimethoprim-Sulfamethoxazole (Bactrim)

If your infection is a urinary tract infection and you're trying to avoid fluoroquinolones entirely, Trimethoprim-Sulfamethoxazole (commonly called Bactrim or Septra) is a non-fluoroquinolone alternative.

Key facts:

• Available as oral tablets and suspension
• Usually taken twice daily for 3 to 14 days depending on the infection
• Very inexpensive — often under $5 with a discount card
• Does not carry the fluoroquinolone boxed warning about tendon damage and nerve problems
• Not effective for all the same infections as Ofloxacin (doesn't treat ear or eye infections)

How to Decide Which Alternative Is Right for You

The right alternative depends on:

• What type of infection you have — UTI, ear infection, eye infection, respiratory infection, etc.
• Which formulation you need — oral, eye drops, or ear drops
• Your allergy history — if you're allergic to one fluoroquinolone, you may be allergic to all of them
• Other medications you take — check for drug interactions
• Your medical history — conditions like myasthenia gravis, tendon problems, or a history of seizures may affect which antibiotic is safest for you

Your doctor will weigh all these factors when choosing an alternative. Don't hesitate to ask questions about why they're recommending a particular substitute.

Final Thoughts

Not being able to fill your Ofloxacin prescription is stressful, especially when you're dealing with an active infection. But there are solid alternatives available — Levofloxacin, Ciprofloxacin, Moxifloxacin, and in some cases, non-fluoroquinolone options like Bactrim.

Before switching, use Medfinder to check if any pharmacies near you still have Ofloxacin in stock. You might find it's available just a short drive away. And for more tips on locating your medication, see our guide on how to find Ofloxacin in stock near you.