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magnesium-aluminum-alginic ac oral

Selected Oral Quinolones/Selected Oral Cations

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:

Your medicine contains aluminum, calcium, iron, lanthanum, magnesium, and/or zinc, which are cations that may bind to your antibiotic in your digestive tract. 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 other medicine so that you do not take: ---ciprofloxacin for at least 2 hours before or 6 hours after oral cations. ---enoxacin for at least 2 hours before or 8 hours after oral cations. ---levofloxacin for at least 2 hours before or 2 hours after oral cations. ---nalidixic acid for at least 2 hours before or 2 hours after oral cations. ---norfloxacin for at least 2 hours before or 2 hours after oral cations. ---ofloxacin for at least 2 hours before or 2 hours after oral cations. ---sparfloxacin for at least 4 hours before oral cations.If you are taking lanthanum, your doctor may tell you to follow the above timing instructions or different ones, or your doctor may tell you 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, if you do not see your antibiotic listed, 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.Cipro (ciprofloxacin hydrochloride) US prescribing information. Bayer Corporation August, 2013.
2.Penetrex (enoxacin) US prescribing information. Aventis Pharmaceuticals, Inc. July, 1998.
3.Levaquin (levofloxacin) US prescribing information. Ortho-McNeil Pharmaceutical, Inc. August, 2013.
4.NegGram (nalidixic acid) US prescribing information. Sanofi-Synthelabo, Inc. November, 2012.
5.Noroxin (norfloxacin) US prescribing information. Merck & Co., Inc. August, 2013.
6.Floxin (ofloxacin) US prescribing information. Ortho-McNeil Pharmaceutical, Inc. February, 2011.
7.Zagam (sparfloxacin) US prescribing information. Bertek Pharmaceuticals, Inc. February, 2003.
8.Fosrenol (lanthanum carbonate) Canadian prescribing information. Shire BioChem February 19, 2007.
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13.Videx (didanosine) US prescribing information. Bristol-Myers Squibb Company November, 2011.
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23.Brouwers JR, Van der Kam HJ, Sijtsma J, Proost JH. Decreased ciprofloxacin absorption with concomitant administration of ferrous fumarate. Pharm Weekbl Sci 1990 Oct 19;12(5):182-3.
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25.Lehto P, Kivisto KT, Neuvonen PJ. The effect of ferrous sulphate on the absorption of norfloxacin, ciprofloxacin and ofloxacin. Br J Clin Pharmacol 1994 Jan;37(1):82-5.
26.Kara M, Hasinoff BB, McKay DW, Campbell NR. Clinical and chemical interactions between iron preparations and ciprofloxacin. Br J Clin Pharmacol 1991 Mar;31(3):257-61.
27.Polk RE, Healy DP, Sahai J, Drwal L, Racht E. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989 Nov;33(11):1841-4.
28.How PP, Fischer JH, Arruda JA, Lau AH. Effects of lanthanum carbonate on the absorption and oral bioavailability of ciprofloxacin. Clin J Am Soc Nephrol 2007 Nov;2(6):1235-40.
29.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.
30.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.
31.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.
32.Pai MP, Allen SE, Amsden GW. Altered steady state pharmacokinetics of levofloxacin in adult cystic fibrosis patients receiving calcium carbonate. J Cyst Fibros 2006 Aug;5(3):153-7.
33.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.
34.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.
35.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.
36.Akerele JO, Okhamafe AO. Influence of oral co-administered metallic drugs on ofloxacin pharmacokinetics. J Antimicrob Chemother 1991 Jul; 28(1):87-94.
37.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.
38.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.
39.Phansalkar S, van der Sijs H, Tucker AD, Desai AA, Bell DS, Teich JM, Middleton B, Bates DW. Drug-drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records. J Am Med Inform Assoc 2012 Sep 25.

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