Skip to main content
SpringerLink
Log in

Absorption Interactions With Fluoroquinolones

1995 Update

  • Review Article
  • Drug Experience
  • Published:
Drug Safety Aims and scope Submit manuscript

Summary

The utility of the fluoroquinolone class of antibiotics is rapidly expanding due to their favourable pharmacokinetic profile and the continuing development of new compounds. These agents are often used for indications not successfully treated with other orally available antimicrobials in the past, or for ‘step-down’ therapy in patients originally treated with intravenous agents. As the usage of these agents expands for serious systemic infections, knowledge of absorptive interactions with fluoroquinolones becomes paramount.

Fluoroquinolones are often utilised in dosages and against modestly susceptible pathogens which allow a narrow margin for acceptable decreases in bioavailability. Chelation interactions with multivalent cations can result in inactivation of the fluoroquinolone with ramifications in vitro and in vivo. Chelation interactions have been reported to occur in between 22 and 76% of patients prescribed fluoroquinolones. Concurrent administration of magnesium-aluminium antacids and sucralfate has the greatest effect on the bioavailability of quinolones followed by iron, calcium and zinc. Spacing doses of fluoroquinolones and interactants has been suggested as a method of ensuring adequate quinolone absorption, but this can make optimal administration of the cation interactant difficult, if not imposible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Neu HC. Chemical evolution of the fluoroquinolone antimicrobial agents. Am J Med 1989; 87 Suppl. 6C: 2S–9S

    PubMed  CAS  Google Scholar 

  2. Foster MT. Clinical use of fluoroquinolones. Postgrad Med 1991 Dec 4; 89 Suppl.: 23–6

    Google Scholar 

  3. Chu DTW, Fernandes PB. Structure-activity relationships of the fluoroquinolones. Antimicrob Agents Chemother 1989; 33: 131–5

    PubMed  CAS  Google Scholar 

  4. Maxwell A. The molecular basis of quinolone action. J Antimicrob Chemother 1992; 30: 409–14

    PubMed  CAS  Google Scholar 

  5. Sanders Jr WE. Efficacy, safety, and potential economic benefits of oral ciprofloxacin in the treatment of infections. Rev Infect Dis 1988; 10: 528–43

    PubMed  Google Scholar 

  6. Sanders Jr WE. Oral ofloxacin: a critical review of the new drug application. Clin Infect Dis 1992; 14: 539–54

    PubMed  Google Scholar 

  7. Monk JP, Campoli-Richards DM. Ofloxacin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic uses. Drugs 1987; 33: 346–91

    PubMed  CAS  Google Scholar 

  8. Campoli-Richards DM, Monk JP, Price A, et al. Ciprofloxacin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic use. Drugs 1988; 35: 373–447

    PubMed  CAS  Google Scholar 

  9. LeBel M. Ciprofloxacin: chemistry, mechanisms of action, resistance, antimicrobial spectrum, pharmacokinetics, clinical trials, and adverse reactions. Pharmacotherapy 1988; 8: 3–33

    PubMed  CAS  Google Scholar 

  10. Wolfson JS, Hooper DC. Pharmacokinetics of quinolones: newer aspects. Eur J Clin Microbiol Infect Dis 1991; 10: 267–74

    PubMed  CAS  Google Scholar 

  11. Schentag JJ, Nix DE. Pharmacokinetics and tissue penetration of fluoroquinolones. In: Sanders WE, Sanders CC, editors. Fluoroquinolones in the treatment of infectious diseases. Glenview, Illinois: Physicians and Scientists Publishing Co. Inc, 1990: 29–44

    Google Scholar 

  12. Louie TJ, Committee on Antimicrobial Agents, Canadian Infectious Disease Society. Ciprofloxacin: an oral quinolone for the treatment of infections with Gram-negative pathogens. Can Med Assoc J 1994; 150: 669–76

    CAS  Google Scholar 

  13. Barriere S. Economic impact of oral ciprofloxacin. Am J Med 1987; 82 Suppl. 4A: 387–90

    PubMed  CAS  Google Scholar 

  14. Paladino JA, Sperry HE, Backes JM, et al. Clinical and economic evaluation of oral ciprofloxacin after an abbreviated course of intravenous antibiotics. Am J Med 1991; 91: 462–70

    PubMed  CAS  Google Scholar 

  15. Domagala JM. Structure-activity and structure-side-effect relationships for the quinolone antibacterials. J Antimicrob Chemother 1994; 33: 685–706

