Cinoxacin – Oral Route

Cinoxacin is a prescription-only medication that is given to patients with urinary tract infections. It works to treat existing conditions, as well as preventing the condition from returning. The drug is administered orally in the form of a tablet.

Overview

Cinoxacin is also known by its brand name, Cinobac, in the United States. The drug is part of the antibiotic family, used to treat infections in the body. It is not effective at treating viral infections, such as the common cold or flu.

Urinary tract infections happen when bacteria enters the urinary tract, usually from the gut, via the urethra. They affect areas other than the urinary tract, including the kidneys, bladder and the tubes connecting these organs.

Urinary tract infections are grouped into two categories: lower urinary tract infections and upper urinary tract infections. Lower infections include conditions such as cystitis (infection of the bladder) and infection of the urethra. These are particularly common and are usually nothing to worry about. Anyone can get lower infections, but they are more common in women, with half of all women expected to experience them in their lifetime. Symptoms include a need to pass urine more often and pain when passing urine. The bladder may also always feel as though it isn’t empty. Upper infections include those in the kidneys or ureters, and can be more serious. Symptoms include fever, shivering and chills.

Cinoxacin is usually prescribed when the infection has become persistent and does not go away on its own after a few days. It is a short term treatment that is typically given as a three or five day course. However, this medication is rarely used today; it was a popular choice in the 1980s, but, since then, more effective medicines with fewer side effects and health risks have become more widely used.

Condition(s) treated

  • Urinary tract infections

Type of medication

  • Tablet

Side effects

There are certain side effects that cinoxacin may cause in patients. However, these are fairly uncommon, and patients needn’t normally worry about experiencing side effects as a result of taking cinoxacin unless they become more severe, painful or persistent.

It has been found that around 2% of cinoxacin patients will experience nervous system toxicity. Symptoms of this condition include dizziness, headache, insomnia, nervousness and a change in mood. If patients notice any of these symptoms persisting, they should report it to their doctor, where they may be offered a different course of treatment. Other serious conditions that can develop in a small number of cinoxacin patients include tinnitus, somnolence and paresthesias.

Other possible side effects include:

  • Black or darker stools
  • Blood in the stools or urine
  • Sensitive skin when exposed to sunlight
  • Dizziness
  • Faintness
  • Vomiting or nausea
  • Bleeding gums
  • Headache
  • Skin rash, including pin spots, redness or swelling
  • Pain in the side or lower back area
  • Pain in the bones
  • Pain in the shoulders, calves or hands
  • Swollen joints
  • Joint pain
  • Easily bruised skin
  • Unusual bleeding
  • Seizures
  • Diarrhea
  • Lack of appetite
  • Stomach cramps

Reports have shown that adverse effects happen in around 5% of patients.

Dosage

The dosage that you may be given will depend on your medical history and any other conditions you may have or medicines you might be taking. Cinoxacin is supplied in tablets of 250 mg.

Depending on the severity of your infection, you will usually be prescribed this drug over either a three or five day treatment course.

You should take each tablet with a meal to help it absorb. The drug is most effective when you stick to the dosage instructions given to you by your doctor. If you miss one dose, you take it as soon as you remember, but if you are close to your next dose, just skip the missed dose entirely. You should take your full course of tablets until the pack is empty.

Major drug interactions

There are quite a few drugs that interact with cinoxacin. Therefore, you should always tell your doctor about any other medications you are taking, including over the counter medicines and herbal supplements. Drugs with major interactions should not be prescribed at the same time. Taking drugs with a major interaction can cause dangerous and even life threatening side effects. There are 141 generic drugs that have a major reaction when taken with cinoxacin. They are:

