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Fluoroquinolone antibiotic

Ciprofloxacin with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Ciprofloxacin (Ciprofloxacin). Most antibiotics do not interfere meaningfully with Ciprofloxacin at 250mg, 500mg, 750mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Fluoroquinolone antibiotic agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Ciprofloxacin at 250mg, 500mg, 750mg.

Practical guidance

According to the prescribing information for Ciprofloxacin, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Ciprofloxacin is co-administered. Adjusted 250mg, 500mg, 750mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Ciprofloxacin during an antibiotic course?

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Ciprofloxacin is metabolised and may need a temporary 250mg, 500mg, 750mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Ciprofloxacin regimen.

Will antibiotics make Ciprofloxacin stop working?

Most antibiotics do not affect Ciprofloxacin efficacy. Rifampicin and a few others can lower Ciprofloxacin levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

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