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Penetrex Disease Interactions

There are 4 disease interactions with Penetrex (enoxacin).

Major

Quinolones (applies to Penetrex) CNS disorders

Major Potential Hazard, Moderate plausibility.

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. Ball P "Ciprofloxacin: an overview of adverse experiences." J Antimicrob Chemother 18 (1986): 187-93
  2. 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
  3. McCue JD, Zandt JR "Acute psychoses associated with the use of ciprofloxacin and trimethoprim-sulfamethoxazole." Am J Med 90 (1991): 528-9
  4. Arcieri G, August R, Becker N, et al. "Clinical experience with ciprofloxacin in the USA." Eur J Clin Microbiol 5 (1986): 220-5
  5. Altes J, Gasco J, De Antonio J, Villalonga C "Ciprofloxacin and delirium." Ann Intern Med 110 (1989): 170-1
  6. 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
  7. Slavich IL, Gleffe Rf, Haas EJ "Grand mal epileptic seizures during ciprofloxacin therapy." JAMA 261 (1989): 558-9
  8. Moore B, Safani M, Keesey J "Possible exacerbation of myasthenia gravis by ciprofloxacin." Lancet Jan (1988): 882
  9. Semel JD, Allen N "Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole." South Med J 84 (1991): 465-8
  10. Karki SD, Bentley DW, Raghavan M "Seizure with ciprofloxacin and theophylline combined therapy." DICP 24 (1990): 595-6
  11. Schwartz MT, Calvert JF "Potential neurologic toxicity related to ciprofloxacin." Ann Pharmacother 24 (1990): 138-40
  12. Anastasio GD, Menscer D, Little JM "Norfloxacin and seizures." Ann Intern Med 109 (1988): 169-70
  13. Todd PA, Faulds D "Ofloxacin: a reappraisal of its antimicrobial activity, pharmacology, and therapeutic use." Drugs 42 (1991): 825-76
  14. 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
  15. Fennig S, Mauas L "Ofloxacin-induced delirium." J Clin Psychiatry 53 (1992): 137-8
  16. Tack KJ, Smith JA "The safety profile of ofloxacin." Am J Med 87 (1989): s78-81
  17. Jaber LA, Bailey EM, Rybak MJ "Enoxacin: a new fluoroquinolone." Clin Pharm 8 (1989): 97-107
  18. Wadworth AN, Goa KL "Lomefloxacin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic use." Drugs 42 (1991): 1018-60
  19. 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
  20. Poc TE, Marion GS, Jackson DS "Seizures due to nalidixic acid therapy." South Med J 77 (1984): 539-40
  21. Burt RA "Review of adverse reactions associated with cinoxacin and other drugs used to treat urinary tract infections." Urology 23 (1984): 101-7
  22. Norrby SR "Side-effects of quinolones: comparisons between quinolones and other antibiotics." Eur J Clin Microbiol Infect Dis 10 (1991): 378-83
  23. Fraser AG, Harrower AD "Convulsions and hyperglycaemia asociated with nalidixic acid." Br Med J 2 (1977): 1518
  24. Kremer L, Walton M, Wardle EN "Nalidixic acid and intracranial hypertension." Br Med J 4 (1967): 488
  25. Leslie PJ, Cregeen RJ, Proudfoot AT "Lactic acidosis, hyperglycaemia and convulsions following nalidixic acid overdosage." Hum Toxicol 3 (1984): 239-43
  26. Cox CE, Simmons JR "Cinoxacin therapy for urinary tract infections: therapeutic safety and efficacy." South Med J 75 (1982): 549-50