  • acalabrutinib
  • acetaminophen / caffeine / chlorpheniramine / hydrocodone / phenylephrine
  • acetaminophen / hydrocodone
  • acetaminophen / oxycodone
  • acetaminophen / tramadol
  • aminophylline
  • aminophylline / amobarbital / ephedrine
  • aminophylline / ephedrine / guaifenesin / phenobarbital
  • aminophylline / ephedrine / phenobarbital / potassium iodide
  • aminophylline / guaifenesin
  • amiodarone
  • anagrelide
  • anisindione
  • arsenic trioxide
  • artemether / lumefantrine
  • aspirin / hydrocodone
  • aspirin / oxycodone
  • avanafil
  • bedaquiline
  • bepridil
  • betamethasone
  • bosutinib
  • brexpiprazole
  • brompheniramine / hydrocodone / phenylephrine
  • brompheniramine / hydrocodone / pseudoephedrine
  • bupivacaine / lidocaine / triamcinolone
  • bupropion
  • bupropion / naltrexone
  • butorphanol
  • carbinoxamine / hydrocodone / phenylephrine
  • carbinoxamine / hydrocodone / pseudoephedrine
    ceritinib
  • chlorpheniramine / guaifenesin / hydrocodone / pseudoephedrine
  • chlorpheniramine / hydrocodone
  • chlorpheniramine / hydrocodone / phenylephrine
  • chlorpheniramine / hydrocodone / pseudoephedrine
  • cholera vaccine, live
  • cisapride
  • citalopram
  • clozapine
  • cobimetinib
  • cortisone
  • crizotinib
  • deflazacort
  • dexamethasone
  • dexamethasone / lidocaine
  • dexbrompheniramine / hydrocodone / phenylephrine
  • dexchlorpheniramine / hydrocodone / phenylephrine
  • dextromethorphan / quinidine
  • dicumarol
  • diphenhydramine / hydrocodone / phenylephrine
  • disopyramide
  • dofetilide
  • dolasetron
  • dronedarone
  • droperidol
  • droperidol / fentanyl
  • duloxetine
  • efavirenz
  • efavirenz / emtricitabine / tenofovir
  • eliglustat
  • ephedrine / guaifenesin / theophylline
  • ephedrine / hydroxyzine / theophylline
  • ephedrine / phenobarbital / potassium iodide / theophylline
  • ephedrine / phenobarbital / theophylline
  • escitalopram
  • fingolimod
  • flibanserin
    fludrocortisone
  • guaifenesin / hydrocodone
  • guaifenesin / hydrocodone / pheniramine / phenylephrine / phenylpropanolamine
  • guaifenesin / hydrocodone / pheniramine / phenylpropanolamine / pyrilamine
  • guaifenesin / hydrocodone / phenylephrine
  • guaifenesin / hydrocodone / pseudoephedrine
  • guaifenesin / oxtriphylline
  • guaifenesin / theophylline
  • guanfacine
  • halofantrine
  • haloperidol
  • homatropine / hydrocodone
  • hydrocodone
  • hydrocodone / ibuprofen
  • hydrocodone / pheniramine / phenylephrine / phenylpropanolamine / pyrilamine
  • hydrocodone / phenylephrine
  • hydrocodone / phenylephrine / pyrilamine
  • hydrocodone / phenylpropanolamine
  • hydrocodone / potassium guaiacolsulfonate
  • hydrocodone / potassium guaiacolsulfonate / pseudoephedrine
  • hydrocodone / pseudoephedrine
  • hydrocodone / pseudoephedrine / triprolidine
  • hydrocortisone
  • ibrutinib
  • ibuprofen / oxycodone
  • ibutilide
  • iloperidone
  • iohexol
  • iopamidol
    ivabradine
  • letrozole / ribociclib
  • levomethadyl acetate
  • lomitapide
  • mesoridazine
  • methadone
  • methylprednisolone
  • metrizamide
  • mifepristone
  • naloxegol
  • naloxone / oxycodone
  • naltrexone / oxycodone
  • neratinib
  • nilotinib
  • olaparib
  • oxtriphylline
  • oxycodone
  • panobinostat
  • papaverine
  • pasireotide
  • pimozide
  • pirfenidone
  • potassium iodide / theophylline
  • prednisolone
  • prednisone
  • procainamide
  • quinidine
  • ribociclib
  • saquinavir
  • sonidegib
  • sotalol
  • suvorexant
  • tasimelteon
  • theophylline
  • thioridazine
  • tizanidine
  • toremifene
  • tramadol
  • triamcinolone
  • vandetanib
  • vemurafenib
  • venetoclax
  • warfarin
  • ziprasidone

Warnings

Alcohol and food interactions

It is generally not advised to consume alcohol when taking any antibiotic drugs. Alcohol can cause a reaction with antibiotics, leading to unpleasant side effects, such as nausea, vomiting, stomach cramps, lightheadedness, fainting, diarrhea, dizziness and lack of judgement. You are also more likely to experience the regular effects of alcohol, but at a quicker rate.

