Skip to content
My WebMD Sign In, Sign Up

Cipro

Interactions

Oral Quinolones/Aluminum; Lanthanum; Magnesium (mono deleted 12/01/2011)

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, the aluminum and/or magnesium in the antacid or Videx chewable/dispersible tablet or your lanthanum may bind to your antibiotic. This prevents your body from absorbing the antibiotic.

What might happen:

The blood levels of your antibiotic may be decreased, which will decrease the effectiveness in treating your infection.

What you should do about this interaction:

You should time when you take your antibiotic and your antacid or Videx chewable/dispersible tablets (which contain magnesium) so that you do not these medicines: --within 6 hours before or 2 hours after ciprofloxacin --within 8 hours before or 2 hours after enoxacin --until 4 hours after gatifloxacin --within 3 hours before or 2 hours after gemifloxacin --within 2 hours before or 2 hours after levofloxacin --within 4 hours before or 2 hours after lomefloxacin --within 8 hours before or 4 hours after moxifloxacin --within 2 hours before or after nalidixic acid --within 2 hours before or 2 hours after norfloxacin --within 2 hours before or 2 hours after ofloxacin --until 4 hours after sparfloxacin --within 2 hours before or 2 hours after trovafloxacin.If you are taking lanthanum, your doctor may tell you to follow the above timing instructions, or to time your lanthanum so that you take your antibiotic at least 1 hour before your lanthanum or 4 hours after it, or to skip doses that you would normally take at the same time as your antibiotic.If you are not sure which antibiotic you are on or if you have questions about the timing of doses of your medicine, contact your healthcare professionals (e.g. doctor or pharmacist). They may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Fosrenol (lanthanum carbonate) US prescribing information. Shire US Inc. September, 2011.

2.Cipro (ciprofloxacin hydrochloride) US prescribing information. Bayer Corporation February, 2011.

3.Penetrex (enoxacin) US prescribing information. Aventis Pharmaceuticals, Inc. July, 1998.

4.Tequin (gatifloxacin) US prescribing information. Bristol-Myers Squibb Company January, 2006.

5.Factive (gemifloxacin mesylate) US prescribing information. Oscient Pharmaceuticals February, 2011.

6.Levaquin (levofloxacin) US prescribing information. Ortho-McNeil Pharmaceutical, Inc. February, 2011.

7.Maxaquin (lomefloxacin hydrochloride) US prescribing information. Pfizer Inc. January, 2005.

8.Avelox (moxifloxacin hydrochloride) US prescribing information. Bayer Pharmaceuticals Corporation February, 2011.

9.NegGram (nalidixic acid) US prescribing information. Sanofi-Synthelabo, Inc. November, 2012.

10.Noroxin (norfloxacin) US prescribing information. Merck & Co., Inc. September, 2011.

11.Floxin (ofloxacin) US prescribing information. Ortho-McNeil Pharmaceutical, Inc. February, 2011.

12.Zagam (sparfloxacin) US prescribing information. Bertek Pharmaceuticals, Inc. February, 2003.

13.Trovan (trovafloxacin mesylate) US prescribing information. Roerig April, 2000.

14.Hoffken G, Borner K, Glatzel PD, Koeppe P, Lode H. Reduced enteral absorption of ciprofloxacin in the presence of antacids. Eur J Clin Microbiol 1985 Jun;4(3):345.

15.Golper TA, Hartstein AI, Morthland VH, Christensen JM. Effects of antacids and dialysate dwell times on multiple-dose pharmacokinetics of oral ciprofloxacin in patients on continuous ambulatory peritoneal dialysis. Antimicrob Agents Chemother 1987 Nov;31(11):1787-90.

16.Maesen FP, Davies BI, Geraedts WH, Sumajow CA. Ofloxacin and antacids. J Antimicrob Chemother 1987 Jun;19(6):848-50.

17.Nix DE, Watson WA, Lener ME, Frost RW, Krol G, Goldstein H, Lettieri J, Schentag JJ. Effects of aluminum and magnesium antacids and ranitidine on the absorption of ciprofloxacin. Clin Pharmacol Ther 1989 Dec; 46(6):700-5.

18.Grasela TH Jr, Schentag JJ, Sedman AJ, Wilton JH, Thomas DJ, Schultz RW, Lebsack ME, Kinkel AW. Inhibition of enoxacin absorption by antacids or ranitidine. Antimicrob Agents Chemother 1989 May;33(5):615-7.

19.Nix DE, Wilton JH, Ronald B, Distlerath L, Williams VC, Norman A. Inhibition of norfloxacin absorption by antacids. Antimicrob Agents Chemother 1990 Mar;34(3):432-5.

20.Flor S, Guay DR, Opsahl JA, Tack K, Matzke GR. Effects of magnesium-aluminum hydroxide and calcium carbonate antacids on bioavailability of ofloxacin. Antimicrob Agents Chemother 1990 Dec; 34(12):2436-8.

21.Martinez Cabarga M, Sanchez Navarro A, Colino Gandarillas CI, Dominguez-Gil A. Effects of two cations on gastrointestinal absorption of ofloxacin. Antimicrob Agents Chemother 1991 Oct;35(10):2102-5.

