Enoxacin

• Type of Drug: Fluoroquinolone anti-infective.
• Prescribed for: Urinary infections and sexually transmitted diseases. Enoxacin does not work against syphilis.

General Information

The fluoroquinolones are widely used and work against many organisms that traditional antibiotic treatments have trouble killing. In addition to the above uses, fluoroquinolone anti- infectives can be used for the lower respiratory tract, skin, bones and joints, lung infections in people with cystic fibrosis, bronchitis, pneumonia, prostate infection, and traveler’s diarrhea and infectious diarrhea. Fluoroquinolone medications are chemically related to an older antibacterial called Nalidixic Acid, but work better than that drug against urinary infections. Enoxacin does not work against the common cold, flu, or other viral infections.

Cautions and Warnings

Do not take Enoxacin if you have had an allergic reaction to it or another fluoroquinolone in the past, or if you have had a reaction to related medications like Nalidixic Acid. Severe, possibly fatal, allergic reactions can occur even after the very first dose; these include cardiovascular collapse, loss of consciousness, tingling, swelling of the face or throat, breathing difficulty, itching, or rash. Stop taking the drug if this happens and seek medical help at once.

Enoxacin dosage must be adjusted in the presence of kidney failure.

Enoxacin may cause increased pressure on parts of the brain, leading to convulsions and psychotic reactions. Other adverse effects include tremors, restlessness, confusion, lightheadedness, and hallucinations. Enoxacin should be used with caution in people with seizure disorders or other conditions of the nervous system.

People taking fluoroquinolone medicines can be unusually sensitive to direct or indirect sunlight (photosensitivity). Avoid the sun while taking this drug and for several days following therapy, even if you are using a sunscreen!

As with any other anti-infective, people taking Enoxacin may develop colitis that could range from mild to very serious. See your doctor if you develop diarrhea or cramps while taking this drug.
Prolonged use of Enoxacin, as with any other anti-infective, can lead to fungal overgrowth. Follow your doctor’s directions exactly.

At very high doses, Enoxacin may cause decreased sperm production and reduce male fertility.

Possible Side Effects

• Most common: nausea and vomiting.
• Less common: abdominal pain, heartburn, upset stomach, diarrhea, itching, headache, sleeplessness, dizziness, and taste changes.
• Rare: constipation; gas; colitis; appetite loss; fatigue or drowsiness; not feeling well; seizures; confusion; tingling in the hands or feet; sensitivity to the sun; rash; sweating; fungal infections of the skin; skin peeling; nervousness; agitation; anxiety; tremors; weakness; muscle stiffness; muscle or joint pain in the back or chest; depersonalization; visual disturbances; ringing or buzzing in the ears; pink-eye; cough; nosebleeds; vaginal irritation or infection; kidney failure; heart palpitations; fainting; chills; fever; swollen legs, arms, or ankles; liver irritation; and black-and-blue marks.

Drug Interactions

• Antacids, Didanosine, Bismuth Subsalicylate (the active ingredient in Pepto-Bismol), Iron supplements, Sucralfate, and Zinc will decrease the amount of Enoxacin absorbed into the bloodstream. If you must take any of these products, separate them from your Enoxacin dosage by at least 2 hours.
• Anticancer drugs may also reduce the amount of Enoxacin in your bloodstream.
• Probenecid and Cimetidine interfere with the release of Enoxacin from your body, and may increase the chance of drug side effects.
• Enoxacin may increase the effects of oral anticoagulant (blood-thinning) drugs. Your anticoagulant dose may have to be adjusted.
• Enoxacin may increase the toxic effects of Cyclosporine (for organ transplants) on your kidneys.
• Enoxacin may reduce the rate at which Theophylline is released from your body, increasing blood levels of the drug and the chance for Theophylline-related drug side effects.
• Enoxacin decreases the clearance of Caffeine from your body, possibly increasing its effect on your system.
• Enoxacin increases blood levels of Digoxin. Your doctor may have to alter your Digoxin dose if you are taking this combination.

Food Interactions

Enoxacin is best taken at least 1 hour before or 2 hours after a meal.

Usual Dose

400 to 800 mg a day. Dosage is adjusted in the presence of kidney failure.

Overdosage

The symptoms of Enoxacin overdose are the same as those found under Possible Side Effects. One person experienced kidney failure following an overdose of Ciprofloxacin, another fluoroquinolone. Overdose victims should be taken to a hospital emergency room for treatment of those symptoms. ALWAYS bring the medicine bottle. You may induce vomiting with Syrup of Ipecac (available at any pharmacy) to remove excess medication from the victim’s stomach. Consult your local poison control center or hospital emergency room for specific instructions.

Special Information

Take each dose with a full glass of water. Be sure to drink at least 8 glasses of water per day while taking Enoxacin to promote removal of the drug from your system and to help avoid side effects.

If you are taking an antacid, an Iron or Zinc supplement, Didanosine, or Sucralfate while taking Enoxacin, be sure to separate the doses by at least 2 hours to avoid a drug interaction.

Drug sensitivity reactions can develop even after only one dose of this medicine! Stop taking it and get immediate medical attention if you faint or if you develop itching rash, facial swelling, difficulty breathing, convulsions, depression, visual disturbances, dizziness, headache, light-headedness, or any sign of a drug reaction.

Colitis can be caused by any anti-infective drug. If diarrhea develops after taking Enoxacin, call your doctor at once.

Avoid excessive sunlight or exposure to a sunlamp while taking Enoxacin and call your doctor if you become unusually sensitive to the sun.

It is essential that you take Enoxacin according to your doctor’s directions. Do not stop taking it even if you feel better after a few days, unless directed to do so by your doctor.

If you forget to take a dose of Enoxacin, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose.

Special Populations

Pregnancy/Breast-feeding
Pregnant women should not take Enoxacin unless it’s benefits have been carefully weighed against its risks. Animal studies have shown that Enoxacin may reduce the chance for a successful pregnancy or cause damage to a developing fetus.
It is not known if Enoxacin passes into breast milk. Nursing mothers who must take Enoxacin should bottle-feed their babies.

Seniors
Enoxacin blood levels are 50 percent higher in seniors than in younger adults. Daily drug dosage may be reduced if your kidney function is compromised.