Possible Interaction: Caffeine and Enoxacin

“Intraindividual comparisons showed that ciprofloxacin and enoxacin significantly inhibited the elimination of caffeine.”

“Thus, caffeine should be avoided in patients with liver disorders, cardiac arrhythmias, latent epilepsy or in intensive care while undergoing treatment with enoxacin or ciprofloxacin.”

“The naphthyridine derivative enoxacin and the pyrido-pyrimidine derivative pipemidic acid had caused marked inhibition of caffeine and paraxanthine metabolism, whereas the genuine quinolone derivatives norfloxacin and ciprofloxacin had little effect, and the pyrido-benzoxacine derivative ofloxacin had no detectable effect.”

“ Enoxacin and ciprofloxacin impair the hepatic metabolism of theophylline and caffeine , leading to significantly increased serum concentrations.”

“The metabolism of theophylline and caffeine is inhibited by enoxacin and ciprofloxacin such that the dosage of theophylline may need to be reduced in order to avoid toxicity.”

“Fluoroquinolones, especially enoxacin , and to a lesser extent ciprofloxacin and pefloxacin, inhibit the metabolic clearance of theophylline and caffeine.”

“Oxo-metabolites of enoxacin and, to a lesser extent, pefloxacin and ciprofloxacin interfere with the hepatic elimination of theophylline and caffeine and may result in toxicity due to these agents if dosage is not modified.”

“A positive correlation exists between the doses of enoxacin or ciprofloxacin and the prolongation (increases) in the caffeine elimination half-life.”

“ Enoxacin and pipemidic acid markedly prolonged caffeine elimination in vivo.”

“ Enoxacin and ciprofloxacin have also been found to reduce the clearance of caffeine , while ofloxacin has no effect.”

“There were a significant increase in urinary theophylline and a decrease in urinary 3-methylxanthine after coadministration of enoxacin.”

“The results of this intra-individual comparison of caffeine pharmacokinetic data demonstrate that treatment with ciprofloxacin and enoxacin may have a significant inhibitory effect on caffeine elimination.”