Diazepam Ciprofloxacin

The results showed that the compounds studied with more frequency in the aquatic environment, and of which, logically, there is more information, are the antibiotics, analgesics and anti-inflammatories (like diclofenac, ibuprofen, naproxen, acetylsalicylic acid, and paracetamol), as well as the p-blocker atenolol. In the category of antibiotics, several families are included, like the macrolides (erythromycin), the fluoroquinolones (ofloxacin and ciprofloxacin), sulfonamides (sulfamethoxazole), penicillins (amoxicillin), the metronidazol, and trimethoprim. Other therapeutic groups also widely studied and frequently found in the environmental waters are the lipid regulators (gemfibrozil and bezafibrat), antiepileptic carbamaze-pine, and antidepressants (diazepam, fluoxetine, paroxetine) (see Table 3). 

Ciprofloxacin (Cipro, Cipro XR, Proquin XR) [Antibiotic/ Fluoroquinolone] Uses Rx lower resp tract, sinuses, skin skin structure, bone/joints, urinary tract Infxns including prostatitis Action Quinolone antibiotic DNA gyrase Dose Adults. 250-750 mg PO ql2h XR 500-1000 mg PO q24h or 200-400 mg IV ql2h in renal impair Caution [C, /-] Children <18 y Contra Component sensitivity Disp Tabs, susp, inj SE Restlessness, N/V/D, rash, ruptured tendons, T LFTs Interactions T Effects Wf probenecid T effects OF diazepam, theophylline, caffeine, metoprolol, propranolol, phenytoin, warfarin effects W/ antacids, didanosine, Fe salts. Mg, sucralfate, Na bicarbonate,... 

L E. Quinidine. These are the classic signs of cinchon-ism and are adverse effects of quinidine and quinine, constituents of the cinchona tree. Some of these effects could be seen as toxic effects of phenytoin. However, auditory acuity is associated with cinchonism and not with phenytoin toxicity. Nausea but not the other effects could be associated with ciprofloxacin. Excessive drowsiness would be expected if diazepam were involved. These effects would not be expected with the estrogen replacement therapy. 

Heparin and its salts are incompatible with many drugs including alteplase, amikacin sulfate, amiodarone hydrochloride, ampicillin sodium, aprotinin, benzylpenicillin potassium or sodium, cephalothin sodium, ciprofloxacin lactate, cytarabine, dacarbazine, daunorubicin hydrochloride, diazepam, dobutamine hydrochloride, doxorubicin hydrochloride, droperidol, erythromycin lactobionate, gentamicin sulfate, haloperidol lactate, hyaluronidase, hydrocortisone sodium succinate, kanamycin sulfate, methicillin sodium, netilmicin sulfate, some opioid analgesics, oxytetracycline hydrochloride, some phenothiazines, polymyxin B sulfate, streptomycin sulfate, tetracycline hydrochloride, tobramycin sulfate, vancomycin hydrochloride, vinblastine sulfate, cisatracurium besylate, labetalol hydrochloride, nicardipine hydrochloride, cefmetazole, sodium ions, and fat emulsion.110 112... 

Interactions of macrolides with triazolam and midazolam are clinically important. Increased serum concentration, AUC, and half-life, and reduced clearance have been documented (93,94,118). These changes can result in clinical effects, such as prolonged psychomotor impairment, amnesia, or loss of consciousness (95). No interactions between ciprofloxacin and diazepam have been reported (96). 

Delon, A. Favreliere, S. Couet, W. Courtois, P. Bouquet, S. Rapid and sensitive determination of thalidomide in human plasma hy high-performance liquid chromatography. J.Liq.Chromatogr., 1996, 18, 297—309 [SPE ciprofloxacin is IS simultaneous acyclovir, azathioprine, cefotaxime, ceftazidime, flucytosine, metronidazole non-interfering amphotericin, clobazam, clonazepam, cyclophosphamide, cyclosporin, diazepam, diltiazem, hydro zine, nifedipine, prednisolone]... 

Noninterfering amiloride, acebutolol, acenocoumarol, acetaminophen, aspirin, allopuri-nol, ambroxol, amoxicillin, atenolol, bendroflumethiazide, benzbromarone, bezafibrate, biperiden, bisacodyl, bromazepam, butizide, captopril, cimetidine, ciprofloxacin, clobu-tinol, clonidine, cotinine, diazepam, diclofenac, digitoxin, digoxin, dihydrocodeine, dihy-droergotamine, diltiazem, doxepin, doxycycline, enalapril, erythromycin, fenoterol, furosemide, glibenclamide, heparin, h3qjoxanthine, ibuprofen, indomethacin, isosorbide... 

Ciprofloxacin causes a marked reduction in the clearance of diazepam, but this does not appear to be clinically important in most individuals. Ciprofloxacin appears not to interact with temazepam, and gatifloxacin appears not to interact with midazolam. 

Ciprofloxacin 500 mg twice daily for 3 days was found to have no effect on the pharmacokinetics of diazepam in a study in 10 healthy subjects. However, a later study in 12 healthy subjects found that ciprofloxacin 500 mg twice daily for 5 days increased the AUC of a single 5-mg intra-... 

Wijnands WJA, Trooster IFG, Teunissen PC, Cats HA, Vree TB. Ciprofloxacin does not impair the elimination of diazepam in humans. DnigMetab Dispos (1990) 18, 954-7. 

Kamali F, Thomas SHL, Edwards C. The influence of steady-state ciprofloxacin on the pharmacokinetics and pharmacodynamics of a single dose of diazepam in healthy volunteers. Eur J Clin Pharmacol (1993) 44, 365-7. 

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