Fleroxacin Caffeine

In 24 healthy volunteers, 12 men and 12 women, the women had significantly different caffeine pharmacokinetics in the presence of ciprofloxacin and fleroxacin compared with the men (132). There were also significant differences between the sexes in the pharmacokinetics of ciprofloxacin and fleroxacin in the presence of caffeine. The differences were in part due to different body weights. 

Kim MK, Nightingale C, Nicolau D. Influence of sex on the pharmacokinetic interaction of fleroxacin and ciprofloxacin with caffeine. Clin Pharmacokinet 2003 42(ll) 985-96. 

Noninterfering adenosine, albuterol, alphenal, aspirin, caffeine, carbamazepine, cefazo-lin, cephalexin, cephalothin, cimetidine, ciprofloxacin, claforan, desipramine, enoxacin, fleroxacin, furosemide, hydralazine, hydrochlorothiazide, minoxidil, norfloxacin, pheny-toin, propafenone, sulindac, teicoplanin, theophylline, vancomycin Interfering some indocyanine green impurities... 

Enoxacin markedly increases caffeine levels. The effects of caffeine derived from drinks such as tea, coffee or cola, would be expected to be increased. Pipemidic acid interacts to a lesser extent, and ciprofloxacin, norfloxacin and pefloxacin interact less still Fleroxacin, lomefloxacin, ofloxacin, rufloxacin, and trovafloxacin appear not to interact. 

The effects of various quinolones on the pharmacokinetics of caffeine " are summarised in Table 33.3 , (p.l 167). In one study ciprofloxacin and fleroxacin increased caffeine levels more in women than men, but this difference in effect was not significant when the results were normalised for body weight. ... 

Established interactions. Based on the results of two studies, on a scale of 100 to 0, the relative potencies of these quinolones as inhibitors of caffeine elimination have been determined as follows enoxacin 100, pipemidic acid 29, ciprofloxacin 11, norfloxacin 9 and ofloxacin 0. From further studies, clinafloxacin appears to be similar to enoxacin (profound effect), pefloxacin to norfloxacin (to which it is metabolised modest effect), and fleroxacin, lomefloxacin, rufloxacin, and trovafloxacin appear to behave like ofloxacin (no effect). Patients taking enoxacin might be expected to experience an increase in the effects of caffeine (such as headache, jitteriness, restlessness, insomnia) if, for example, they continue to drink their usual amounts of caffeine-containing drinks (tea, coffee, cola drinks, etc.). They should be warned to cut out or reduce their intake of caffeine if this occurs. The authors of one report suggest that patients with hepatic disorders, cardiac arrhythmias or latent epilepsy should avoid caffeine if they take enoxacin for one week or more. The effects of pipemidic acid arc less, and those of ciprofloxacin, norfloxacin and pefloxacin arc probably of little or no clinical importance. Fleroxacin, lomefloxacin, ofloxacin, rufloxacin, and trovafloxacin do not interact. 

Nicolau DP, Nightingale CH, Tessier PR, Fu Q, Xuan D-W, Esguerra EM, Quintiliani R. The effect of fleroxacin and ciprofloxacin on the pharmacokinetics of multiple dose caffeine. Drugs (1995) 49 (Suppl 2), 357-9. 

---

See also in sourсe #XX -- [ ]

---