Drug General Information (ID: DDII8XDPC0)
Drug Name			Enoxacin		Drug Info		Didanosine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiinfective Agents				Anti-Hiv Agents
Structure

Mechanism of Enoxacin-Didanosine Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Enoxacin				Didanosine
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 Didanosine due to formation of complexes caused by Enoxacin

Recommended Action
Management		Enoxacin should be administered at least 2 hours before or 8 hours after didanosine buffered tablets or pediatric oral solution, and patients should be monitored for potentially decreased antimicrobial efficacy during concomitant therapy. Didanosine buffered powder for oral solution, which uses a citrate-phosphate buffer, and the delayed-release capsules, which are not buffered, are not expected to cause this interaction.

References
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3	Knupp CA, Barbhaiya RH "A multiple-dose pharmacokinetic interaction study between didanosine (videx(r)) and ciprofloxacin (cipro(r)) in male subjects seropositive for HIV but asymptomatic." Biopharm Drug Dispos 18 (1997): 65-77. [PMID: 9008270]
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7	Product Information. Penetrex (enoxacin). Rhone-Poulenc Rorer, Collegeville, PA.
8	Product Information. Videx (didanosine). Bristol-Myers Squibb, Princeton, NJ.
9	Sahai J, Gallicano K, Oliveras L, Khaliq S, Hawley-Foss N, Garber G "Cations in the didanosine tablet reduce ciprofloxacin bioavailability." Clin Pharmacol Ther 53 (1993): 292-7. [PMID: 8453847]
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