Skip to Content

Penetrex (enoxacin) Disease Interactions

There are 4 disease interactions with Penetrex (enoxacin):

Major

Quinolones (Includes Penetrex) ↔ CNS disorders

Severe Potential Hazard, Moderate plausibility. Applies to: CNS Disorder

Quinolones may cause CNS stimulation manifested as tremors, agitation, restlessness, anxiety, confusion, hallucinations, paranoia, insomnia, toxic psychosis, and/or seizures. Benign intracranial hypertension has also been reported. Therapy with quinolones should be administered cautiously in patients with or predisposed to seizures or other CNS abnormalities. In addition, these patients should be advised to avoid the consumption of caffeine-containing products during therapy with some quinolones, most notably ciprofloxacin, enoxacin, and cinoxacin, since these agents can substantially reduce the clearance of caffeine and other methylxanthines, potentially resulting in severe CNS reactions.

References

  1. Wadworth AN, Goa KL "Lomefloxacin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic use." Drugs 42 (1991): 1018-60
  2. Jaber LA, Bailey EM, Rybak MJ "Enoxacin: a new fluoroquinolone." Clin Pharm 8 (1989): 97-107
  3. Schwartz MT, Calvert JF "Potential neurologic toxicity related to ciprofloxacin." Ann Pharmacother 24 (1990): 138-40
  4. Traeger SM, Bonfiglio MF, Wilson JA, Martin BR, Nackes NA "Seizures associated with ofloxacin therapy." Clin Infect Dis 21 (1995): 1504-6
  5. Arcieri G, Griffith E, Gruenwaldt G, et al "A survey of clinical experience with ciprofloxacin, a new quinolone antimicrobial." J Clin Pharmacol 28 (1988): 179-89
  6. "Product Information. Maxaquin (lomefloxacin)." Searle, Skokie, IL.
  7. Anastasio GD, Menscer D, Little JM "Norfloxacin and seizures." Ann Intern Med 109 (1988): 169-70
  8. McDermott JL, Gideonse N, Campbell JW "Acute delirium associated with ciprofloxacin administration in a hospitalized elderly patient." J Am Geriatr Soc 39 (1991): 909-10
  9. "Product Information. Tequin (gatifloxacin)" Bristol-Myers Squibb, Princeton, NJ.
  10. Cox CE, Simmons JR "Cinoxacin therapy for urinary tract infections: therapeutic safety and efficacy." South Med J 75 (1982): 549-50
  11. "Product Information. Levaquin (levofloxacin)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  12. Darwish T "Ciprofloxacin-induced seizures in a healthy patient." N Z Med J 121 (2008): 104-5
  13. Tack KJ, Smith JA "The safety profile of ofloxacin." Am J Med 87 (1989): s78-81
  14. "Product Information. Cipro (ciprofloxacin)." Bayer, West Haven, CT.
  15. "Product Information. NegGram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  16. Karki SD, Bentley DW, Raghavan M "Seizure with ciprofloxacin and theophylline combined therapy." DICP 24 (1990): 595-6
  17. "Product Information. Floxin (ofloxacin)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  18. Ernst ME, Ernst EJ, Klepser ME "Levofloxacin and trovafloxacin: the next generation of fluoroquinolones?" Am J Health Syst Pharm 54 (1997): 2569-84
  19. "Product Information. Avelox (moxifloxacin)" Bayer, West Haven, CT.
  20. "Product Information. Cinobac (cinoxacin)." Oclassen Pharmaceuticals Inc, San Rafael, CA.
  21. Fennig S, Mauas L "Ofloxacin-induced delirium." J Clin Psychiatry 53 (1992): 137-8
  22. Melvani S, Speed BR "Alatrofloxacin-induced seizures during slow intravenous infusion." Ann Pharmacother 34 (2000): 1017-9
  23. Thomas RJ, Regan DR "Association of a tourette-like syndrome with ofloxacin." Ann Pharmacother 30 (1996): 138-41
  24. Isaacson SH, Carr J, Rowan AJ "Ciprofloxacin-induced complex partial status epilepticus manifesting as an acute confusional state." Neurology 43 (1993): 1619-21
  25. Todd PA, Faulds D "Ofloxacin: a reappraisal of its antimicrobial activity, pharmacology, and therapeutic use." Drugs 42 (1991): 825-76
  26. Winrow AP, Supramaniam G "Benign intracranial hypertension after ciprofloxacin administration." Arch Dis Child 65 (1990): 1165-6
