Cinoxacin

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Cinoxacin Brand Name– Cinobac

What is Cinoxacin

NOTE: This drug is discontinued in the US.

Cinoxacin is an oral first generation quinolone antibiotic, structurally related to nalidixic acid.

It is indicated for the treatment of initial (acute) and recurrent urinary tract infections caused by susceptible gram-negative organisms.

Cinoxacin is also effective in preventing urinary tract infections for up to 5 months in women with a history of recurrent urinary tract infections. The drug appears to be well tolerated and has a low propensity for adverse effects compared to nalidixic acid and trimethoprim-sulfamethoxazole.

Cinoxacin is not recommended in the treatment of other infections; the drug is not active against Pseudomonas species, gram positive bacteria, or anaerobic organisms.

Resistance to cinoxacin may develop during therapy and cross resistance to nalidixic acid has been demonstrated.

The FDA approved cinoxacin in 1980.

Cinoxacin is no longer marketed in the United States.

Indications

  1. Enterobacter sp.
  2. Escherichia coli
  3. Klebsiella sp.
  4. Proteus mirabilis
  5. Proteus vulgaris
  6. urinary tract infection (UTI)
  7. urinary tract infection (UTI) prophylaxis

NOTE: To reduce the development of drug-resistant bacteria and maintain the effectiveness of antibacterial drugs, this drug should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. angioedema
  4. anorexia
  5. anxiety
  6. confusion
  7. depression
  8. diarrhea
  9. dizziness
  10. drowsiness
  11. dysgeusia
  12. edema
  13. eosinophilia
  14. erythema multiforme
  15. hallucinations
  16. headache
  17. increased intracranial pressure
  18. insomnia
  19. nausea
  20. nightmares
  21. paranoia
  22. perineal pain
  23. photophobia
  24. photosensitivity
  25. pruritus
  26. rash
  27. restlessness
  28. seizures
  29. Stevens-Johnson syndrome
  30. tendon rupture
  31. tinnitus
  32. toxic epidermal necrolysis
  33. tremor
  34. urticaria
  35. vomiting

Monitoring Parameters

  • serum creatinine
  • urinalysis

Contraindications

  • anuria
  • breast-feeding
  • cerebrovascular disease
  • children
  • colitis
  • corticosteroid therapy
  • dehydration
  • diabetes mellitus
  • diarrhea
  • driving or operating machinery
  • geriatric
  • GI disease
  • hepatic disease
  • hepatitis
  • hepatotoxicity
  • infants
  • inflammatory bowel disease
  • jaundice
  • myasthenia gravis
  • neonates
  • neurotoxicity
  • organ transplant
  • peripheral neuropathy
  • pregnancy
  • pseudomembranous colitis
  • quinolone hypersensitivity
  • renal failure
  • renal impairment
  • seizure disorder
  • sunlight (UV) exposure
  • tendinitis
  • tendinopathy
  • tendon pain
  • tendon rupture
  • ulcerative colitis
  • viral infection

Interactions

  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid

Sodium picosulfate; Magnesium oxide; Anhydrous citric acid: (Major) Prior or concomitant use of antibiotics with sodium picosulfate; magnesium oxide; anhydrous citric acid may reduce efficacy of the bowel preparation as conversion of sodium picosulfate to its active metabolite bis-(p-hydroxy-phenyl)-pyridyl-2-methane (BHPM) is mediated by colonic bacteria. If possible, avoid coadministration.

Certain antibiotics (i.e., tetracyclines and quinolones) may chelate with the magnesium in sodium picosulfate; magnesium oxide; anhydrous citric acid solution.

Therefore, these antibiotics should be taken at least 2 hours before and not less than 6 hours after the administration of sodium picosulfate; magnesium oxide; anhydrous citric acid solution.

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