    PubMed  CAS  Google Scholar 

  16. Piddock LJV. Mechanism of quinolone uptake into bacterial cells. J Antimicrob Chemother 1991; 27: 399–403

    PubMed  CAS  Google Scholar 

  17. Marshall AJH, Piddock LJV. Effect of cations and EDTA upon the activity of 18 quinolones, gentamicin, ceftazidime and polymyxin against Gram-negative and Gram-positive bacteria. Drugs 1993; 45 Suppl. 3: 150–1

    Google Scholar 

  18. Lecomte S, Baron MH, Chenon MT, et al. Effect of magnesium complexation by fluoroquinolones on their antibacterial properties. Antimicrob Agents Chemother 1994; 38: 2810–6

    PubMed  CAS  Google Scholar 

  19. Chapman JS, Georgopapadakou NH. Routes of quinolone permeation in Escherichia coli. Antimicrob Agents Chemother 1988; 32: 438–42

    PubMed  CAS  Google Scholar 

  20. Nikaido H, Thanassi DG. Penetration of lipophilic agents with multiple protonation sites into bacterial cells: tetracyclines and fluoroquinolones as examples. Antimicrob Agents Chemother 1993; 37: 1393–9

    PubMed  CAS  Google Scholar 

  21. Furet YX, Pechere JC. Usual and unusual antibacterial effects of quinolones. J Antimicrob Chemother 1990; 26 Suppl. B: 7–15

    PubMed  CAS  Google Scholar 

  22. Perez-Giraldo C, Hurtado C, Morgan FJ, et al. The influence of magnesium on ofloxacin activity against different growth phases of Escherichia coli. J Antimicrob Chemother 1990; 25: 1021–6

    PubMed  CAS  Google Scholar 

  23. Sanders CC. Ciprofloxacin: in vitro activity, mechanism of action, and resistance. Rev Infect Dis 1988; 10: 516–27

    PubMed  CAS  Google Scholar 

  24. Marshall AJH, Piddock LJV. Interaction of divalent cations, quinolones and bacteria. J Antimicrob Chemother 1994; 34: 465–83

    PubMed  CAS  Google Scholar 

  25. Willmott CJR, Maxwell A. A single point mutation in the DNA gyrase A protein greatly reduces binding of fluoroquinolones to the gyrase-DNA complex. Antimicrob Agents Chemother 1993; 37: 126–7

    PubMed  CAS  Google Scholar 

  26. Palu G, Valisena S, Ciarrocchi G, et al. Quinolone binding to DNA is mediated by magnesium ions. Proc Natl Acad Sci USA 1992; 89: 9671–5

    PubMed  CAS  Google Scholar 

  27. Nightingale CH. Pharmacokinetic considerations in quinolone therapy. Pharmacotherapy 1993; 13(2 Part 2): 34S–38S

    PubMed  CAS  Google Scholar 

  28. Lomaestro BM, Bailie GR. Quinolone-cation interactions: a review. DCIP 1991; 25: 1249–58

    CAS  Google Scholar 

  29. Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989; 33: 1841–4

    PubMed  CAS  Google Scholar 

  30. Radandt JM, Marchbanks CR, Dudley MN. Interactions of fluoroquinolones with other drugs: mechanisms, variability, clinical significance and management. Clin Infect Dis 1992; 14: 272–84

    PubMed  CAS  Google Scholar 

  31. Lewin CS, Smith JT. 4-Quinolones and multivalent ions. J Antimicrob Chemother 1990; 26: 149–64

    PubMed  CAS  Google Scholar 

  32. Nix DE, Schentag JJ. The quinolones: an overview and comparative appraisal of their pharmacokinetics and pharmacodynamics. J Clin Pharmacol 1988; 28: 169–78

    PubMed  CAS  Google Scholar 

  33. Wise R, Lister D, McNulty CAM, et al. The comparative pharmacokinetics of five quinolones. J Antimicrob Chemother 1986; 18 Suppl. D: 71–81

    PubMed  CAS  Google Scholar 

  34. Lode H, Hoffken G, Boeckk N, et al. Quinolone pharmacokinetics and metabolism. J Antimicrob Chemother 1990; 26 Suppl. B: 41–9

    PubMed  CAS  Google Scholar 

  35. Drusano GL. Pharmacokinetics of the quinolone antimicrobial agents. In: Wolfson JS, Hooper DC, editors. Quinolone antimicrobial agents. Washington, DC: American Society for Microbiology, 1992: 71–106

    Google Scholar 

  36. Drew RH, Gallis HA. Ofloxacin: its pharmacology, pharmacokinetics, and potential for clinical application. Pharmacotherapy 1988; 8: 35–46

    PubMed  CAS  Google Scholar 

  37. Stein GE. The 4-quinolone antibiotics: past, present and future. Pharmacotherapy 1988; 8: 301–14

    PubMed  CAS  Google Scholar 

  38. Davis R, Bryson HM. Levofloxacin: a review of its antibacterial activity, pharmacokinetics and therapeutic efficacy. Drugs 1994; 47: 677–700

