Enoxacin

Antacids containing aluminum hydroxide or magnesium hydroxide, oral iron supplements, sucralfate: decreased enoxacin absorption. Administration times are separated by at least 2 hours.

HOW SUPPLIED

Tablets (film-coated): 200 mg, 400 mg

ACTION

Inhibits bacterial DNA synthesis, mainly by blocking DNA gyrase; bactericidal.

INDICATIONS & DOSAGE

Uncomplicated urinary tract infections (UTIs) due to susceptible strains of Escherichia coli, Staphylococcus epidermidis, and S. saprophyticus -

Adults ages 18 and older: 200 mg P.O. q 12 hours for 7 days.

Severe or complicated UTIs due to susceptible strains of E. coli, Proteus mirabilis, Pseudomonas aeruginosa, S. epidermidis, and Enterobacter cloacae ­

Adults ages 18 and older: 400 mg P.O. q 12 hours for 14 days.

Uncomplicated urethral or endocervical gonorrhea -

Adults: 400 mg P.O. as a single dose.

Doxycycline therapy may follow to treat possible coexisting chlamydial infection.

Dosage adjustment: For patients with re­nal failure, if creatinine clearance is 30 ml/minute or less, therapy is started with usual initial dose. Subsequent doses are decreased by 50%.

ADVERSE REACTIONS

CNS: headache, restlessness, tremor, light­headedness, confusion, hallucinations, seizures.

GI: nausea, diarrhea, vomiting, abdominal pain or discomfort, oral candidiasis.

GU: crystalluria.

Hematologic: eosinophilia.

Hepatic: elevated liver enzymes.

Respiratory: dyspnea, cough.

Skin: rash, photosensitivity, pruritus.

Other: hypersensitivity.

INTERACTIONS

Drug-drug. Aminophylline, cyclosporine, theophylline: increased levels of these drugs because of decreased metabolism. Use together cautiously.

Bismuth subsalicylate: bioavailability of enoxacin is decreased when given within 60 minutes of bismuth subsalicylate. Avoid concomitant use.

Digoxin: may increase digoxin serum levels. Patient is monitored closely for toxicity.

Oral anticoagulants: increased anticoagulant effect. Use together cautiously.

Drug-food. Any food: affects absorption. Drug is given on an empty stomach. Caffeine: increased effect of caffeine. Monitor closely.

EFFECTS ON DIAGNOSTIC TESTS

None reported .

CONTRAINDICATIONS

Contraindicated in patients with hyper­sensitivity to drug or other fluoroquinolone antibiotics.

SPECIAL CONSIDERATIONS

Use cautiously in patients with CNS disorders, such as severe cerebral arteriosclerosis or seizure disorders, and in those at increased risk for seizures. Drug may cause CNS stimulation.

Use cautiously and with dosage adjustments in patients with impaired renal or hepatic function. Renal function and liver function tests must be monitored.

A specimen for culture and sensitivity tests should be obtained before giving first dose. Therapy may begin pending results.



Alert: Before treatment for gonorrhea begins, patient should have an initial serologic test for syphilis. Drug hasn't been effective in treating syphilis and may mask signs and symptoms of infection. Have the serologic test repeated in 1 to 3 months.

Drug is administered 2 hours after a meal or 2 hours before or after antacids containing magnesium hydroxide or aluminum hydroxide, sucralfate, or products that contain iron (such as vitamins with mineral supplements).

Patient is monitored closely for superinfection.

Safety in children under age 18 has not been established. Drug has caused cartilage erosion.

Tendon rupture has been reported in patients receiving quinolones. Drug is discontinued if pain, inflammation, or rupture of a tendon occurs.



Patient teaching

Take drug as prescribed, even after feeling better.

Take drug on an empty stomach.

Drink plenty of fluids to reduce risk of crystalluria.

Don't drink beverages containing caffeine. Enoxacin inhibits the metabolism of caffeine and can result in toxicity.

Avoid hazardous tasks until adverse CNS effects of drug are known.

Avoid overexposure to direct sunlight, use a sunblock, and wear protective clothing while outdoors.

Stop taking drug at first signs of an allergic reaction, and notify health care provider.

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