Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Enoxin (Faulding Pharmaceuticals)
200 mg and 400 mg tablets
Indication: specified infections
Enoxacin is a 4quinolone antibiotic related to norfloxacin.
The drug is rapidly absorbed after oral administration to produce peak plasma levels within 2 hours. The half life is 4-6 hours, so with twice daily dosing, steady state is reached within 2-3 days.
Most of the drug is excreted unchanged in the urine, but there are some active metabolites. The dose should be adjusted in patients with reduced renal function and in the elderly.
Although enoxacin has in vitro activity against many organisms, the anaerobes and some streptococci are less susceptible. Enoxacin has been approved for the treatment of skin and skin structure infections, but not as first-line treatment as there are more effective antibiotics. The drug has been approved for use in urinary tract infections, chancroid and simple urethral or endocervical gonorrhoea. It should not be prescribed for children or pregnant women.
In clinical trials, approximately 5% of patients had to discontinue treatment due to adverse effects. Most adverse effects involve the gastrointestinal system, but central nervous system stimulation can occur. As this may result in seizures, enoxacin should be used with great caution in patients with epilepsy, cerebral arteriosclerosis and other neurological disturbances.
Enoxacin interacts with several commonly used drugs including theophylline, antacids and H2 antagonists.
This drug increases the number of conditions which may be treated with a quinolone antibiotic.