Skip to main content

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 (1986) "Ciprofloxacin: an overview of adverse experiences." J Antimicrob Chemother, 18, p. 187-93
  2. Arcieri G, Griffith E, Gruenwaldt G, et al. (1988) "A survey of clinical experience with ciprofloxacin, a new quinolone antimicrobial." J Clin Pharmacol, 28, p. 179-89
  3. McCue JD, Zandt JR (1991) "Acute psychoses associated with the use of ciprofloxacin and trimethoprim-sulfamethoxazole." Am J Med, 90, p. 528-9
  4. Arcieri G, August R, Becker N, et al. (1986) "Clinical experience with ciprofloxacin in the USA." Eur J Clin Microbiol, 5, p. 220-5
  5. Altes J, Gasco J, De Antonio J, Villalonga C (1989) "Ciprofloxacin and delirium." Ann Intern Med, 110, p. 170-1
  6. McDermott JL, Gideonse N, Campbell JW (1991) "Acute delirium associated with ciprofloxacin administration in a hospitalized elderly patient." J Am Geriatr Soc, 39, p. 909-10
  7. Slavich IL, Gleffe Rf, Haas EJ (1989) "Grand mal epileptic seizures during ciprofloxacin therapy." JAMA, 261, p. 558-9
  8. Moore B, Safani M, Keesey J (1988) "Possible exacerbation of myasthenia gravis by ciprofloxacin." Lancet, Jan, p. 882
  9. Semel JD, Allen N (1991) "Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole." South Med J, 84, p. 465-8
  10. Karki SD, Bentley DW, Raghavan M (1990) "Seizure with ciprofloxacin and theophylline combined therapy." DICP, 24, p. 595-6
  11. Schwartz MT, Calvert JF (1990) "Potential neurologic toxicity related to ciprofloxacin." Ann Pharmacother, 24, p. 138-40
  12. Anastasio GD, Menscer D, Little JM (1988) "Norfloxacin and seizures." Ann Intern Med, 109, p. 169-70
  13. Todd PA, Faulds D (1991) "Ofloxacin: a reappraisal of its antimicrobial activity, pharmacology, and therapeutic use." Drugs, 42, p. 825-76
  14. Unseld E, Ziegler G, Gemeinhardt A, Janssen U, Klotz U (1990) "Possible interaction of fluoroquinolones with benzodiazepine-GABA-receptorn complex." Br J Clin Pharmacol, 30, p. 63-70
  15. Fennig S, Mauas L (1992) "Ofloxacin-induced delirium." J Clin Psychiatry, 53, p. 137-8
  16. Tack KJ, Smith JA (1989) "The safety profile of ofloxacin." Am J Med, 87, s78-81
  17. Jaber LA, Bailey EM, Rybak MJ (1989) "Enoxacin: a new fluoroquinolone." Clin Pharm, 8, p. 97-107
  18. Wadworth AN, Goa KL (1991) "Lomefloxacin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic use." Drugs, 42, p. 1018-60
  19. Bednarczyk EM, Green JA, Nelson D, et al. (1992) "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, p. 369-75
  20. Poc TE, Marion GS, Jackson DS (1984) "Seizures due to nalidixic acid therapy." South Med J, 77, p. 539-40
  21. Burt RA (1984) "Review of adverse reactions associated with cinoxacin and other drugs used to treat urinary tract infections." Urology, 23, p. 101-7
  22. Norrby SR (1991) "Side-effects of quinolones: comparisons between quinolones and other antibiotics." Eur J Clin Microbiol Infect Dis, 10, p. 378-83
  23. Fraser AG, Harrower AD (1977) "Convulsions and hyperglycaemia asociated with nalidixic acid." Br Med J, 2, p. 1518
  24. Kremer L, Walton M, Wardle EN (1967) "Nalidixic acid and intracranial hypertension." Br Med J, 4, p. 488
  25. Leslie PJ, Cregeen RJ, Proudfoot AT (1984) "Lactic acidosis, hyperglycaemia and convulsions following nalidixic acid overdosage." Hum Toxicol, 3, p. 239-43
  26. Cox CE, Simmons JR (1982) "Cinoxacin therapy for urinary tract infections: therapeutic safety and efficacy." South Med J, 75, p. 549-50
  27. Sisca TS, Heel RC, Romankiewicz JA (1983) "Cinoxacin. A review of its pharmacological properties and therapeutic efficacy in the treatment of urinary tract infections." Drugs, 25, p. 544-69