  27. Burt RA "Review of adverse reactions associated with cinoxacin and other drugs used to treat urinary tract infections." Urology 23 (1984): 101-7
  28. "Product Information. Penetrex (enoxacin)." Rhone-Poulenc Rorer, Collegeville, PA.
  29. Kremer L, Walton M, Wardle EN "Nalidixic acid and intracranial hypertension." Br Med J 4 (1967): 488
  30. "Product Information. Trovan (trovafloxacin)." Pfizer US Pharmaceuticals, New York, NY.
  31. Leslie PJ, Cregeen RJ, Proudfoot AT "Lactic acidosis, hyperglycaemia and convulsions following nalidixic acid overdosage." Hum Toxicol 3 (1984): 239-43
  32. Akhtar S, Ahmad H "Ciprofloxacin-induced catatonia." J Clin Psychiatry 54 (1993): 115-6
  33. Norrby SR "Side-effects of quinolones: comparisons between quinolones and other antibiotics." Eur J Clin Microbiol Infect Dis 10 (1991): 378-83
  34. Poc TE, Marion GS, Jackson DS "Seizures due to nalidixic acid therapy." South Med J 77 (1984): 539-40
  35. Fraser AG, Harrower AD "Convulsions and hyperglycaemia asociated with nalidixic acid." Br Med J 2 (1977): 1518
  36. "Product Information. Noroxin (norfloxacin)." Merck & Co, Inc, West Point, PA.
  37. McCue JD, Zandt JR "Acute psychoses associated with the use of ciprofloxacin and trimethoprim-sulfamethoxazole." Am J Med 90 (1991): 528-9
  38. Sisca TS, Heel RC, Romankiewicz JA "Cinoxacin. A review of its pharmacological properties and therapeutic efficacy in the treatment of urinary tract infections." Drugs 25 (1983): 544-69
  39. Arcieri G, August R, Becker N, et al "Clinical experience with ciprofloxacin in the USA." Eur J Clin Microbiol 5 (1986): 220-5
  40. Walton GD, Hon JK, Mulpur TG "Ofloxacin-induced seizure." Ann Pharmacother 31 (1997): 1475-7
  41. Schacht P, Arcieri G, Hullmann R "Safety of oral ciprofloxacin. An update based on clinical trial results." Am J Med 87 (1989): s98-102
  42. "Product Information. Zagam (sparfloxacin)." Rhone-Poulenc Rorer, Collegeville, PA.
  43. "Product Information. Factive (gemifloxacin)." GeneSoft Inc, San Francisco, CA.
  44. Haria M, Lamb HM "Trovafloxacin." Drugs 54 (1997): 435-45;disc. 446
  45. Moore B, Safani M, Keesey J "Possible exacerbation of myasthenia gravis by ciprofloxacin." Lancet Jan (1988): 882
  46. Bednarczyk EM, Green JA, Nelson D, et al "Comparative assessment of the effect of lomefloxacin, ciprofloxacin, and placebo on cerebral blood flow, and glucose and oxygen metabolism in healthy subjects by position emission tomography." Pharmacotherapy 12 (1992): 369-75
  47. De Sarro A, De Sarro G "Adverse reactions to fluoroquinolones. An overview on mechanistic aspects." Curr Med Chem 8 (2001): 371-84
  48. Stamey TA "Cinoxacin: an overview." Urology 17 (1981): 492-5
  49. Just PM "Overview of the fluoroquinolone antibiotics." Pharmacotherapy 13 (1993): s4-17
  50. Getenet JC, Croisile B, Vighetto A, et al. "Idiopathic intracranial hypertension after ofloxacin treatment." Acta Neurol Scand 87 (1993): 503-4
  51. Unseld E, Ziegler G, Gemeinhardt A, Janssen U, Klotz U "Possible interaction of fluoroquinolones with benzodiazepine-GABA-receptorn complex." Br J Clin Pharmacol 30 (1990): 63-70
  52. Rosolen A, Drigo P, Zanesco L "Acute hemiparesis associated with ciprofloxacin." BMJ 309 (1994): 1411
  53. Slavich IL, Gleffe Rf, Haas EJ "Grand mal epileptic seizures during ciprofloxacin therapy." JAMA 261 (1989): 558-9
  54. Semel JD, Allen N "Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole." South Med J 84 (1991): 465-8
  55. Altes J, Gasco J, De Antonio J, Villalonga C "Ciprofloxacin and delirium." Ann Intern Med 110 (1989): 170-1
  56. Fanhavard P, Sanchorawala V, Oh J, Moser EM, Smith SP "Concurrent use of foscarnet and ciprofloxacin may increase the propensity for seizures." Ann Pharmacother 28 (1994): 869-72
  57. Ball P "Ciprofloxacin: an overview of adverse experiences." J Antimicrob Chemother 18 (1986): 187-93
View all 57 references
Major

