Cinagen
Cinagen Uses, Dosage, Side Effects, Food Interaction and all others data.
Cinagen is a synthetic broad spectrum, flouroquinolone derivative antibacterial agent. Cinagen has in vitro activity against a wide range of Gram-positive and Gram-negative microorganisms. The bactericidal action of Cinagen results from inhibition of the topoisomerase II (DNA gyrase) and topoisomerase IV required for bacterial DNA replication, transcription, repair and recombination.
Cinagen is a quinolone/fluoroquinolone antibiotic. Cinagen can be used to treat infections caused by the following bacteria: Aerobic Gram-positive microorganisms: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumoniae, and Streptococcus viridans group. Aerobic Gram-negative microorganisms: Acinetobacter lwoffii, Haemophilus influenzae, and Haemophilus parainfluenzae. Other microorganisms: Chlamydia trachomatis.Cinagen is bactericidal and its mode of action depends on blocking of bacterial DNA replication by binding itself to an enzyme called DNA gyrase, which allows the untwisting required to replicate one DNA double helix into two. Notably the drug has 100 times higher affinity for bacterial DNA gyrase than for mammalian. Cinagen is a broad-spectrum antibiotic that is active against both Gram-positive and Gram-negative bacteria.
| Trade Name | Cinagen |
| Availability | Prescription only |
| Generic | Moxifloxacin |
| Moxifloxacin Other Names | Moxifloxacin, Moxifloxacino |
| Related Drugs | amoxicillin, prednisone, doxycycline, ciprofloxacin, cephalexin, metronidazole, azithromycin, clindamycin, ceftriaxone, levofloxacin |
| Weight | 0.5% |
| Type | Eye Drops |
| Formula | C21H24FN3O4 |
| Weight | Average: 401.4314 Monoisotopic: 401.175084476 |
| Protein binding | 50% bound to serum proteins, independent of drug concentration. |
| Groups | Approved, Investigational |
| Therapeutic Class | 4-Quinolone preparations |
| Manufacturer | Navana Pharmaceuticals Ltd |
| Available Country | Bangladesh |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Cinagen is used for the treatment of adults (>18 years of age) with infections caused by susceptible strains of the designated microorganisms in the conditions listed below-
- Acute Bacterial Sinusitis caused by Streptococcus pneumoniae, Haemophilus infuenzae or Moraxella catarrhalis.
- Acute Bacterial Exacerbation of Chronic Bronchitis caused by Streptococcus pneumoniae, Haemophilus infuenzae, Haemophilus parainfuenzae, Klebsiella pneumoniae, methicillin-susceptible Staphylococcus aureus or Moraxella catarrhalis
- Community Acquired Pneumonia caused by Streptococcus pneumoniae (including multi-drug resistant strains), Haemophilus infuenzae, Moraxella catarrhalis, methicillin-susceptible Staphylococcus aureus, Klebsiella pneumoniae, Mycoplasma pneumoniae or Chlamydophilia pneumoniae.
- Uncomplicated Skin and Skin Structure Infections caused by methicillin-susceptible Staphylococcus aureus or Streptococcus pyogen.
- Complicated Skin and Skin Structure Infections caused by methicillin-susceptible Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae or Enterobacter cloacae.
- Complicated Intra-Abdominal Infections including polymicrobial infections such as abscess caused by Escherichia coli, Bacteroides fragilis, Streptococcus anginosus, Streptococcus constellatus, Enterococcus faecalis, Proteus mirabilis, Clostridium perfringens, Bacteroides thetaiotaomicron or Peptostreptococcus species.
Cinagen is also used to associated treatment for these conditions: Acute Exacerbation of Chronic Bronchitis (AECB), Bacterial Conjunctivitis, Community Acquired Pneumonia (CAP), Plague, Postoperative Inflammatory Response, Sinusitis, Skin Infections, Ocular bacterial infections, Post-operative infection
How Cinagen works
The bactericidal action of moxifloxacin results from inhibition of the enzymes topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.
Dosage
Cinagen dosage
The dose of Cinagen is 400 mg once every 24 hours. The duration of therapy depends on the type of infection as described bellow-
- In Acute Bacterial Sinusitis: Cinagen 400 mg is given once daily for 10 days.