    PubMed  CAS  Google Scholar 

  39. Scheife RT. Pharmacokinetic considerations in the choice of antimicrobials. Postgrad Med 1991 Dec 4; 89 Suppl.: 15–21

    Google Scholar 

  40. Staib AH, Beerman D, Harder S, et al. Absorption differences of ciprofloxacin along the human gastrointestinal tract determined using a remote-control drug delivery device (HF-capsule). Am J Med 1989; 87 Suppl. 5A: 66–9

    Google Scholar 

  41. Borner K, Hoffken G, Lode H, et al. Pharmacokinetics of ciprofloxacin in healthy volunteers after oral and intravenous administration. Eur J Clin Microbiol Infect Dis 1986; 5: 179–86

    CAS  Google Scholar 

  42. Drusano GL, Standiford HC, Plaisance K, et al. Absolute oral bioavailability of ciprofloxacin. Antimicrob Agents Chemother 1986; 30: 444–6

    PubMed  CAS  Google Scholar 

  43. Hoffken G, Lode H, Prinzing C, et al. Pharmacokinetics of ciprofloxacin after oral and parenteral administration. Antimicrob Agents Chemother 1985; 27: 375–9

    PubMed  CAS  Google Scholar 

  44. Chang T, Black A, Dunky A, et al. Pharmacokinetics of intravenous and oral enoxacin in healthy volunteers. J Antimicrob Chemother 1988; 21 Suppl. B: 49–56

    PubMed  CAS  Google Scholar 

  45. Yuk JH, Nightingale CH, Quintiliani R, et al. Bioavailability and pharmacokinetics of ofloxacin in healthy volunteers. Antimicrob Agents Chemother 1991; 35: 384–6

    PubMed  CAS  Google Scholar 

  46. Lode H, Hoffken G, Olschewski P, et al. Pharmacokinetics of ofloxacin after parenteral and oral administration. Antimicrob Agents Chemother 1987; 31: 1338–42

    PubMed  CAS  Google Scholar 

  47. Barre J, Houin G, Tillement JP. Dose-dependent pharmacokinetic study of pefloxacin, a new antibacterial agent, in humans. J Pharmaceut Sci 1984; 73: 1379–82

    CAS  Google Scholar 

  48. Granneman GR, Carpentier P, Morrison PJ, et al. Pharmacokinetics of temafloxacin in humans after single oral doses. Antimicrob Agents Chemother 1991; 35: 436–41

    PubMed  CAS  Google Scholar 

  49. Granneman GR, Braeckman R, Kraut J, et al. Temafloxacin pharmacokinetics in subjects with normal and impaired renal function. Antimicrob Agents Chemother 1991; 35: 2345–51

    PubMed  CAS  Google Scholar 

  50. Stone JW, Andrews JM, Ashby JP, et al. Pharmacokinetics and tissue penetration of orally administered lomefloxacin. Antimicrob Agents Chemother 1988; 32: 1508–10

    PubMed  CAS  Google Scholar 

  51. Morrison PJ, Mant TGK, Norman GT, et al. Pharmacokinetics and tolerance of lomefloxacin after sequentially increasing oral doses. Antimicrob Agents Chemother 1988; 32: 1503–7

    PubMed  CAS  Google Scholar 

  52. Gros I, Carbon C. Pharmacokinetics of lomefloxacin in healthy volunteers: comparison of 400mg once daily and 200mg twice daily given orally for 5 days. Antimicrob Agents Chemother 1990; 34: 150–2

    PubMed  CAS  Google Scholar 

  53. Blum RA, Schultz RW, Schentag JJ. Pharmacokinetics of lomefloxacin in renally compromised patients. Antimicrob Agents Chemother 1990; 34: 2364–8

    PubMed  CAS  Google Scholar 

  54. Morse IS. Pharmacokinetics and safety of single oral doses of lomefloxacin. Biopharm Drug Dispos 1990; 11: 543–51

    PubMed  CAS  Google Scholar 

  55. Freeman CD, Nicolau DP, Beliveau PP, et al. Lomefloxacin clinical pharmacokinetics. Clin Pharmacokinet 1993; 25: 6–19

    PubMed  CAS  Google Scholar 

  56. Weidekamm E, Portmann R, Partos C, et al. Single and multiple dose pharmacokinetics of fleroxacin. J Antimicrob Chemother 1988; 22 Suppl. D: 145–54

    PubMed  CAS  Google Scholar 

  57. Eandi M, Viano I, Di Nola F, et al. Pharmacokinetics of norfloxacin in healthy volunteers and patients with renal and hepatic damage. Eur J Clin Microbiol 1983; 2: 253–9