Quinolones (Includes Penetrex) ↔ myasthenia gravis

Severe Potential Hazard, Moderate plausibility. Applies to: Myasthenia Gravis

Fluoroquinolones have neuromuscular blocking activity and may exacerbate muscle weakness in persons with myasthenia gravis. Postmarketing serious adverse events, including deaths and requirement for ventilatory support, have been associated with fluoroquinolones use in persons with myasthenia gravis. Fluoroquinolones should be avoided in patients with history of myasthenia gravis.

Major

Quinolones (Includes Penetrex) ↔ peripheral neuropathy

Severe Potential Hazard, Moderate plausibility. Applies to: Peripheral Neuropathy

The use of quinolones has been associated with an increased risk of peripheral neuropathy. Monitor closely and discontinue their use in patients experiencing symptoms of peripheral neuropathy. It is recommended to avoid these agents in patients who have previously experienced peripheral neuropathy.

Major

Quinolones (Includes Penetrex) ↔ tendonitis

Severe Potential Hazard, Moderate plausibility. Applies to: Tendonitis, Rheumatoid Arthritis, Renal Dysfunction, Organ Transplant

Tendonitis and ruptures of the shoulder, hand, and Achilles tendons have been reported in patients receiving quinolones, both during and after treatment. Avoid the use of these agents in patients who have a history of tendon disorders or have experienced tendinitis or tendon rupture. Therapy with quinolones should be administered cautiously in patients with patients with kidney, heart, and lung transplant, since it may delay the recognition or confound the diagnosis of a quinolone-induced musculoskeletal effect. Factors that may independently increase the risk of tendon rupture include strenuous physical activity, renal failure, and previous tendon disorders such as rheumatoid arthritis. It is recommended to discontinue these agents if, at any time during therapy, pain, inflammation or rupture of a tendon develops and institute appropriate treatment.

References

  1. "Product Information. Penetrex (enoxacin)." Rhone-Poulenc Rorer, Collegeville, PA.
  2. "Product Information. Factive (gemifloxacin)." GeneSoft Inc, San Francisco, CA.
  3. "Product Information. Zagam (sparfloxacin)." Rhone-Poulenc Rorer, Collegeville, PA.
  4. Schacht P, Arcieri G, Hullmann R "Safety of oral ciprofloxacin. An update based on clinical trial results." Am J Med 87 (1989): s98-102
  5. Casparian JM, Luchi M, Moffat RE, Hinthorn D "Quinolones and tendon ruptures." South Med J 93 (2000): 392-6
  6. "Product Information. Trovan (trovafloxacin)." Pfizer US Pharmaceuticals, New York, NY.
  7. "Product Information. Noroxin (norfloxacin)." Merck & Co, Inc, West Point, PA.
  8. "Product Information. Tequin (gatifloxacin)" Bristol-Myers Squibb, Princeton, NJ.
  9. "Product Information. Levaquin (levofloxacin)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  10. "Product Information. NegGram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  11. Zabraniecki L, Negrier I, Vergne P, Arnaud M, Bonnet C, Bertin P, Treves R "Fluoroquinolone induced tendinopathy: report of 6 cases." J Rheumatol 23 (1996): 516-20
  12. "Product Information. Maxaquin (lomefloxacin)." Searle, Skokie, IL.
  13. Donck JB, Segaert MF, Vanrenterghem YF "Fluoroquinolones and achilles tendinopathy in renal transplant recipients." Transplantation 58 (1994): 736-7
  14. "Product Information. Avelox (moxifloxacin)" Bayer, West Haven, CT.
  15. Carrasco JM, Garcia B, Andujar C, Garrote F, de Juana P, Bermejo T "Tendinitis associated with ciprofloxacin." Ann Pharmacother 31 (1997): 120
  16. "Product Information. Floxin (ofloxacin)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  17. "Product Information. Cipro (ciprofloxacin)." Bayer, West Haven, CT.
  18. "Product Information. Cinobac (cinoxacin)." Oclassen Pharmaceuticals Inc, San Rafael, CA.
View all 18 references

Penetrex (enoxacin) drug interactions

There are 463 drug interactions with Penetrex (enoxacin)

Penetrex (enoxacin) alcohol/food interactions

There are 2 alcohol/food interactions with Penetrex (enoxacin)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Hide