  28. Stamey TA (1981) "Cinoxacin: an overview." Urology, 17, p. 492-5
  29. (2002) "Product Information. Cipro (ciprofloxacin)." Bayer
  30. (2002) "Product Information. Penetrex (enoxacin)." Rhone Poulenc Rorer
  31. (2002) "Product Information. Maxaquin (lomefloxacin)." Searle
  32. "Product Information. Neggram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals
  33. (2001) "Product Information. Noroxin (norfloxacin)." Merck & Co., Inc
  34. (2001) "Product Information. Floxin (ofloxacin)." Ortho McNeil Pharmaceutical
  35. Just PM (1993) "Overview of the fluoroquinolone antibiotics." Pharmacotherapy, 13, s4-17
  36. Akhtar S, Ahmad H (1993) "Ciprofloxacin-induced catatonia." J Clin Psychiatry, 54, p. 115-6
  37. Isaacson SH, Carr J, Rowan AJ (1993) "Ciprofloxacin-induced complex partial status epilepticus manifesting as an acute confusional state." Neurology, 43, p. 1619-21
  38. Getenet JC, Croisile B, Vighetto A, et al. (1993) "Idiopathic intracranial hypertension after ofloxacin treatment." Acta Neurol Scand, 87, p. 503-4
  39. (2001) "Product Information. Cinobac (cinoxacin)." Oclassen Pharmaceuticals Inc
  40. Fanhavard P, Sanchorawala V, Oh J, Moser EM, Smith SP (1994) "Concurrent use of foscarnet and ciprofloxacin may increase the propensity for seizures." Ann Pharmacother, 28, p. 869-72
  41. Rosolen A, Drigo P, Zanesco L (1994) "Acute hemiparesis associated with ciprofloxacin." BMJ, 309, p. 1411
  42. Schacht P, Arcieri G, Hullmann R (1989) "Safety of oral ciprofloxacin. An update based on clinical trial results." Am J Med, 87, s98-102
  43. Winrow AP, Supramaniam G (1990) "Benign intracranial hypertension after ciprofloxacin administration." Arch Dis Child, 65, p. 1165-6
  44. Thomas RJ, Regan DR (1996) "Association of a tourette-like syndrome with ofloxacin." Ann Pharmacother, 30, p. 138-41
  45. Traeger SM, Bonfiglio MF, Wilson JA, Martin BR, Nackes NA (1995) "Seizures associated with ofloxacin therapy." Clin Infect Dis, 21, p. 1504-6
  46. (2001) "Product Information. Levaquin (levofloxacin)." Ortho McNeil Pharmaceutical
  47. (2001) "Product Information. Zagam (sparfloxacin)." Rhone Poulenc Rorer
  48. Ernst ME, Ernst EJ, Klepser ME (1997) "Levofloxacin and trovafloxacin: the next generation of fluoroquinolones?" Am J Health Syst Pharm, 54, p. 2569-84
  49. (2001) "Product Information. Trovan (trovafloxacin)." Pfizer U.S. Pharmaceuticals
  50. Haria M, Lamb HM (1997) "Trovafloxacin." Drugs, 54, 435-45;disc. 446
  51. Walton GD, Hon JK, Mulpur TG (1997) "Ofloxacin-induced seizure." Ann Pharmacother, 31, p. 1475-7
  52. (2001) "Product Information. Avelox (moxifloxacin)." Bayer
  53. (2001) "Product Information. Tequin (gatifloxacin)." Bristol-Myers Squibb
  54. Melvani S, Speed BR (2000) "Alatrofloxacin-induced seizures during slow intravenous infusion." Ann Pharmacother, 34, p. 1017-9
  55. (2003) "Product Information. Factive (gemifloxacin)." *GeneSoft Inc
  56. De Sarro A, De Sarro G (2001) "Adverse reactions to fluoroquinolones. An overview on mechanistic aspects." Curr Med Chem, 8, p. 371-84
  57. (2017) "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc.
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. (2002) "Product Information. Cipro (ciprofloxacin)." Bayer
  2. (2001) "Product Information. Noroxin (norfloxacin)." Merck & Co., Inc
  3. (2001) "Product Information. Floxin (ofloxacin)." Ortho McNeil Pharmaceutical
  4. (2001) "Product Information. Levaquin (levofloxacin)." Ortho McNeil Pharmaceutical
