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Action/Kinetics:
Related chemically to nalidixic acid. Acts by inhibiting DNA replication, resulting in a bactericidal action. Rapidly absorbed after PO administration; a 500-mg dose results in a urine concentration of 300 mcg/mL during the first 4-hr period and 100 mcg/mL during the second 4-hr period. Within 24 hr, 97% is excreted in the urine, 60% unchanged.
Mean serum t
1/2: 1.5 hr. Food decreases peak serum levels by approximately 30% but not the total amount absorbed.
Uses:
Initial and recurrent UTIs caused by
Escherichia coli, Proteus mirabilis, P. vulgaris, Klebsiella and
Enterobacter species. Prevents UTIs for up to 5 months in women with a history of UTIs.
NOTE: Cinoxacin is ineffective against
Pseudomonas staphylococci, and enterococci infections. Prophylaxis of UTIs.
Contraindications:
Hypersensitivity to cinoxacin or other quinolones. Infants and prepubertal children. Anuric clients. Lactation.
Special Concerns:
Use with caution in clients with hepatic or kidney disease. Safety and efficacy in children less than 18 years of age have not been determined.
Side Effects:
GI: N&V;, anorexia, abdominal cramps and pain, diarrhea, altered sensation of taste.
CNS: Headache, dizziness, insomnia, drowsiness, confusion, nervousness.
Hypersensitivity: Rash, pruritus, urticaria, edema, angioedema, eosinophilia,
anaphylaxis (rare) toxic epidermal necrolysis (rare), erythema multiforme,
Stevens-Johnson syndrome.
Other: Tingling sensation, photophobia, perineal burning, tinnitus, thrombocytopenia.
Laboratory Test Alterations:
BUN, AST, ALT, serum creatinine, and alkaline phosphatase.
Hematocrit/hemoglobin.
Overdose Management:
Symptoms: Anorexia, N&V;, epigastric distress, diarrhea, headache, dizziness, insomnia, photophobia, tinnitus, and a tingling sensation.
Treatment: Well hydrate the client to prevent crystalluria. Maintain an airway and support ventilation and perfusion. Carefully monitor VS, blood gases, and serum electrolytes. Give activated charcoal to decrease absorption.
Drug Interactions:
Probenecid
excretion of cinoxacin
concentration in the urine.
How Supplied:
Capsule: 250 mg, 500 mg
Dosage
?Capsules
UTIs.
Adults: 1 g/day in two to four divided doses for 7-14 days.
In clients with impaired renal function:
Initial, 500 mg;
then, dosage schedule based on creatinine clearance (see package insert).
Prophylaxis of UTIs in women.
250 mg at bedtime for up to 5 months.
