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norfloxacin oral

Cyclosporine/Selected Quinolones

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:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Quinolone antibiotics may prevent your liver from processing cyclosporine and may prevent your kidneys from removing cyclosporine from your blood. Both cyclosporine and quinolone antibiotics can harm your kidneys.

What might happen:

The amount of cyclosporine in your blood may increase and may harm your kidneys.

What you should do about this interaction:

Make sure that your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to check the amount of cyclosporine in your blood and your kidney function more often while you are taking your antibiotic.Tell your doctor if you have any kidney problems. If you experience any shortness of breath, unusual swelling, changes in the color or amount of your urine, or changes in how often you urinate, contact your doctor.Your healthcare professionals 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.Avent CK, Krinsky D, Kirklin JK, Bourge RC, Figg WD. Synergistic nephrotoxicity due to ciprofloxacin and cyclosporine. Am J Med 1988 Sep; 85(3):452-3.
2.Elston RA, Taylor J. Possible interaction of ciprofloxacin with cyclosporin A. J Antimicrob Chemother 1988 May;21(5):679-80.
3.Wrishko RE, Levine M, Primmett DR, Kim S, Partovi N, Lewis S, Landsberg D, Keown PA. Investigation of a possible interaction between ciprofloxacin and cyclosporine in renal transplant patients. Transplantation 1997 Oct 15;64(7):996-9.
4.Kruger HU, Schuler U, Proksch B, Gobel M, Ehninger G. Investigation of potential interaction of ciprofloxacin with cyclosporine in bone marrow transplant recipients. Antimicrob Agents Chemother 1990 Jun;34(6):1048-52.
5.Lang J, Finaz de Villaine J, Garraffo R, Touraine JL. Cyclosporine (cyclosporin A) pharmacokinetics in renal transplant patients receiving ciprofloxacin. Am J Med 1989 Nov 30;87(5A):82S-85S.
6.de Witte T, Novakova I, Branolte J, Muytjens H, de Pauw B. Long-term oral ciprofloxacin for infection prophylaxis in allogeneic bone marrow transplantation. Pharm Weekbl Sci 1987 Dec 11;9 Suppl:S48-52.
7.Doose DR, Walker SA, Chien SC, Williams RR, Nayak RK. Levofloxacin does not alter cyclosporine disposition. J Clin Pharmacol 1998 Jan;38(1):90-3.
8.McLellan RA, Drobitch RK, McLellan H, Acott PD, Crocker JF, Renton KW. Norfloxacin interferes with cyclosporine disposition in pediatric patients undergoing renal transplantation. Clin Pharmacol Ther 1995 Sep; 58(3):322-7.
9.Thomson DJ, Menkis AH, McKenzie FN. Norfloxacin-cyclosporine interaction. Transplantation 1988 Aug;46(2):312-3.

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