    PubMed  CAS  Google Scholar 

  58. Adhami ZN, Wise R, Weston D, et al. The pharmacokinetics and tissue penetration of norfloxacin. J Antimicrobial Chemother 1984; 13: 87–92

    CAS  Google Scholar 

  59. Stein GE. Review of the bioavailability and pharmacokinetics of oral norfloxacin. Am J Med 1987; 82 Suppl. 6B: 18–21

    PubMed  CAS  Google Scholar 

  60. Swanson BN, Boppana VK, Vlasses PH, et al. Norfloxacin disposition after sequentially increasing oral doses. Antimicrob Agents Chemother 1983; 23: 284–8

    PubMed  CAS  Google Scholar 

  61. Lomaestro BM, Lesar TS. Concurrent administration of ciprofloxacin and potentially interacting drugs [letter]. Am J Hosp Pharm 1989; 46: 1770

    PubMed  CAS  Google Scholar 

  62. Lomaestro BM, Lesar TS. Continuing problem of ciprofloxacin administered with interacting drugs [letter]. Am J Hosp Pharm 1994; 51: 832

    PubMed  CAS  Google Scholar 

  63. Vitillo JA. Pharmacy-directed program to prevent selected ciprofloxacin (cipro) drug interactions [abstract P-325E]. Presented at the 28th Annual ASHP Midyear Clinical Meeting and Exhibits: 1993 Dec 5–9: Atlanta, Georgia

  64. Yuk JH, Williams TW. Drug interactions with quinolone antibiotics in intensive care unit patients [letter]. Arch Intern Med 1991; 151: 619

    PubMed  CAS  Google Scholar 

  65. Yamanaka-Yeun NA, Cantu TG. Fluoroquinolone drug interactions [letter]. Am J Hosp Pharm 1990; 47: 1270

    Google Scholar 

  66. Polk RE. Drug-drug interactions with ciprofloxacin and other fluoroquinolones. Am J Med 1989; 87 Suppl. 5A: 76–81

    Google Scholar 

  67. Nakano M, Yamamoto M, Arita T. Interactions of aluminum, magnesium and calcium ions with nalidixic acid. Chem Pharm Bull 1978; 26: 1505–10

    PubMed  CAS  Google Scholar 

  68. Schentag JJ, Watson WA, Nix DE, et al. Time dependent interactions between antacids and quinolone antibiotics [abstract]. Clin Pharmacol Ther 1988; 43: 135

    Google Scholar 

  69. Okazaki O, Kurata T, Tachizawa H. Studies on the mechanism of pharmacokinetic interaction of aluminum hydroxide, and antacid, with new quinolones in rats. Xenobio Metab Dispos 1988; 3: 387–94

    Google Scholar 

  70. Gurdal H, Tulunay FC, Altay G. Post antibiotic effect of ofloxacin and the activity of magnesium. J Antimicrob Chemother 1990; 26: 291–300

    PubMed  CAS  Google Scholar 

  71. Gillum JG, Israel DS, Polk RE. Pharmacokinetic drug interactions with antimicrobial agents. Clin Pharmacokinet 1993; 25: 450–82

    PubMed  CAS  Google Scholar 

  72. Jaehde U, Sorgel F, Stephan U, et al. Effect of an antacid containing magnesium and aluminum on the absorption, metabolism, and mechanism of renal elimination of pefloxacin in humans. Antimicrob Agents Chemother 1994; 38: 1129–33

    PubMed  CAS  Google Scholar 

  73. Sanchez-Navarro A, Martinez-Cabarga M, Dominguez-Gil-Hurle A. Comparative study of the influence of Ca2+ on absorption parameters of ciprofloxacin and ofloxacin. J Antimicrob Chemother 1994; 34: 119–25

    PubMed  CAS  Google Scholar 

  74. Sanchez-Navarro A, Martinez-Cabarga M, Dominguez-Gil-Hurle A. Oral absorption of ofloxacin administered together with aluminum. Antimicrob Agents Chemother 1994; 38: 2510–2

    PubMed  CAS  Google Scholar 

  75. Okhamafe AO, Akerele JO, Chukuka CS. Pharmacokinetic interactions of norfloxacin with some metallic medicinal agents. Int J Pharm 1991; 68: 11–8

    CAS  Google Scholar 

  76. Nix DE, Wilton JH, Ronald B, et al. Inhibition of norfloxacin absorption by antacids. Antimicrob Agents Chemother 1990; 34: 432–5

    PubMed  CAS  Google Scholar 

  77. Hoffken G, Lode H, Wiley R, et al. Pharmacokinetics and bio-availability of ciprofloxacin and ofloxacin: effect of food and antacid intake. Rev Infect Dis 1988; 10 Suppl. 1: S138–9

