Selected Oral Quinolones/Selected Oral Cations Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Your medicine contains aluminum, calcium, iron, lanthanum, magnesium, and/or zinc, which are cations that may bind to your antibiotic in your digestive tract. This prevents your body from absorbing the antibiotic.

What might happen:

The blood levels of your antibiotic may be decreased, which will decrease the effectiveness in treating your infection.

What you should do about this interaction:

You should time when you take your antibiotic and your other medicine so that you do not take: ---ciprofloxacin for at least 2 hours before or 6 hours after oral cations. ---delafloxacin for at least 2 hours before or 6 hours after oral cations. ---enoxacin for at least 2 hours before or 8 hours after oral cations. ---levofloxacin for at least 2 hours before or 2 hours after oral cations. ---nalidixic acid for at least 2 hours before or 2 hours after oral cations. ---norfloxacin for at least 2 hours before or 2 hours after oral cations. ---ofloxacin for at least 2 hours before or 2 hours after oral cations. ---sparfloxacin for at least 4 hours before oral cations.If you are taking lanthanum, your doctor may tell you to follow the above timing instructions or different ones, or your doctor may tell you to skip doses that you would normally take at the same time as your antibiotic.If you are not sure which antibiotic you are on, if you do not see your antibiotic listed, or if you have questions about the timing of doses of your medicine, contact your healthcare professionals (e.g. doctor or pharmacist). They may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Cipro (ciprofloxacin hydrochloride) US prescribing information. Bayer Corporation March, 2022.
  • 2.Baxdela (delafloxacin) US prescribing information. Melinta Therapeutics, Inc. June 19, 2017.
  • 3.Penetrex (enoxacin) US prescribing information. Aventis Pharmaceuticals, Inc. July, 1998.
  • 4.Levaquin (levofloxacin) US prescribing information. Janssen Pharmaceuticals, Inc. October 18, 2018.
  • 5.NegGram (nalidixic acid) US prescribing information. Sanofi-Synthelabo, Inc. November, 2012.
  • 6.Noroxin (norfloxacin) US prescribing information. Merck & Co., Inc. July, 2016.
  • 7.Floxin (ofloxacin) US prescribing information. Ortho-McNeil Pharmaceutical, Inc. February, 2011.
  • 8.Zagam (sparfloxacin) US prescribing information. Bertek Pharmaceuticals, Inc. February, 2003.
  • 9.Fosrenol (lanthanum carbonate) US prescribing information. Shire US Inc. May, 2020.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.