Ciprofloxacin and Antacids

Fleming, LauraW.; Moreland, T. A.; Stewart, W. K.; Scott, A. C.

doi:10.1016/s0140-6736(86)92120-3

Cited by 44 publications

(15 citation statements)

References 1 publication

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“…Even if a magnesiumciprofloxacin interaction occurs, it may not be evident after enteral feeding since a relatively small amount of magnesium is provided in a large volume of fluid over a long period of time. The degree of interaction reported with calcium is much lower (3,4). Even if it occurs, such an interaction would not be noted in this study for the same reason.…”

contrasting

confidence: 57%

“…Food has been shown to delay the absorption of ciprofloxacin, but the overall extent of absorption is not affected (8). The absorption of ciprofloxacin has been shown to be decreased with the concurrent use of antacids (3,6). In view of the importance of ensuring adequate drug concentrations for the treatment of serious infections and the need for the exploration of the effect of different modes of administration on bioavailability, a study was conducted to determine the effect of administering ciprofloxacin through an NG tube with and without concurrent enteral feeding.…”

mentioning

confidence: 99%

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Relative bioavailability in healthy volunteers of ciprofloxacin administered through a nasogastric tube with and without enteral feeding

Yuk

Nightingale

Sweeney

et al. 1989

Antimicrob Agents Chemother

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The bioavailability of ciprofloxacin after its administration through a nasogastric (NG) feeding tube was studied in six healthy volunteers. Each subject received, on separate occasions, an intact 750-mg ciprofloxacin tablet, a crushed tablet as a suspension through an NG tube, and a crushed tablet as a suspension through an NG tube while receiving enteral feeding. No statistically significant differences were observed in the area under the curve, maximum concentration in serum, and time to peak concentration among these three modes of administration. These findings suggest that ciprofloxacin is well absorbed after administration via an NG tube (compared with an orally administered intact tablet) even in the presence of enteral feeding.

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contrasting

confidence: 57%

mentioning

confidence: 99%

Relative bioavailability in healthy volunteers of ciprofloxacin administered through a nasogastric tube with and without enteral feeding

Yuk

Nightingale

Sweeney

et al. 1989

Antimicrob Agents Chemother

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“…In addition, as another type of new quinolone interaction, it has been reported recently that antacids including aluminum hydroxide have a profound influence on the oral absorbability of ofloxacin and ciprofloxacin (3)(4)(5)(6)(7)(8). Aluminum hydroxide has been prescribed frequently for the suppression of symptoms of the gastrointestinal tract such as nausea and vomiting which have been shown to be major among untoward adverse reactions of new quinolones (9).…”

mentioning

confidence: 99%

Effect of aluminum hydroxide, an antacid, on the pharmacokinetics of new quinolones in humans.

Shiba

Saitô

Miyahara

et al. 1988

Drug Metabolism and Pharmacokinetics

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“…Group 3 subjects were receiving chronic antacid therapy to decrease the absorption of dietary phosphates. The interaction between ciprofloxacin and magnesium-aluminum-containing antacids has been well described (6,9,10). Our study design required that subjects refrain from taking medications for the first 3 h after administration of ciprofloxacin.…”

Section: Methodsmentioning

confidence: 99%

Effect of renal function on the bioavailability of ciprofloxacin

Plaisance

Drusano

Forrest

et al. 1990

Antimicrob Agents Chemother

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The effect of renal function on the bioavailability of ciprofloxacin was studied in 21 subjects with measured creatinine clearances ranging from 0 (4). The literature assessing the impact of renal dysfunction on the oral absorption of drugs is relatively sparse. While it is usually assumed that drug absorption is unimpaired, furosemide (11), D-xylose (2), and pindolol (1) have been reported to have diminished bioavailability associated with renal impairment. Additionally, patients with renal failure often receive concomitant aluminum-containing antacids which are known to alter the absorption of oral ciprofloxacin. Because oral ciprofloxacin will be used to treat serious gram-negative infections, potentially in individuals with impaired renal function, we thought it necessary to determine the influence of renal function on the bioavailability of ciprofloxacin. MATERIALS AND METHODSSubject selection. Twenty-one subjects with various degrees of renal function received ciprofloxacin (200 mg i.v. and 750 mg p.o.). All subjects were participating in concurrent studies of the effects of renal function on the disposition of ciprofloxacin after oral (7) and i.v. (5) istration. Group 3 subjects were specifically instructed to omit antacid administration during this period. Each subject received both oral and i.v. ciprofloxacin, with at least 1 week elapsing between studies. One 750-mg tablet of ciprofloxacin was administered p.o. with 180 to 240 ml of tap water, and 200 mg of i.v. ciprofloxacin was administered over 10 min (group 1) or 30 min (groups 2 and 3). Group 3 subjects were studied between their dialysis periods. Ciprofloxacin was provided by Miles Pharmaceuticals.Specimen collection and handling. For the oral doses, blood was obtained before drug administration and at 0.25, 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, and 24 h after administration. In patients with creatinine clearances of less than 3 liters/h per 1.73 m2, additional blood samples were obtained at 16, 36, and 48 h after drug administration. For the i.v. study in group 1 subjects, blood samples were obtained before administration and at 0.083, 0.17, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 12, and 24 h after the end of the 10-min infusion. For the i.v. study in groups 2 and 3, blood samples were obtained before administration and at 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 12, 16, 24, 36, and 48

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Ciprofloxacin and Antacids

Cited by 44 publications

References 1 publication

Relative bioavailability in healthy volunteers of ciprofloxacin administered through a nasogastric tube with and without enteral feeding

Relative bioavailability in healthy volunteers of ciprofloxacin administered through a nasogastric tube with and without enteral feeding

Effect of aluminum hydroxide, an antacid, on the pharmacokinetics of new quinolones in humans.

Effect of renal function on the bioavailability of ciprofloxacin

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