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Single-Dose Studies

During clinical trials, approximately 9% of patients treated with a single dose of 400 mg of enoxacin for uncomplicated urethral or endocervical gonorrhea reported adverse events.

The most frequently reported events in single-dose trials, without regard to drug relationship, were nausea and vomiting (2%). Events that occurred in less than 1% of patients are listed below.

CENTRAL NERVOUS SYSTEM:  headache, dizziness, somnolence; GASTROINTESTINAL: abdominal pain; GYNECOLOGIC: vaginal moniliasis; SKIN/HYPERSENSITIVITY: rash; LABORATORY ABNORMALITIES: increased AST (SGOT), decreased hemoglobin, decreased hematocrit, eosinophilia, leukocytosis, leukopenia, thrombocytosis, increased urinary protein, increased alkaline phosphatase, increased ALT (SGPT), increased bilirubin, hyperkalemia.

Multiple-Dose Studies

The incidence of adverse events reported by patients in multiple-dose clinical trials, without regard to drug relationship, was 23%. The incidence of drug-related adverse reactions in multiple-dose clinical trials was 16%. Among patients receiving multiple-dose therapy, enoxacin was discontinued because of an adverse event in 3.8% of patients.

The following events were considered likely to be drug-related in patients receiving multiple doses of enoxacin in clinical trials: nausea and/or vomiting 6%, dizziness 2%, headache 1%, abdominal pain 1%, diarrhea 1%, dyspepsia 1%.

The most frequently reported events in all multiple-dose clinical trials, without regard to drug relationship, were as follows: nausea and/or vomiting 8%, dizziness and/or vertigo 3%, headache 2%, diarrhea 2%, abdominal pain 2%, insomnia 1%, dyspepsia 1%, rash 1%, nervousness and/or anxiety 1%, unusual taste 1%, pruritus 1%.

Additional events that occurred in less than 1% of patients but >0.1% of patients are listed below.

BODY AS A WHOLE:  asthenia, fatigue, fever, malaise, back pain, chest pain, edema, chills; GASTROINTESTINAL: flatulence, constipation, dry mouth/throat, stomatitis, anorexia, gastritis, bloody stools; CENTRAL NERVOUS SYSTEM: somnolence, tremor, convulsions, paresthesia, confusion, agitation, depression, syncope, myoclonus, depersonalization, hypertonia; SKIN/HYPERSENSITIVITY: photosensitivity reaction, urticaria, hyperhidrosis, mycotic infection, erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome; SPECIAL SENSES: tinnitus, conjunctivitis, visual disturbances including amblyopia; MUSCULOSKELETAL: myalgia, arthralgia; CARDIOVASCULAR: palpitations, tachycardia, vasodilation; RESPIRATORY: dyspnea, cough, epistaxis; HEMIC AND LYMPHATIC: purpura; UROGENITAL: vaginal moniliasis, vaginitis, urinary incontinence, renal failure.

The following adverse events occurred in less than 0.1% of patients in multiple-dose clinical trials but were considered significant: pseudomembranous colitis, hyperkinesia, amnesia, ataxia, hypotonia, psychosis, emotional lability, hallucination, schizophrenic reaction.

LABORATORY CHANGES: The following laboratory abnormalities appeared in ≥1.0% of patients receiving multiple doses of enoxacin: elevated AST (SGOT), elevated ALT (SGPT). It is not known whether these abnormalities were caused by the drug or the underlying conditions.

Worldwide Post-Marketing Experience

The most frequent spontaneously-reported adverse events in the worldwide post-marketing experience with multiple- and single-dose enoxacin use have been rashes, seizures/convulsions, and photosensitivity reactions; however, there is no evidence that the incidences of these events were larger than those observed in the clinical trials population.

Quinolone-class adverse reactions:   Although not reported in completed clinical studies with enoxacin, a variety of adverse events have been reported with other quinolones.

Clinical adverse events include:  erythema nodosum, hepatic necrosis, possible exacerbation of myasthenia gravis, nystagmus, intestinal perforation, hyperpigmentation, interstitial nephritis, polyuria, urinary retention, renal calculi, cardiopulmonary arrest, cerebral thrombosis, and laryngeal or pulmonary edema.

Laboratory adverse events include:  agranulocytosis, elevation of serum triglycerides and/or serum cholesterol, prolongation of the prothrombin time, candiduria, and crystalluria.