  27. 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
  28. Stamey TA "Cinoxacin: an overview." Urology 17 (1981): 492-5
  29. "Product Information. Cipro (ciprofloxacin)." Bayer (2002):
  30. "Product Information. Penetrex (enoxacin)." Rhone Poulenc Rorer (2002):
  31. "Product Information. Maxaquin (lomefloxacin)." Searle (2002):
  32. "Product Information. NegGram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  33. "Product Information. Noroxin (norfloxacin)." Merck & Company Inc (2001):
  34. "Product Information. Floxin (ofloxacin)." Ortho McNeil Pharmaceutical (2001):
  35. Just PM "Overview of the fluoroquinolone antibiotics." Pharmacotherapy 13 (1993): s4-17
  36. Akhtar S, Ahmad H "Ciprofloxacin-induced catatonia." J Clin Psychiatry 54 (1993): 115-6
  37. Isaacson SH, Carr J, Rowan AJ "Ciprofloxacin-induced complex partial status epilepticus manifesting as an acute confusional state." Neurology 43 (1993): 1619-21
  38. Getenet JC, Croisile B, Vighetto A, et al. "Idiopathic intracranial hypertension after ofloxacin treatment." Acta Neurol Scand 87 (1993): 503-4
  39. "Product Information. Cinobac (cinoxacin)." Oclassen Pharmaceuticals Inc (2001):
  40. 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
  41. Rosolen A, Drigo P, Zanesco L "Acute hemiparesis associated with ciprofloxacin." BMJ 309 (1994): 1411
  42. Schacht P, Arcieri G, Hullmann R "Safety of oral ciprofloxacin. An update based on clinical trial results." Am J Med 87 (1989): s98-102
  43. Winrow AP, Supramaniam G "Benign intracranial hypertension after ciprofloxacin administration." Arch Dis Child 65 (1990): 1165-6
  44. Thomas RJ, Regan DR "Association of a tourette-like syndrome with ofloxacin." Ann Pharmacother 30 (1996): 138-41
  45. Traeger SM, Bonfiglio MF, Wilson JA, Martin BR, Nackes NA "Seizures associated with ofloxacin therapy." Clin Infect Dis 21 (1995): 1504-6
  46. "Product Information. Levaquin (levofloxacin)." Ortho McNeil Pharmaceutical (2001):
  47. "Product Information. Zagam (sparfloxacin)." Rhone Poulenc Rorer (2001):
  48. Ernst ME, Ernst EJ, Klepser ME "Levofloxacin and trovafloxacin: the next generation of fluoroquinolones?" Am J Health Syst Pharm 54 (1997): 2569-84
  49. "Product Information. Trovan (trovafloxacin)." Pfizer U.S. Pharmaceuticals (2001):
  50. Haria M, Lamb HM "Trovafloxacin." Drugs 54 (1997): 435-45;disc. 446
  51. Walton GD, Hon JK, Mulpur TG "Ofloxacin-induced seizure." Ann Pharmacother 31 (1997): 1475-7
  52. "Product Information. Avelox (moxifloxacin)." Bayer (2001):
  53. "Product Information. Tequin (gatifloxacin)." Bristol-Myers Squibb (2001):
  54. Melvani S, Speed BR "Alatrofloxacin-induced seizures during slow intravenous infusion." Ann Pharmacother 34 (2000): 1017-9
  55. "Product Information. Factive (gemifloxacin)." *GeneSoft Inc (2003):
  56. De Sarro A, De Sarro G "Adverse reactions to fluoroquinolones. An overview on mechanistic aspects." Curr Med Chem 8 (2001): 371-84
  57. "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc. (2017):
View all 57 references
Major