- In Acute Bacterial Exacerbation of Chronic Bronchitis: Cinagen 400 mg is given once daily for 5 days.
- In Community Acquired Pneumonia: Cinagen 400 mg is given once daily for 7-14 days.
- In Uncomplicated Skin & Skin Structure infections: Cinagen 400 mg is given once daily for 7 days.
- In Complicated Skin & Skin Structure infections: Cinagen 400 mg is given once daily for 7-21 days.
- In Complicated Intra-Abdominal infections: Cinagen 400 mg is given once daily for 5-14 days.
Cinagen 400 mg IV infusion can be administered intravenously for the entire treatment duration. Alternatively, therapy may be initial intravenous administration, followed by oral administration when clinically indicated. The recommended duration of treatment for the indication being treated should not be exceeded. The solution for infusion should be infused intravenously over 60 minutes.
Side Effects
The following one or more side effects may be observed: tendinopathy and tendon rupture, QT prolongation, hypersensitivity reactions, Clostridium difficile-associated diarrhea, peripheral neuropathy, photosensitivity, phototoxicity etc.
Toxicity
Symptoms of overdose include CNS and gastrointestinal effects such as decreased activity, somnolence, tremor, convulsions, vomiting, and diarrhea. The minimal lethal intravenous dose in mice and rats is 100 mg/kg.
Precaution
Cinagen should be discontinued at the first appearance of a skin rash or any other sign of hypersensitivity. Cinagen should be discontinued if the patient experiences pain, swelling, inflammation or rupture of a tendon.
Interaction
No quinolone should be co-administered with any solution containing multivalent cations (e.g. magnesium) through the same intravenous line. Antacids, iron and adsorbents reduce absorption of Cinagen. NSAID may increase the risk of CNS stimulation. Warfarin may increase the risk of bleeding.
Food Interaction
- Drink plenty of fluids.
- Take with or without food.
Cinagen multivitamins interaction
[Moderate] ADJUST DOSING INTERVAL: Oral preparations that contain magnesium, aluminum, or calcium may significantly decrease the gastrointestinal absorption of quinolone antibiotics.
Absorption may also be reduced by sucralfate, which contains aluminum, as well as other polyvalent cations such as iron and zinc.
The mechanism is chelation of quinolones by polyvalent cations, forming a complex that is poorly absorbed from the gastrointestinal tract.
The bioavailability of ciprofloxacin has been reported to decrease by as much as 90% when administered with antacids containing aluminum or magnesium hydroxide.
When coadministration cannot be avoided, quinolone antibiotics should be dosed either 2 to 4 hours before or 4 to 6 hours after polyvalent cation-containing products to minimize the potential for interaction.
When coadministered with Suprep Bowel Prep (magnesium Please consult individual product labeling for specific recommendations.
Cinagen Drug Interaction
Moderate: aspirin, aspirin, aspirin, celecoxib, albuterol / ipratropium, budesonide / formoterolUnknown: amoxicillin / clavulanate, diphenhydramine, ubiquinone, duloxetine, omega-3 polyunsaturated fatty acids, furosemide, atorvastatin, metoprolol, acetaminophen, acetaminophen, cyanocobalamin, pyridoxine, ascorbic acid, cholecalciferol
Cinagen Disease Interaction
Major: colitis, liver disease, CNS disorders, myasthenia gravis, peripheral neuropathy, QT interval prolongation, tendonitisModerate: crystalluria, diabetes
Volume of Distribution
- 1.7 to 2.7 L/kg
Elimination Route
Well absorbed from the gastrointestinal tract. Absolute oral bioavailability is approximately 90%. Food has little effect on absorption.
Half Life
11.5-15.6 hours (single dose, oral)
Clearance
- 12 +/- 2 L/hr
Elimination Route
Approximately 45% of an oral or intravenous dose of moxifloxacin is excreted as unchanged drug (~20% in urine and ~25% in feces).
Pregnancy & Breastfeeding use
Pregnancy Category C. Cinagen is not recommended during pregnancy & lactation.
Contraindication
Cinagen is contraindicated in persons with a history of hypersensitivity to Cinagen or any member of the quinolone class of antimicrobial agents and any component of this formulation.
