Drug General Information (ID: DDIOH2PTC8)
Drug Name			Enoxacin		Drug Info		Dexamethasone		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiinfective Agents				Antiinflammatory Agents
Structure

Mechanism of Enoxacin-Dexamethasone Interaction (Severity Level: Major)
Increased risk of tendinitis/tendon rupture Click to Show/Hide Mechanism Graph
Drug Name		Enoxacin				Dexamethasone
Mechanism		Tendinitis/tendon rupture				Tendinitis/tendon rupture
Key Mechanism Factor 1
		Factor Name		Tendinitis/tendon rupture
		Factor Description		Tendons are tough bands of tissue that attach your muscles to your bones. A tendon rupture is a partial or complete tear of a tendon; tendonitis is inflammation or irritation of a tendon, a condition that causes pain and tenderness outside the joint.
Mechanism Description		Increased risk of tendinitis/tendon rupture by the combination of Enoxacin and Dexamethasone

Recommended Action
Management		Caution is recommended if fluoroquinolones are prescribed in combination with corticosteroids, particularly in patients with other concomitant risk factors (e.g., age over 60 years recipient of kidney, heart, and/or lung transplant). Patients should be advised to stop taking the fluoroquinolone, avoid exercise and use of the affected area, and promptly contact their physician if they experience pain, swelling, or inflammation of a tendon.

References
1	FDA. U.S. Food and Drug Administration "Information for Healthcare Professionals. Fluoroquinolone Antimicrobial Drugs. FDA Alert [7/8/2008].".
2	Khaliq Y, Zhanel GG "Fluoroquinolone-Associated Tendinopathy: A Critical Review of the Literature." Clin Infect Dis 36 (2003): 1404-1410. [PMID: 12766835]
3	Product Information. Avelox (moxifloxacin) Bayer, West Haven, CT.
4	Product Information. Baxdela (delafloxacin). Melinta Therapeutics, Lincolnshire, IL.
5	Product Information. Cipro (ciprofloxacin). Bayer, West Haven, CT.
6	Product Information. Levaquin (levofloxacin). Ortho Pharmaceutical Corporation, Raritan, NJ.
7	van der Linden PD, Sturkenboom MC, Herings RM, Leufkens HM, Rowlands S, Stricker BH "Increased risk of achilles tendon rupture with quinolone antibacterial use, especially in elderly patients taking oral corticosteroids." Arch Intern Med 163 (2003): 1801-7. [PMID: 12912715]