Quinolones (applies to Penetrex) myasthenia gravis

Major Potential Hazard, Moderate plausibility.

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.

References

  1. "Product Information. Cipro (ciprofloxacin)." Bayer (2002):
  2. "Product Information. Noroxin (norfloxacin)." Merck & Company Inc (2001):
  3. "Product Information. Floxin (ofloxacin)." Ortho McNeil Pharmaceutical (2001):
  4. "Product Information. Levaquin (levofloxacin)." Ortho McNeil Pharmaceutical (2001):
  5. "Product Information. Raxar (grepafloxacin)." Glaxo Wellcome (2001):
  6. "Product Information. Factive (gemifloxacin)." *GeneSoft Inc (2003):
  7. "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc. (2017):
View all 7 references
Major

Quinolones (applies to Penetrex) peripheral neuropathy

Major Potential Hazard, Moderate plausibility.

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.

References

  1. "Product Information. Cipro (ciprofloxacin)." Bayer (2002):
  2. "Product Information. Penetrex (enoxacin)." Rhone Poulenc Rorer (2002):
  3. "Product Information. Maxaquin (lomefloxacin)." Searle (2002):
  4. "Product Information. NegGram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  5. "Product Information. Noroxin (norfloxacin)." Merck & Company Inc (2001):
  6. "Product Information. Floxin (ofloxacin)." Ortho McNeil Pharmaceutical (2001):
  7. "Product Information. Cinobac (cinoxacin)." Oclassen Pharmaceuticals Inc (2001):
  8. "Product Information. Levaquin (levofloxacin)." Ortho McNeil Pharmaceutical (2001):
  9. "Product Information. Zagam (sparfloxacin)." Rhone Poulenc Rorer (2001):
  10. "Product Information. Trovan (trovafloxacin)." Pfizer U.S. Pharmaceuticals (2001):
  11. "Product Information. Avelox (moxifloxacin)." Bayer (2001):
  12. "Product Information. Tequin (gatifloxacin)." Bristol-Myers Squibb (2001):
  13. "Product Information. Factive (gemifloxacin)." *GeneSoft Inc (2003):
  14. "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc. (2017):
View all 14 references
Major

Quinolones (applies to Penetrex) tendonitis

Major Potential Hazard, Moderate plausibility. Applicable conditions: 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. Cipro (ciprofloxacin)." Bayer (2002):
  2. "Product Information. Penetrex (enoxacin)." Rhone Poulenc Rorer (2002):
  3. "Product Information. Maxaquin (lomefloxacin)." Searle (2002):
  4. "Product Information. NegGram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  5. "Product Information. Noroxin (norfloxacin)." Merck & Company Inc (2001):
  6. "Product Information. Floxin (ofloxacin)." Ortho McNeil Pharmaceutical (2001):
  7. "Product Information. Cinobac (cinoxacin)." Oclassen Pharmaceuticals Inc (2001):
  8. Donck JB, Segaert MF, Vanrenterghem YF "Fluoroquinolones and achilles tendinopathy in renal transplant recipients." Transplantation 58 (1994): 736-7
  9. Schacht P, Arcieri G, Hullmann R "Safety of oral ciprofloxacin. An update based on clinical trial results." Am J Med 87 (1989): s98-102
  10. 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
  11. "Product Information. Levaquin (levofloxacin)." Ortho McNeil Pharmaceutical (2001):
  12. Carrasco JM, Garcia B, Andujar C, Garrote F, de Juana P, Bermejo T "Tendinitis associated with ciprofloxacin." Ann Pharmacother 31 (1997): 120
  13. "Product Information. Zagam (sparfloxacin)." Rhone Poulenc Rorer (2001):
  14. "Product Information. Trovan (trovafloxacin)." Pfizer U.S. Pharmaceuticals (2001):
  15. "Product Information. Avelox (moxifloxacin)." Bayer (2001):
  16. "Product Information. Tequin (gatifloxacin)." Bristol-Myers Squibb (2001):
  17. Casparian JM, Luchi M, Moffat RE, Hinthorn D "Quinolones and tendon ruptures." South Med J 93 (2000): 392-6
  18. "Product Information. Factive (gemifloxacin)." *GeneSoft Inc (2003):
  19. "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc. (2017):
View all 19 references

Penetrex drug interactions

There are 275 drug interactions with Penetrex (enoxacin).

Penetrex alcohol/food interactions

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


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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 interaction information available.

Further information

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