Special Warning
Elderly: No adjustment of dosage is required in the elderly.
Children: Efficacy and safety of Cinagen IV infusion in children and adolescent have not been established.
Acute Overdose
In the events of an acute overdose, the stomach should be emptied. The patient should be kept under observation and appropriate hydration should be maintained.
Storage Condition
Store between 15 to 30° C. Protect from light and moisture. Keep away from reach of children.
Innovators Monograph
You find simplified version here Cinagen
Cinagen contains Moxifloxacin see full prescribing information from innovator Cinagen Monograph, Cinagen MSDS, Cinagen FDA label
FAQ
What is Cinagen used for?
Cinagen is used to treat certain infections caused by bacteria such as pneumonia, and skin, and abdominal (stomach area) infections.Cinagen is also used to prevent and treat plague a serious infection that may be spread on purpose as part of a bioterror attack.
How safe is Cinagen?
Cinagen may cause problems with bones, joints, and tissues around joints in children.Cinagen should not be given to children younger than 18 years old.Cinagen may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
How does Cinagen work?
Cinagen works by killing the bacteria that cause infections. Antibiotics such as Cinagen will not work for colds, flu, or other viral infections.
What are the common side effects of Cinagen?
The common side effects of Cinagen are include:
- nausea.
- vomiting.
- stomach pain.
- diarrhea.
- constipation.
- heartburn
Is Cinagen safe during pregnancy?
Use is considered acceptable; according to some experts,this drug should be used during pregnancy only if the benefit outweighs the risk to the fetus.
Is Cinagen safe during breastfeeding?
Use of Cinagen is acceptable in nursing mothers with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis..Cinagen is preferable to use an alternate drug for which safety information is available.
Can I drink alcohol with Cinagen?
Do not drink alcohol. Drinking alcohol can increase the chance of liver problems while you are taking Cinagen. Avoid hard physical activity. Although not common, Cinagen can make it easier to get tendon injuries.
Can I drive after taking Cinagen?
Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
What is the best time to take Cinagen?
Cinagen is usually taken with or without food once a day for 5 to 21 days. The length of treatment depends on the type of infection being treated. Your doctor will tell you how long to take Cinagen. Take Cinagen at around the same time every day.
Can I take Cinagen at night?
Take Cinagen exactly as your doctor tells you to. You will be prescribed a dose of one tablet a day. Try to take the tablets at the same time of day each day, as this will help you to remember to take Cinagen regularly.
Is Cinagen a good antibiotic?
Normally, Cinagenis not a dangerous antibiotic for most people, but in rare cases, it can cause serious side effects such as heart rhythm problems, liver damage, and tendon rupture.
Does Cinagen make me sleepy?
Cinagen may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally.
Can Cinagen cause blurry vision?
Cinagen ophthalmic may cause blurred vision and may impair your reactions. Avoid driving or hazardous activity until you know how this medicine will affect you.
Can Cinagen increase heart rate?
Cinagen causes increase heart rate greater than 10 bpm.
How often can I use Cinagen?
Cinagen is usually used three times a day for 7 days. Try to use at around the same times every day.
Can I overdose on Cinagen?
An overdose of Cinagen ophthalmic is not expected to be dangerous. Seek emergency medical attention if anyone has accidentally swallowed the medication. Do not use other eye medications unless your doctor tells you to.
Can Cinagen cause permanent damage?
Cinagen can cause long-lasting, disabling and potentially permanent side effects involving tendons, muscles, joints and the nervous system.
How long does btrand stay in my body?
The elimination half-life of Cinagen is 11.5 to 15.6 hours .About 45% of an oral or intravenous dose of Cinagen is excreted as unchanged drug.
Can I take Cinagen for a long time?
Cinagen oral tablet is used for short-term treatment.
How long can I take Cinagen?
Cinagen comes as tablet to take by mouth.Cinagen is usually taken with or without food once a day for 5 to 21 days. The length of treatment depends on the type of infection being treated.
Who should Cinagen take Cinagen?
Stop using Cinagen and call your doctor at once if you have symptoms such as:headache, hunger, irritability, numbness, tingling, burning pain, confusion, agitation, paranoia, problems with memory or concentration, thoughts of suicide, or sudden pain or movement problems in any of your joints.