    Google Scholar 

  78. Nix DE, Watson WA, Lener ME, et al. Effects of aluminum and magnesium antacids and ranitidine on the absorption of ciprofloxacin. Clin Pharmacol Ther 1989; 46: 700–5

    PubMed  CAS  Google Scholar 

  79. Hoffken GK, Borner K, Glatzel PD, et al. Reduced enteral absorption of ciprofloxacin in the presence of antacids [letter]. Eur J Clin Microbiol 1985; 4: 345

    PubMed  CAS  Google Scholar 

  80. Preheim LC, Cuevas TA, Roccaforte JS, et al. Ciprofloxacin and antacids [letter]. Lancet 1986; 2: 48

    PubMed  CAS  Google Scholar 

  81. Golper TA, Hartstein AI, Morthland VH, et al. Effects of antacids and dialysate dwell times on multiple-dose pharmacokinetics of oral ciprofloxacin in patients on continuous ambulatory peritoneal dialysis. Antimicrob Agents Chemother 1987; 31: 1787–90

    PubMed  CAS  Google Scholar 

  82. Lode H. Drug interactions with quinolones. Rev Infect Dis 1988; 10 Suppl. 1: S132–6

    PubMed  CAS  Google Scholar 

  83. Fleming LW, Moreland TA, Stewart WK, et al. Ciprofloxacin and antacids [letter]. Lancet 1986; 2: 294

    PubMed  CAS  Google Scholar 

  84. Frost RW, Lasseter KC, Noe AJ, et al. Effects of aluminum hydroxide and calcium carbonate antacids on the bioavailability of ciprofloxacin. Antimicrob Agents Chemother 1992; 36: 830–2

    PubMed  CAS  Google Scholar 

  85. Flor S, Guay DRP, Opsahl JA, et al. Effects of magnesium-aluminum hydroxide and calcium carbonate antacids on bioavailability of ofloxacin. Antimicrob Agents Chemother 1990; 34: 2436–8

    PubMed  CAS  Google Scholar 

  86. Maesen FPV, Davies BI, Geraedts WH, et al. Ofloxacin and antacids [letter]. J Antimicrob Chemother 1987; 19: 848–9

    PubMed  CAS  Google Scholar 

  87. Grasela TH, Schentag JJ, Sedman AJ, et al. Inhibition of enoxacin absorption by antacids or ranitidine. Antimicrob Agents Chemother 1989; 33: 615–7

    PubMed  CAS  Google Scholar 

  88. Shimada J, Shiba K, Oguma T, et al. Effect of antacid on absorption of the quinolone lomefloxacin. Antimicrob Agents Chemother 1992; 36: 1219–24

    PubMed  CAS  Google Scholar 

  89. Granneman GR, Stephan U, Birner B, et al. Effect of antacid medication on the pharmacokinetics of temafloxacin. Clin Pharmacokinet 1992; 22 Suppl. 1: 83–9

    PubMed  CAS  Google Scholar 

  90. Lazzaroni M, Imbibo BP, Bargiggia S, et al. Effects of magnesium-aluminum hydroxide antacid on absorption of rufloxacin. Antimicrob Agents Chemother 1993; 37: 2212–6

    PubMed  CAS  Google Scholar 

  91. Shimada J, Hori S, Masanobu K, et al. Interactions of fleroxacin with dried aluminum hydroxide gel and probenecid. Rev Infect Dis 1989; 11 Suppl. 5: S1097–8

    Google Scholar 

  92. Shiba K, Sakai O, Shimada J, et al. Effects of antacids, ferrous sulphate, and ranitidine on absorption of DR-3355 in humans. Antimicrob Agents Chemother 1992; 36: 2270–4

    PubMed  CAS  Google Scholar 

  93. Martinez-Cabarga M, Sanchez-Navarro A, Colino-Gandarillas CI, et al. Effects of two cations on gastrointestinal absorption of ofloxacin. Antimicrob Agents Chemother 1991; 35: 2102–5

    PubMed  CAS  Google Scholar 

  94. Parpia SH, Nix DE, Hejmanowski LG, et al. Sucralfate reduces the gastrointestinal absorption of norfloxacin. Antimicrob Agents Chemother 1989; 33: 99–102

    PubMed  CAS  Google Scholar 

  95. Lehto P, Kivisto KT. Effect of sucralfate on absorption of norfloxacin and ofloxacin. Antimicrob Agents Chemother 1994; 38: 248–51

    PubMed  CAS  Google Scholar 

  96. Ryerson B, Toothaker R, Schleyer I, et al. Effect of sucralfate on enoxacin pharmacokinetics [abstract 214]. Proceedings of the 29th Interscience Conference on Antimicrobial Agents and Chemotherapy, American Society for Microbiology; 1989 Sep 17–20; Houston, Texas, 136

