Drug General Information (ID: DDIDMBYWKQ)
Drug Name			Cinoxacin		Drug Info		Kaolin		Drug Info
Drug Type		Small molecule				Natural product
Therapeutic Class		Antiinfective Agents				Herbal Products
Structure

Mechanism of Cinoxacin-Kaolin Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Cinoxacin				Kaolin
Mechanism		Binds to polyvalent cations				Polyvalent cations
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Kaolin due to formation of complexes caused by Cinoxacin

Recommended Action
Management		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.

References
1	Nix DE, Wilton JH, Ronald B, Distlerath L, Williams VC, Norman A "Inhibition of norfloxacin absorption by antacids." Antimicrob Agents Chemother 34 (1990): 432-5. [PMID: 2334155]
2	Noyes M, Polk RE "Norfloxacin and absorption of magnesium-aluminum." Ann Intern Med 109 (1988): 168-9. [PMID: 3382110]
3	Teng R, Dogolo LC, Willavize SA, Friedman HL, Vincent J "Effect of Maalox and omeprazole on the bioavailability of trovafloxacin." J Antimicrob Chemother 39 Suppl B (1997): 93-7. [PMID: 9222077]