No

Antibiotic, Quinolone

Treatment of urinary tract infections

B

History of convulsive disorders, hypersensitivity to cinoxacin or any component or other quinolones

CNS stimulation may occur (tremor, restlessness, confusion, and very rarely hallucinations or seizures). Use with caution in patients with known or suspected CNS disorders or renal impairment. Not recommended in children <18 years of age, ciprofloxacin (a related compound), has caused a transient arthropathy in children; prolonged use may result in superinfection; modify dosage in patients with renal impairment.

Generally well tolerated

Central nervous system: Headache, dizziness

Gastrointestinal: Heartburn, abdominal pain, GI bleeding, belching, flatulence, anorexia, nausea

<1%: Insomnia, confusion, seizures (rare), diarrhea, thrombocytopenia, photophobia, tinnitus

Symptoms of overdose include acute renal failure, seizures

GI decontamination and supportive care; not removed by peritoneal or hemodialysis

Decreased effect: Decreased urine levels with probenecid; decreased absorption with aluminum-, magnesium-, calcium-containing antacids

Increased serum levels: Probenecid

Inhibits microbial synthesis of DNA with resultant inhibition of protein synthesis

Absorption: Oral: Rapid and complete; food decreases peak levels by 30% but not total amount absorbed

Distribution: Crosses the placenta; concentrates in prostate tissue

Protein binding: 60% to 80%

Half-life: 1.5 hours, prolonged in renal impairment

Time to peak serum concentration: Oral: Within 2-3 hours

Elimination: ~60% excreted as unchanged drug in urine

Children >12 years and Adults: Oral: 1 g/day in 2-4 doses for 7-14 days

Cl_cr 20-50 mL/minute: 250 mg twice daily

Cl_cr <20 mL/minute: 250 mg/day

May cause dizziness, insomnia or confusion; quinolones reported to cause restlessness, hallucinations, euphoria, depression, panic, and paranoia

None reported

No information available to require special precautions

No effects or complications reported

Take prescribed dose with food. Maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake). Avoid antacid use. May cause dizziness; avoid driving or engaging in tasks that require alertness until response to drug is known. Small frequent meals, frequent mouth care, sucking lozenges, or chewing gum may reduce nausea or vomiting. Report skin rash, itching, redness, or swelling; pain, inflammation, or rupture of tendon; pain or burning on urination; or persistent diarrhea or vomiting. Breast-feeding precautions: Do not breast-feed.

Hold antacids for 3-4 hours after giving

Capsule: 250 mg, 500 mg

Sisca TS, Heel RC, and Romankiewicz JA, "Cinoxacin: A Review of Its Pharmacological Properties and Therapeutic Efficacy in the Treatment of Urinary Tract Infections," Drugs, 1983, 25(6):544-69.

Stricker BH, Slagboom G, Demaeseneer R, et al, "Anaphylactic Reactions to Cinoxacin," BMJ, 1988, 297(6661):1434-5.

Szarfman A, Chen M, and Blum MD, "More on Fluoroquinolone Antibiotics and Tendon Rupture," N Engl J Med, 1995, 332(3):193.