Ferrous sulfate Ciprofloxacin

Interference with T4 absorption Cholestyramine, chromium picolinate, colestipol, ciprofloxacin, proton pump inhibitors, sucralfate, sodium polystyrene sulfonate, raloxifene, sevelamer hydrochloride, aluminum hydroxide, ferrous sulfate, calcium carbonate, bran, soy, coffee. 

If ciprofloxacin, a member of the fluoroquinolones family, is prescribed, then it should be given two hours before the patient is given antacids, ferrous sulfate, or sucralfate because these medications lower the absorption of ciprofloxacin. 

Ferrous fumarate, gluconate, sulfate and other iron compounds can reduce the absorption of ciprofloxacin, gatifloxacin, levofloxacin, moxifloxacin, norfloxacin, ofloxacin and sparfloxacin from the gut. Serum levels of the antibacterial may become sub-therapeutic as a result. Limited evidence suggests that fleroxacin is not affected and lomefloxacin is only minimally affected. Glemi-floxacin does not appear to interact when given 2 hours before or 3 hours after ferrous sulfate. No interaction appears to occur with iron-ovotransferrin. Zinc appears to interact like iron. 

The absorption of ciprofloxacin is markedly reduced by iron and zinc compounds. Several studies have clearly demonstrated reductions in the AUC and maximum serum levels of 30 to 90% with ferrous fumarate, ferrous gluconate, ferrous sulfate, iron-glycine sulfate, Centrum Forte (a multi-mineral preparation containing iron, magnesium, zinc, calcium, copper and manganese) and with Stresstabs 600-with-zinc (a multi vitamin-with-zinc preparation). However iron-ovotransferrin has been found to have no significant effect on the absorption of ciprofloxacin. ... 

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. Antimicrcb Agents Chemo er (1989) 33, 1841. ... 

Wong PY, Zhu M, Li RC. Pharmacokinetic and pharmacodynamic interactions between intravenous ciprofloxacin and oral ferrous sulfate. J Chemother (2000) 12, 286-93. 

---

See also in sourсe #XX -- [ ]

---