You should also refrain from taking multivitamins with minerals when you are taking a course of these antibiotics.

Multivitamin and supplements that contain magnesium, aluminum, calcium or iron could interfere with the absorption of cinoxacin to the blood. This can then impact the effectiveness of the drug in targeting your urinary tract infection. If you do take any of these multivitamin supplements, you should take cinoxacin either two to four hours before the multivitamins or six to eight hours after.

Disease interactions

In the same way that some other drugs can interact with cinoxacin, there are other conditions or diseases that can have the same effect. This is why it is extremely important to tell your doctor about any other conditions you have or are being treated for. This may impact upon a decision to prescribe you cinoxacin and might mean that there is another antibiotic that will be more suitable for you. These are the conditions and diseases that have been found to have an interaction with cinoxacin:

  • CNS disorders
  • Myasthenia Gravis
  • Qt Interval Prolongation
  • Tendonitis
  • Colitis
  • Crystalluria
  • Hemodialysis
  • Renal dysfunction

Storage

Cinoxacin tablets should always be stored in the box they were supplied with. You should also keep them in their original packaging and labelling to avoid any mix ups.

Always keep your tablets at room temperature - between 15 and 25 degrees - and always keep them away from direct heat and light sources. Also, make sure that your prescription is kept in a dry place; keep the tablets out of bathrooms, as they could become damp. Failure to store the drugs at the right conditions may hinder their effectiveness at treating your urinary tract infection.

Disposal

You should not consume antibiotic medicine that has reached or exceeded its expiry date. Drugs that are out of date may lose their effectiveness or be dangerous to consume. You should instead dispose of your unwanted or unused medication in a safe way.

Your doctor will be able to offer advice about disposing of unused medicine safely. You can also follow the FDA’s advice on disposing of tablets, which is to take them out of their wrapping and mix them with an inedible substance, such as cat litter or used ground coffee, and then put the mixture into a sealable plastic bag. You can then put the bag into the trash. Alternatively, visit the FDA’s website to see if there are any medicine take-back schemes in your area.

Overview

Cinoxacin has been used for decades to treat patients with persistent or severe urinary tract infections when they do not go away on their own. It has proven to be an effective medication in the vast majority of cases, helping patients restore health and quality of life within just a three or five day treatment.

Due to the nature of the causes of urinary tract infections, this drug may be prescribed with general health advice to minimize the likelihood that the condition will return. This is likely to include hygiene advice, as well as several subtle lifestyle changes that the patient could make to reduce the chances of a repeat bout.

Cinoxacin is intended as a short term treatment for urinary tract infections. If the symptoms persist, or if the body does not respond to the antibiotic, an alternative treatment will be prescribed.

Although cinoxacin is generally very effective at combatting urinary tract infections, it is thought now to be a very old drug. Having been used since the late seventies, more effective drugs have since been developed, which pose less risk of serious side effects and are likely to be prescribed instead. There are many different types and forms of antibiotics, and these days those used to treat urinary tract infections, such as cystitis, rarely cause any negative side effects, as long as the instructions are followed.

If a doctor recommends taking cinoxacin, patients can help reduce their risk of suffering from side effects by always telling their doctor about any other medications they are taking, or any other conditions they may suffer from or be vulnerable to developing. Cinoxacin has some interactions with some very common over the counter drugs, so it is important that patients are careful about what they consume when they are taking the treatment course.

As long as all instructions are followed, this is a relatively safe drug with a proven effectiveness in most cases of urinary tract infections.