Cinobac
Cinobac - General Information
Synthetic antimicrobial related to oxolinic acid and nalidixic acid and used in urinary tract infections.
Pharmacology of Cinobac
Cinobac is a synthetic antibacterial agent with in vitro activity against many gram-negative aerobic bacteria, particularly strains of the Enterobacteriaceae family. Cinobac inhibits bacterial deoxyribonucleic acid (DNA) synthesis, is bactericidal, and is active over the entire urinary pH range. Cross resistance with nalidixic acid has been demonstrated.
Cinobac for patients
Patients should be advised that cinoxacin may be taken with or without meals. Patients should drink fluids liberally. Antacids containing magnesium or aluminum, as well as sucralfate, metal cations such as iron, and multivitamin preparations with zinc or VIDEX (didanosine) chewable/buffered tablets or the pediatric powder for oral solution may interfere with the gastrointestinal absorption of cinoxacin. These agents should be taken at least 2 hours before or 2 hours after cinoxacin administration.
Patients should be advised to avoid excessive sunlight during cinoxacin therapy. If phototoxicity occurs, cinoxacin therapy should be discontinued.
Cinoxacin may be associated with hypersensitivity reactions following even a single dose. The drug should be discontinued at the first sign of skin rash or allergic reaction.
Cinoxacin can cause dizziness and light-headedness; therefore, patients should know how they react to the drug before operating an automobile or machinery or engaging in an activity requiring mental alertness or coordination.
Patients should be advised that convulsions have been reported in patients taking quinolones, including cinoxacin acid, and to notify their physician before taking this drug if there is a history of this condition.
Patients should be advised that cinoxacin may increase the effects of theophylline and caffeine. There is a possibility of caffeine accumulation when products containing caffeine are consumed during cinoxacin therapy.
Cinobac Interactions
Elevated plasma levels of theophylline have been reported with concomitant use of some quinolones. There have been reports of theophylline-related side-effects in patients on concomitant theophylline-quinolone therapy. Therefore, monitoring of theophylline plasma levels should be considered and dosage of theophylline adjusted as required.
Quinolones have also been shown to interfere with the metabolism of caffeine. This may lead to reduced clearance of caffeine and a prolongation of its plasma half-life. Although this interaction has not been reported with cinoxacin, caution should be exercised when cinoxacin is given concomitantly with caffeine-containing products.
Antacids or sucralfate substantially interfere with the absorption of some quinolones, resulting in low urine levels. Also, concomitant administration of quinolones with products containing iron, multivitamins containing zinc, or Videx (didanosine) chewable/buffered tablets or the pediatric powder for oral solution may result in low urine levels.
Quinolones, including cinoxacin, may enhance the effects of oral anticoagulants, such as warfarin or its derivatives. When these products are administered concomitantly, prothrombin time or other suitable coagulation tests should be closely monitored.
Seizures have been reported in patients taking another quinolone class antimicrobial and the nonsteroidal anti-inflammatory drug fenbufen concurrently. Animal studies also suggest an increased potential for seizures when these 2 drugs are given concomitantly. Fenbufen is not approved in the United States at this time. Physicians are provided this information to increase awareness of the potential for serious interactions when cinoxacin and certain nonsteroidal anti-inflammatory agents are administered concomitantly.
Elevated cyclosporine serum levels have been reported with the concomitant use of quinolones and cyclosporine.
Cinobac Contraindications
Cinobac is contraindicated in patients with a history of hypersensitivity to cinoxacin or other quinolones.
Additional information about Cinobac
Cinobac Indication: For the treatment of initial and recurrent urinary tract infections in adults caused by the following susceptible microorganisms: Escherichia coli, Proteus mirabilis, Proteus vulgaris, Klebsiella species (including K. pneumoniae), and Enterobacter species.
Mechanism Of Action: Evidence exists that cinoxacin binds strongly, but reversibly, to DNA, interfering with synthesis of RNA and, consequently, with protein synthesis.
Drug Interactions: Not Available
Food Interactions: Not Available
Generic Name: Cinoxacin
Synonyms: Not Available
Drug Category: Anti-Infective Agents
Drug Type: Small Molecule; Approved
Other Brand Names containing Cinoxacin: Cinobac;
Absorption: Rapidly absorbed after oral administration. The presence of food delays absorption but does does not affect total absorption.
Toxicity (Overdose): Oral, subcutaneous, and intravenous LD50 in the rat is 3610 mg/kg, 1380 mg/kg, and 860 mg/kg, respectively. Oral, subcutaneous, and intravenous LD50 in the mouse is 2330 mg/kg, 900 mg/kg, and 850 mg/kg, respectively.Symptoms following an overdose of cinoxacin may include anorexia, nausea, vomiting, epigastric distress, and diarrhea. The severity of the epigastric distress and the diarrhea are dose related. Headache, dizziness, insomnia, photophobia, tinnitus, and a tingling sensation have been reported in some patients.
Protein Binding: 60 to 80%
Biotransformation: Hepatic, with approximately 30-40% metabolized to inactive metabolites.
Half Life: The mean serum half-life is 1.5 hours. Half-life in patients with impaired renal function may exceed 10 hours.
Dosage Forms of Cinobac: Capsule Oral
Chemical IUPAC Name: 1-ethyl-4-oxo-[1,3]dioxolo[4,5-g]cinnoline-3-carboxylic acid
Chemical Formula: C12H10N2O5
Cinoxacin on Wikipedia: https://en.wikipedia.org/wiki/Cinoxacin
Organisms Affected: Enteric bacteria and other eubacteria