  97. Garrelts JC, Godley PJ, Peterie JD, et al. Sucralfate significantly reduces ciprofloxacin concentrations in serum. Antimicrob Agents Chemother 1990; 34: 931–3

    PubMed  CAS  Google Scholar 

  98. Van Slooten AD, Nix DE, Wilton JH, et al. Combined use of ciprofloxacin and sucralfate. DICP 1991; 25: 578–82

    PubMed  Google Scholar 

  99. Nix DE, Watson WA, Handy L, et al. The effect of sucralfate pretreatment on the pharmacokinetics of ciprofloxacin. Pharmacotherapy 1989; 9: 377–80

    PubMed  CAS  Google Scholar 

  100. Yuk JH, Nightingale CN, Quintiliani R. Ciprofloxacin levels when receiving sucralfate [letter]. JAMA 1989; 262: 901

    PubMed  CAS  Google Scholar 

  101. Lubowski TJ, Nightingale CH, Sweeney K, et al. Effect of sucralfate on pharmacokinetics of fleroxacin in healthy volunteers. Antimicrob Agents Chemother 1992; 36: 2758–60

    PubMed  CAS  Google Scholar 

  102. Coste T, Rauturequ J, Beaugrand M, et al. Comparison of two sucralfate dosages presented in tablet form in duodenal ulcer healing. Am J Med 1987; 83 Suppl. 3B: 86–90

    PubMed  CAS  Google Scholar 

  103. Marks IN, Wright JP, Gilinsky NH, et al. A comparison of sucralfate dosage schedule in duodenal ulcer healing: two grams a day versus one gram four times a day. J Clin Gastroenterol 1986; 8: 419–23

    PubMed  CAS  Google Scholar 

  104. Fleming LW, Moreland TA, Scott AC, et al. Ciprofloxacin in plasma and peritoneal dialysate after oral therapy in patients on continuous ambulatory peritoneal dialysis. J Antimicrob Chemother 1987; 19: 493–503

    PubMed  CAS  Google Scholar 

  105. Lode H. Pharmacokinetics and clinical results of parenterally administered new quinolones in humans. Rev Infect Dis 1989; 11 Suppl. 5: 1083–90

    Google Scholar 

  106. Frost RW, Carlson JD, Dietz Jr AJ, et al. Ciprofloxacin pharmacokinetics after a standard or high-fat/high calcium breakfast. J Clin Pharmacol 1989; 29: 953–5

    PubMed  CAS  Google Scholar 

  107. Sahai J, Healy DP, Stotka J, et al. The influence of chronic administration of calcium carbonate on the bioavailability of oral ciprofloxacin. Br J Clin Pharmacol 1993; 35: 302–4

    PubMed  CAS  Google Scholar 

  108. Lomaestro BM, Bailie GR. Effect of staggered dose of calcium on the bioavailability of ciprofloxacin. Antimicrob Agents Chemother 1991; 35: 1004–7

    PubMed  CAS  Google Scholar 

  109. Lomaestro BM, Bailie GR. Effect of multiple staggered doses of calcium on the bioavailability of ciprofloxacin. Ann Pharmacother 1993; 27: 1325–8

    PubMed  CAS  Google Scholar 

  110. Lode H, Stuhlert P, Deppermann KM, et al. Pharmacokinetic interactions between oral ciprofloxacin/ofloxacin and ferro-salts [abstract]. Proceedings of the 29th Interscience Conference on Antimicrobial Agents and Chemotherapy, American Society for Microbiology; 1989 Sep 17–20; Houston, Texas, 213

  111. Kara M, Hasinoff BB, Mckay DW, et al. Clinical and chemical interactions between iron preparations and ciprofloxacin. Br J Clin Pharmacol 1991; 31: 257–61

    PubMed  CAS  Google Scholar 

  112. Le Pennec MP, Kitzis MD, Terdjman M, et al. Possible interactions of ciprofloxacin with ferrous sulphate [letter]. J Antimicrob Agents Chemother 1990; 25: 184–5

    CAS  Google Scholar 

  113. Lehto P, Kivisto KT, Neuvonen PJ. The effect of ferrous sulphate on the absorption of norfloxacin, ciprofloxacin and ofloxacin. Br J Clin Pharmacol 1994; 37: 82–5

    PubMed  CAS  Google Scholar 

  114. Sahai J, Gallicano K, Oliveras L, et al. Cations in the didanosine tablet reduce ciprofloxacin bioavailability. Clin Pharmacol Ther 1993; 53: 292–7

