No

Antibiotic, Quinolone

Treatment of complicated and uncomplicated urinary tract infections caused by susceptible gram-negative and gram-positive bacteria and uncomplicated urethral or cervical gonorrhea due to N. gonorrhoeae

C

Hypersensitivity to enoxacin, any component, or other quinolones

Use with caution in patients with a history of convulsions or epilepsy, renal dysfunction, psychosis, elevated intracranial pressure, prepubertal children, and pregnancy; nalidixic acid and ciprofloxacin (related compounds) have been associated with erosions of the cartilage in weight-bearing joints and other signs of arthropathy in immature animals and children; similar precautions are advised for enoxacin although no data is available; has rarely caused ruptured tendons (discontinue immediately with signs of inflammation or tendon pain)

1% to 10%:

Central nervous system: Dizziness (<3%), headache (<2%), vertigo (3%)

Gastrointestinal: Nausea (2.9%), vomiting (6% to 9%), abdominal pain (1% to 2%), diarrhea (1% to 2%)

<1%: Palpitations, syncope, edema, restlessness, confusion, seizures, fatigue, drowsiness, depression, insomnia, confusion, chills, fever, rash, photosensitivity, pruritus, exfoliative dermatitis, hypo/hyperkalemia, GI bleeding, dyspepsia, xerostomia, constipation, flatulence, anorexia, vaginitis, anemia, leukopenia, eosinophilia, leukocytosis, increased liver enzymes, tremor, arthralgia, ruptured tendons, paresthesias, visual disturbances, increased serum creatinine/BUN, acute renal failure, proteinuria

Symptoms of overdose include acute renal failure, seizures

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

CYP1A2 enzyme inhibitor

Increased toxicity/levels of warfarin, cyclosporine, digoxin, caffeine, and theophylline with enoxacin

Increased levels of enoxacin with cimetidine, probenecid

Inhibits DNA-gyrase in susceptible organisms; inhibits relaxation of supercoiled DNA and promotes breakage of double-stranded DNA

Absorption: 98%

Distribution: Penetrates well into tissues and body secretions

Half-life: 3-6 hours (average)

Elimination: Primarily in urine, however, significant drug concentrations are achieved in feces

Adults: Oral:

Cystitis: 200 mg twice daily for 7 days

Uncomplicated gonorrhea: 400 mg as single dose

Dosing adjustment in renal impairment: Cl_cr <50 mL/minute: Administer 50% of dose

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

Rarely causes leukopenia; use caution with clozapine and carbamazepine

No information available to require special precautions

No effects or complications reported

Take as prescribed and for as long as directed. Take on an empty stomach (1 hour prior to or after meals). Do not use antacids within 2 hours of medication. Maintain adequate hydration (2-3 L/day of fluids unless instructed to restrict fluid intake). You may experience stomach discomfort (eat small, frequent meals) and dizziness or blurred vision (use caution when driving). May cause photosensitivity (use sunscreen, wear protective clothing and eyewear, and avoid direct sunlight). Report skin rash; visual changes; severe gastric upset; weakness; pain, inflammation, or rupture of tendon; or signs or symptoms of opportunistic infection (eg, white spots or sores in mouth or perineal area, itching or vaginal discharge, unhealed sores, fever). Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Do not breast-feed.

Hold antacids for 3-4 hours before or after administering; administer on an empty stomach; encourage fluids

Patients receiving concurrent enoxacin and theophylline should have serum levels of theophylline monitored

Tablet: 200 mg, 400 mg

Dobbs BR, Gazeley LR, Campbell AJ, et al, "The Effect of Age on the Pharmacokinetics of Enoxacin," Eur J Clin Pharmacol, 1987, 33(1):101-4.

Hooper DC and Wolfson JS, "Fluoroquinolone Antimicrobial Agents," N Engl J Med, 1991, 324(6):384-94.

Izu R, Gardeazabal J, Gonzalez M, et al, "Enoxacin-Induced Photosensitivity: Study of Two Cases," Photodermatol Photoimmunol Photomed, 1992, 9(2):86-8.

Lomaestro BM and Bailie GR, "Quinolone-Cation Interactions: A Review," DICP, 1991, 25(11):1249-58.

Patel SS and Spencer CM, "Enoxacin: A Reappraisal of Its Clinical Efficacy in the Treatment of Genitourinary Tract Infections," Drugs, 1996, 51(1):137-60.

Stein GE, "The 4-Quinolone Antibiotics: Past, Present, and Future," Pharmacotherapy, 1988, 8(6):301-14.

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

Walker RC and Wright AJ, "The Fluoroquinolones," Mayo Clin Proc, 1991, 66(12):1249-59.

Wise R, Baker SL, Misra M, et al, "The Pharmacokinetics of Enoxacin in Elderly Patients," J Antimicrob Chemother, 1987, 19(3):343-50.