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 Table of Contents    
LETTER TO THE EDITOR
Year : 2012  |  Volume : 44  |  Issue : 3  |  Page : 426-427
 

Uncontrolled penile erection and increased sexual desire with intravenous moxifloxacin


1 Clinic of Infectious Diseases and Clinical Microbiology, Merzifon Military Hospital, Amasya, Turkey
2 Clinic of Psychiatry, Merzifon Military Hospital, Amasya, Turkey
3 Department of Physiology, Duzce University School of Medicine, Duzce, Turkey
4 Clinic of Chest Diseases, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey

Date of Web Publication17-May-2012

Correspondence Address:
Ersin Günay
Clinic of Chest Diseases, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7613.96359

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How to cite this article:
Kucukbayrak A, Perdeci Z, Kucukbayrak ZS, Günay E. Uncontrolled penile erection and increased sexual desire with intravenous moxifloxacin. Indian J Pharmacol 2012;44:426-7

How to cite this URL:
Kucukbayrak A, Perdeci Z, Kucukbayrak ZS, Günay E. Uncontrolled penile erection and increased sexual desire with intravenous moxifloxacin. Indian J Pharmacol [serial online] 2012 [cited 2021 Mar 5];44:426-7. Available from: https://www.ijp-online.com/text.asp?2012/44/3/426/96359


Sir,

We report an adverse reaction of uncontrolled penile erection and increased sexual desire due to moxifloxacin. To the best of our knowledge, this adverse effect has not been reported in the literature.

A 31-year-old male patient presented to our clinic with complaints of high fever, headache, myalgia, arthralgia, and purulent postnasal drip. Past medical history was unremarkable. There was a family history of hypertension. The respiratory system including chest x-ray was normal. Acute sinusitis was diagnosed and patient was prescribedmoxifloxacin 400 mg/ day intravenously. The patient presented with complaints of increased sexualdesire and uncontrolled penile erection at 12 h after the treatment. His fever was normal after 48 h. Intravenous moxifloxacin was replaced by to oral dosageon the third day. Complaints of uncontrolled penile erection and increased sexual desire of the patient were improved at the end of the fifth day. Oral moxifloxacin was continued to the 10 th day. No symptom was observed on follow-up of the patient.

Moxifloxacin is a quinolone antibiotic. Quinolones are well tolerated with safety profiles similar to those of other antimicrobial agents. Some adverse effects as tendinitis and CNS-related effects are more common with quinolones than other antimicrobial agents. [1]

Brown reported a 31-year-old patient with prostatitis and premature ejaculation. He emphasized a therapeutic effect of ciprofloxacin on premature ejaculation (prolongation of ejaculation from 1-2 to 4-6 min) which was reversible. [2]

CNS side effects after administration of quinolones have been reported at the rate of 1-2%. The most common symptoms involve dizziness, somnolence, and headache. The less commonly reported symptoms have involved agitation, confusion, delirium, abnormal vision, and organic psychosis. [3] Abnormal dreams, depersonalization, depression (potentially culminating in self-endangering behavior, and emotional lability have been reported at the rate of less than 0.1%. [4] Moxifloxacin is a quinolone with potential for side effects associated with CNS. [1] Klossek et al. reported that CNS events such as dizziness and vertigo after moxifloxacin are observed more than five times more often than trovafloxacin. [5]

The cerebral areas especially the limbic system and hypothalamus are responsible for sexual function. However, it has been thought that anterior hypothalamic region and medial preoptic nucleus manage sexual behavior in men. It is known that dopamine is the most important neurotransmitter in sexual desire, fantasy, and motivation. Testosterone is also responsible for sexual desire. [6] To the best of our knowledge, differing side effects between intravenous or oral forms of moxifloxacin have not been described yet. In this particular case, causality assessment using the Naranjo scale, [7] showed that intravenous moxifloxacin was probably the causal drug for this adverse event.

Intravenous and oral moxifloxacin may differ in type and severity of adverse effects. Although rare, moxifloxacin may cause CNS adverse events that are reversible. Patients receiving intravenous moxifloxacinshould be closely followed-up and observed for these adverse events.

 
 » References Top

1.Owens RC Jr, Ambrose PG. Antimicrobial safety: Focus on fluoroquinolones. Clin Infect Dis 2005;41Suppl 2: S1144-57.  Back to cited text no. 1
    
2.Brown AJ. Ciprofloxacin as cure of premature ejaculation. J Sex Marital Ther 2000;26:351-2.  Back to cited text no. 2
    
3.Lipsky BA, Baker CA. Fluoroquinolone toxicity profiles: A review focusing on newer agents. Clin Infect Dis 1999;28:352-64.  Back to cited text no. 3
    
4.Ball P, Stahlmann R, Kubin R, Choudhri S, Owens R. Safety profile of oral and intravenous moxifloxacin: Cumulative data from clinical trials and postmarketing studies. Clin Ther 2004;26:940-50.  Back to cited text no. 4
    
5.Klossek JM, Siegert R, Nikolaidis P, Arvis P, Leberre MA.Comparison of the efficacy and safety of moxifloxacin and trovafloxacin for the treatment of acute, bacterial maxillary sinusitis in adults. J Laryngol Otol 2003;117:43-51.  Back to cited text no. 5
    
6.Crenshaw TL, Goldberg JP. Sexual aspects of neurochemistry. In: Crenshaw TL, Goldberg JP, editors. Sexual Pharmacology. New York: W.W. Norton Company;1996.  Back to cited text no. 6
    
7.Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA,et al. A method for estimating the probability of adverse drug reaction. Clin Pharmacol Ther 1981;30:239-45.  Back to cited text no. 7
    




 

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