    PubMed  CAS  Google Scholar 

  115. Rambout L, Sahai J, Gallicano K. Effect of bismuth subsalicylate on ciprofloxacin absorption in healthy volunteers [abstract 3]. Presented at the Fourth Annual Winter Practice and Research Forum. American College of Clinical Pharmacy Meeting; 1994 Feb 6–9: San Diego, California

  116. Campbell NRC, Kara M, Hasinoff BB, et al. Norfloxacin interaction with antacids and minerals. Br J Clin Pharmacol 1992; 33: 115–6

    PubMed  CAS  Google Scholar 

  117. Sorgel F, Naber KG, Jaehde U, et al. Brief report: gastrointestinal secretion of ciprofloxacin. Evaluation of the charcoal model for investigations in healthy volunteers. Am J Med 1989; 87 Suppl. 5A: 62–5

    Google Scholar 

  118. Ramon J, Dautrey S, Farinoti R, et al. Intestinal elimination of ciprofloxacin in rabbits. Antimicrob Agents Chemother 1994; 38: 757–60

    PubMed  CAS  Google Scholar 

  119. Nix DE, Lebsack ME, Chapelsky M, et al. Effect of oral antacids on disposition of intravenous enoxacin. Antimicrob Agents Chemother 1994; 37: 775–7

    Google Scholar 

  120. Deppermann KM, Lode H. Fluoroquinolones: interaction profile during enteral absorption. Drugs 1993; 45 Suppl. 3: 65–72

    PubMed  Google Scholar 

  121. Wolfson JS, Hooper DC. Fluoroquinolone antimicrobial agents. In: Wolfson JS, Hooper DC, editors. Quinolone antimicrobial agents. Washington, DC: American Society for Microbiology, 1989: 71–105

    Google Scholar 

  122. Ledergerber B, Bettex JD, Joos B, et al. Effect of standard breakfast on drug absorption and multiple-dose pharmacokinetics of ciprofloxacin. Antimicrob Agents Chemother 1985; 27: 350–2

    PubMed  CAS  Google Scholar 

  123. Kalager T, Digranes A, Bergan T, et al. Ofloxacin: serum and skin blister fluid pharmacokinetics in the fasting and non-fasting state. J Antimicrob Chemother 1986; 17: 795–800

    PubMed  CAS  Google Scholar 

  124. Hooper WD, Dickinson RG, Eadie MJ. Effect of food on absorption of lomefloxacin. Antimicrob Agents Chemother 1990; 34: 1797–9

    PubMed  CAS  Google Scholar 

  125. Granneman GR, Mukherjee D. The effect of food on the bioavailability of temafloxacin: a review of 3 studies. Clin Pharmacokinet 1992; 22 Suppl. 1: 48–56

    PubMed  CAS  Google Scholar 

  126. Somogyi AA, Bochner F, Keal JA, et al. Effect of food on enoxacin absorption. Antimicrob Agents Chemother 1987; 4: 638–9

    Google Scholar 

  127. Okhamafe AO, Akerele JO. Some aspects of the bioavailability of orally administered ofloxacin in healthy human volunteers. Int J Pharm 1989; 50: 83–6

    CAS  Google Scholar 

  128. Wijnands WJA, Vree TB, Baars AM, et al. Pharmacokinetics of enoxacin and its penetration into bronchial secretions and lung tissue. J Antimicrob Chemother 1988; 21 Suppl. B: 66–7

    Google Scholar 

  129. Shimada J, Nogita T, Ishibashi Y. Clinical pharmacokinetics of sparfloxacin. Clin Pharmacokinet 1993; 25: 358–69

    PubMed  CAS  Google Scholar 

  130. Bertino JS, Nafziger AN, Wong M, et al. Effect of a fat- and calcium-rich breakfast on pharmacokinetics of fleroxacin administered in single and multiple doses. Antimicrob Agents Chemother 1994; 38: 499–503

    PubMed  CAS  Google Scholar 

  131. Neuvonen PJ, Kivisto KT, Lehto P. Milk and yogurt do not impair the absorption of ofloxacin. Br J Clin Pharmacol 1992; 33: 346–8

    PubMed  CAS  Google Scholar 

  132. Neuvonen PJ, Kivisto KT, Lehto P. Interference of dairy products with the absorption of ciprofloxacin. Clin Pharmacol Ther 1991; 50: 498–502

    PubMed  CAS  Google Scholar 

  133. Kivisto KT, Ojala-Karlsson P, Neuvonen PJ. Inhibition of norfloxacin absorption by dairy products. Antimicrob Agents Chemother 1992; 36: 489–91

    PubMed  CAS  Google Scholar 

  134. Yuk JH, Nightingale CH, Sweeney KR, et al. Relative bioavailability in healthy volunteers of ciprofloxacin administered through a nasogastric tube with and without enteral feeding. Antimicrob Agents Chemother 1989; 33: 1118–20