  5. (2001) "Product Information. Raxar (grepafloxacin)." Glaxo Wellcome
  6. (2003) "Product Information. Factive (gemifloxacin)." *GeneSoft Inc
  7. (2017) "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc.
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. (2002) "Product Information. Cipro (ciprofloxacin)." Bayer
  2. (2002) "Product Information. Penetrex (enoxacin)." Rhone Poulenc Rorer
  3. (2002) "Product Information. Maxaquin (lomefloxacin)." Searle
  4. "Product Information. Neggram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals
  5. (2001) "Product Information. Noroxin (norfloxacin)." Merck & Co., Inc
  6. (2001) "Product Information. Floxin (ofloxacin)." Ortho McNeil Pharmaceutical
  7. (2001) "Product Information. Cinobac (cinoxacin)." Oclassen Pharmaceuticals Inc
  8. (2001) "Product Information. Levaquin (levofloxacin)." Ortho McNeil Pharmaceutical
  9. (2001) "Product Information. Zagam (sparfloxacin)." Rhone Poulenc Rorer
  10. (2001) "Product Information. Trovan (trovafloxacin)." Pfizer U.S. Pharmaceuticals
  11. (2001) "Product Information. Avelox (moxifloxacin)." Bayer
  12. (2001) "Product Information. Tequin (gatifloxacin)." Bristol-Myers Squibb
  13. (2003) "Product Information. Factive (gemifloxacin)." *GeneSoft Inc
  14. (2017) "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc.
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. (2002) "Product Information. Cipro (ciprofloxacin)." Bayer
  2. (2002) "Product Information. Penetrex (enoxacin)." Rhone Poulenc Rorer
  3. (2002) "Product Information. Maxaquin (lomefloxacin)." Searle
  4. "Product Information. Neggram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals
  5. (2001) "Product Information. Noroxin (norfloxacin)." Merck & Co., Inc
  6. (2001) "Product Information. Floxin (ofloxacin)." Ortho McNeil Pharmaceutical
  7. (2001) "Product Information. Cinobac (cinoxacin)." Oclassen Pharmaceuticals Inc
  8. Donck JB, Segaert MF, Vanrenterghem YF (1994) "Fluoroquinolones and achilles tendinopathy in renal transplant recipients." Transplantation, 58, p. 736-7
  9. Schacht P, Arcieri G, Hullmann R (1989) "Safety of oral ciprofloxacin. An update based on clinical trial results." Am J Med, 87, s98-102
  10. Zabraniecki L, Negrier I, Vergne P, Arnaud M, Bonnet C, Bertin P, Treves R (1996) "Fluoroquinolone induced tendinopathy: report of 6 cases." J Rheumatol, 23, p. 516-20
  11. (2001) "Product Information. Levaquin (levofloxacin)." Ortho McNeil Pharmaceutical
  12. Carrasco JM, Garcia B, Andujar C, Garrote F, de Juana P, Bermejo T (1997) "Tendinitis associated with ciprofloxacin." Ann Pharmacother, 31, p. 120
  13. (2001) "Product Information. Zagam (sparfloxacin)." Rhone Poulenc Rorer
  14. (2001) "Product Information. Trovan (trovafloxacin)." Pfizer U.S. Pharmaceuticals
  15. (2001) "Product Information. Avelox (moxifloxacin)." Bayer
  16. (2001) "Product Information. Tequin (gatifloxacin)." Bristol-Myers Squibb
  17. Casparian JM, Luchi M, Moffat RE, Hinthorn D (2000) "Quinolones and tendon ruptures." South Med J, 93, p. 392-6
  18. (2003) "Product Information. Factive (gemifloxacin)." *GeneSoft Inc
  19. (2017) "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc.
View all 19 references

Penetrex drug interactions

There are 302 drug interactions with Penetrex (enoxacin).

Penetrex alcohol/food interactions

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


Report options

Loading...
QR code containing a link to this page

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.