Fleroxacin Ferrous sulfate

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. 

A study in 12 subjects found that ferrous sulfate (equivalent to 100 mg of elemental iron) had no significant effect on the pharmacokinetics of fleroxacin. ... 

None of these quinolones should be taken at the same time as any iron preparation that contains substantial amounts of iron (e.g. ferrous sulfate, ferrous gluconate, ferrous fumarate, iron-glycine sulfate). Since the quinolones are rapidly absorbed, taking them 2 hours before the iron should minimise the risk of admixture in the gut and largely avoid this interaction. Information about other quinolones seems to be lacking but the same precautions should be taken with all of them except fleroxacin, which appears not to interact, and lomefloxacin, which seems to interact only minirnally. 

Sorgel F, Naber KG, Kinzig M, Frank A, Bimer B. Effect of ferrous sulfate on fleroxacin analyzed by the confidence interval (Cl) approach. Pharm Res (1995) 12 (9 Suppl), S-422. 

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See also in sourсe #XX -- [ ]

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