    PubMed  CAS  Google Scholar 

  135. Lubowski TJ, Nightingale CH, Sweeney K, et al. The relative bioavailability of temafloxacin administered through a nasogastric tube with and without enteral feeding. Clin Pharmacokinet 1992; 22 Suppl. 1: 43–7

    PubMed  CAS  Google Scholar 

  136. Noer BL, Angaran DM. The effect of enteral feedings on ciprofloxacin pharmacokinetics [abstract]. Pharmacotherapy 1990; 10: 254

    Google Scholar 

  137. Mueller BA, Brierton DG, Abel SR, et al. Effect of enteral feeding with Ensure® on the oral bioavailability of ofloxacin and ciprofloxacin. Antimicrob Agents Chemother 1994; 38: 2101–5

    PubMed  CAS  Google Scholar 

  138. Lebsack ME, Nix D, Ryerson B, et al. Effect of gastric acidity on enoxacin absorption. Clin Pharmacol Ther 1992; 52: 252–6

    PubMed  CAS  Google Scholar 

  139. Neu HC. The place of quinolones in bacterial infections. Adv Intern Med 1991; 36: 1–32

    PubMed  CAS  Google Scholar 

  140. Sorgel F, Mahr G, Koch HU, et al. Effects of cimetidine on the pharmacokinetics of pefloxacin in healthy volunteers. Rev Infect Dis 1988; 10 Suppl. 1: S137

    Google Scholar 

  141. Misiak P, Toothaker R, Lebsach M, et al. Potential pharmacokinetic interaction between intravenous enoxacin and oral H2-antagonists [abstract 1442]. Proceedings of the 28th Interscience Conference on Antimicrobial Agents and Chemotherapy; 1988 Oct 23–6; Los Angeles, California. Washington, DC: American Society for Microbiology, 1988: 367

    Google Scholar 

  142. Nix DE, Schentag JJ. Lomefloxacin absorption kinetics when administered with ranitidine and sucralfate [abstract 1276]. Proceedings of the 29th Interscience Conference on Antimicrobial Agents and Chemotherapy; 1989 Sep 12–20; Houston, Texas. Washington, DC: American Society for Microbiology, 1989: 317

    Google Scholar 

  143. Lode H, Hampel B, Wachter T, et al. Single dose pharmacokinetics of fleroxacin in volunteers fasting, after standard breakfast and antacids [abstract W-14]. International Congress of Chemotherapy. Jerusalem, Israel: 1989

  144. Sorgel F, Granneman GR, Stephan U, et al. Effect of cimetidine on the pharmacokinetics of temafloxacin. Clin Pharmacokinet 1992; 22 Suppl. 1: 75–82

    PubMed  Google Scholar 

  145. Davey PG. Overview of drug interactions with quinolones. J Antimicrob Chemother 1988; 22 Suppl. C: 97–107

    PubMed  CAS  Google Scholar 

  146. Korner RJ, Reeves DS, MacGowan AP. Dangers of oral fluoroquinolone treatment in community acquired upper respiratory tract infections. BMJ 1994; 308: 191–2

    PubMed  CAS  Google Scholar 

  147. Kowalsky SF, Echols M, Schwartz MT, et al. Pharmacokinetics of ciprofloxacin in subjects with varying degrees of renal function and undergoing hemodialysis or CAPD. Clin Nephrol 1993; 39: 53–8

    PubMed  CAS  Google Scholar 

  148. Ratcliffe NT, Smith JT. Effects of magnesium on the activity of 4-quinolone antibacterial agents [abstract]. J Pharm Pharmacol 1983; 35: 61P

    Google Scholar 

  149. Blaser J, Luthy R. Comparative study on antagonistic effects of low pH and cation supplementation on in vitro activity of quinolones and aminoglycosides against Pseudomonas aeruginosa. J Antimicrob Chemother 1988; 22: 15–22

    PubMed  CAS  Google Scholar 

  150. Noyes M, Polk RE. Norfloxacin and absorption of magnesium-aluminum [letter]. Ann Intern Med 1988; 109: 168–9

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pharmacy Department, Albany Medical Center Hospital, Albany, New York, USA

    Ben M. Lomaestro

  2. Albany College of Pharmacy, Albany, New York, USA

    George R. Bailie

Authors
  1. Ben M. Lomaestro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. George R. Bailie
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lomaestro, B.M., Bailie, G.R. Absorption Interactions With Fluoroquinolones. Drug-Safety 12, 314–333 (1995). https://doi.org/10.2165/00002018-199512050-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002018-199512050-00004

Keywords

Search

Navigation