22.Akerele JO, Okhamafe AO. Influence of oral co-administered metallic drugs on ofloxacin pharmacokinetics. J Antimicrob Chemother 1991 Jul; 28(1):87-94.

23.Frost RW, Lasseter KC, Noe AJ, Shamblen EC, Lettieri JT. Effects of aluminum hydroxide and calcium carbonate antacids on the bioavailability of ciprofloxacin. Antimicrob Agents Chemother 1992 Apr;36(4):830-2.

24.Campbell NR, Kara M, Hasinoff BB, Haddara WM, McKay DW. Norfloxacin interaction with antacids and minerals. Br J Clin Pharmacol 1992 Jan; 33(1):115-6.

25.Shimada J, Shiba K, Oguma T, Miwa H, Yoshimura Y, Nishikawa T, Okabayashi Y, Kitagawa T, Yamamoto S. Effect of antacid on absorption of the quinolone lomefloxacin. Antimicrob Agents Chemother 1992 Jun; 36(6):1219-24.

26.Nix DE, Lebsack ME, Chapelsky M, Sedman AJ, Busch J, Norman A. Effect of oral antacids on disposition of intravenous enoxacin. Antimicrob Agents Chemother 1993 Apr;37(4):775-7.

27.Sahai J, Gallicano K, Oliveras L, Khaliq S, Hawley-Foss N, Garber G. Cations in the didanosine tablet reduce ciprofloxacin bioavailability. Clin Pharmacol Ther 1993 Mar;53(3):292-7.

28.Lehto P, Kivisto KT. Different effects of products containing metal ions on the absorption of lomefloxacin. Clin Pharmacol Ther 1994 Nov; 56(5):477-82.

29.Allen A, Vousden M, Porter A, Lewis A. Effect of Maalox on the bioavailability of oral gemifloxacin in healthy volunteers. Chemotherapy 1999 Nov-Dec;45(6):504-11.

30.Videx (didanosine) US prescribing information. Bristol-Myers Squibb Company November, 2011.

31.Stass H, Bottcher MF, Ochmann K. Evaluation of the influence of antacids and H2 antagonists on the absorption of moxifloxacin after oral administration of a 400mg dose to healthy volunteers. Clin Pharmacokinet 2001;40 Suppl 1:39-48.

32.Sanchez Navarro A, Martinez Cabarga M, Dominguez-Gil Hurle A. Oral absorption of ofloxacin administered together with aluminum. Antimicrob Agents Chemother 1994 Oct;38(10):2510-2.

33.Lazzaroni M, Imbimbo BP, Bargiggia S, Sangaletti O, Dal Bo L, Broccali G, Porro GB. Effects of magnesium-aluminum hydroxide antacid on absorption of rufloxacin. Antimicrob Agents Chemother 1993 Oct;37(10):2212-6.

34.Johnson RD, Dorr MB, Talbot GH, Caille G. Effect of Maalox on the oral absorption of sparfloxacin. Clin Ther 1998 Nov-Dec;20(6):1149-58.

35.Granneman GR, Stephan U, Birner B, Sorgel F, Mukherjee D. Effect of antacid medication on the pharmacokinetics of temafloxacin. Clin Pharmacokinet 1992;22 Suppl 1:83-9.

36.Teng R, Dogolo LC, Willavize SA, Friedman HL, Vincent J. Effect of Maalox and omeprazole on the bioavailability of trovafloxacin. J Antimicrob Chemother 1997 Jun;39 Suppl B:93-7.

37.Spivey JM, Cummings DM, Pierson NR. Failure of prostatitis treatment secondary to probable ciprofloxacin-sucralfate drug interaction. Pharmacotherapy 1996 Mar-Apr;16(2):314-6.

38.Mallet L, Huang A. Coadministration of gatifloxacin and multivitamin preparation containing minerals: potential treatment failure in an elderly patient. Ann Pharmacother 2005 Jan;39(1):150-2.

39.Noyes M, Polk RE. Norfloxacin and absorption of magnesium-aluminum. Ann Intern Med 1988 Jul 15;109(2):168-9.

40.Vinceneux P, Weber P, Gaudin H, Boussougant Y. Decreased absorption of pefloxacin by gastric antacids. Preliminary study. Presse Med 1986 Oct 18;15(36):1826.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

More about Drugs and Medications

Newsletters

Subscribe to free WebMD newsletters.

  • WebMD Daily

    WebMD Daily

    Subscribe to the WebMD Daily, and you'll get today's top health news and trending topics, and the latest and best information from WebMD.

  • Men's Health

    Men's Health

    Subscribe to the Men's Health newsletter for the latest on disease prevention, fitness, sex, nutrition, and more from WebMD.

  • Women's Health

    Women's Health

    Subscribe to the Women's Health newsletter for the latest on disease prevention, fitness, sex, diet, anti-aging, and more from WebMD.

By clicking Submit, I agree to the WebMD Terms & Conditions & Privacy Policy

URAC: Accredited Health Web Site TRUSTe online privacy certification HONcode Seal AdChoices