Impact of ciprofloxacin on theophylline clearance and steady-state concentrations in serum

Schwartz, J; Jáuregui, Luis; Lettieri, John; Bachmann, Kenneth

doi:10.1128/aac.32.1.75

Cited by 92 publications

(39 citation statements)

References 8 publications

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“…Ciprofloxacin is a potent inhibitor of CYP1A2 and a weak inhibitor of CYP3A4 [4,5] . Some npg studies have demonstrated a drug-drug interaction when ciprofloxacin was co-administered with other drugs, including theophylline [6,7] , caffeine [8] , clozapine [9] , methadone [10] and zolpidem [11] . Ciprofloxacin is commonly prescribed with analgesics for the management of infection, pain and inflammation.…”

Section: Introductionmentioning

confidence: 99%

Ciprofloxacin blocked enterohepatic circulation of diclofenac and alleviated NSAID-induced enteropathy in rats partly by inhibiting intestinal β-glucuronidase activity

et al. 2016

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Aim: Diclofenac is a non-steroidal anti-inflammatory drug (NSAID), which may cause serious intestinal adverse reactions (enteropathy). In this study we investigated whether co-administration of ciprofloxacin affected the pharmacokinetics of diclofenac and diclofenacinduced enteropathy in rats. Methods: The pharmacokinetics of diclofenac was assessed in rats after receiving diclofenac (10 mg/kg, ig, or 5 mg/kg, iv), with or without ciprofloxacin (20 mg/kg, ig) co-administered. After receiving 6 oral doses or 15 intravenous doses of diclofenac, the rats were sacrificed, and small intestine was removed to examine diclofenac-induced enteropathy. β-Glucuronidase activity in intestinal content, bovine liver and E coli was evaluated. Results: Following oral or intravenous administration, the pharmacokinetic profile of diclofenac displayed typical enterohepatic circulation, and co-administration of ciprofloxacin abolished the enterohepatic circulation, resulted in significant reduction in the plasma content of diclofenac. In control rats, β-glucuronidase activity in small intestinal content was region-dependent: proximal intestine

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Section: Introductionmentioning

confidence: 99%

Ciprofloxacin blocked enterohepatic circulation of diclofenac and alleviated NSAID-induced enteropathy in rats partly by inhibiting intestinal β-glucuronidase activity

et al. 2016

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“…i. The mean pharmacokinetic parameters are provided in Table 1. DISCUSSION Enoxacin was the first new fluoroquinolone noted to decrease theophylline clearance (2,15,16 (10,13,16). However, a decrease in theophylline clearance up to 65% was well documented in a patient receiving ciprofloxacin and theophylline (14).…”

Section: Methodsmentioning

confidence: 99%

Effect of lomefloxacin on theophylline pharmacokinetics

Nix

Norman

Schentag

1989

Antimicrob Agents Chemother

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A study involving 25 healthy male volunteers was conducted to evaluate the effect of lomefloxacin on the pharmacokinetics of theophylline. The mean age was 22.4 + 3.0 years, and the mean weight was 77.3 ± 7.7 kg. A single 6-mg/kg aminophylline dose was given intravenously on study days 1 and 15. The subjects received a 400-mg lomefloxacin dose (four 100-mg capsules) on study days 9 through 15. No treatment was given on study days 2 through 8. Thirteen blood samples were collected within 24 h after each aminophyUline dose. Theophylline concentrations in serum were measured by enzyme immunoassay (EMIT). The mean aminophylline dose was 437 + 36 mg, equivalent to 344 mg of theophylline. Multiple doses of lomefloxacin had no effect on the area under the concentration-time curve from 0 h to infinity, maximal concentration, or clearance of theophylline from serum. There was a slight increase in the theophylline half-life from 6.72 1.63 to 7.02 + 1.37 h after lomefloxacin dosing (P = 0.04); however, the change was clinically insignificant. No change in theophylline dose is required when lomefloxacin therapy is instituted in a patient receiving theophylline.Lomefloxacin is one of several new fluoroquinolone antimicrobial agents and is distinguished by a longer half-life (7.7 h), allowing once-daily dosing (9). Lomefloxacin possesses excellent in vitro activity against Haemophilus influenzae, Branhamella catarrhalis, Klebsiella pneumoniae, and several other organisms associated with purulent bronchitis and pneumonia in patients with obstructive lung disease (4). Thus, theophylline will likely be given with lomefloxacin in some patients.Other fluoroquinolones, including enoxacin and ciprofloxacin, may reduce theophylline clearance by inhibiting metabolism. Enoxacin possesses the most potent metabolic inhibition, resulting in a 41 to 74% reduction in theophylline clearance (2,15,16). Patients receiving enoxacin and theophylline together without compensation for the interaction have suffered nausea, vomiting, seizures, hallucinations, and psychotic reactions (8). Clinically significant elevations in theophylline concentrations in serum associated with severe theophylline toxicity have also been reported with ciprofloxacin treatment (12). Although ofloxacin was associated with a significant decline in theophylline clearance (12%), the magnitude was not clinically significant (6). This study was conducted to determine the effect of lomefloxacin on theophylline elimination. MATERIALS AND METHODSThe study was 0, 0.17, 0.33, 0.5, 0.75, 1, 2, 4, 8, 12, 16, 20, and 24 h relative to the beginning of each theophylline infusion. The blood samples were allowed to clot and were then centrifuged to separate the serum. The serum samples were maintained frozen at -20°C until the theophylline assay.Theophylline in human serum was determined by an enzyme immunoassay (EMIT; Syva Co., Palo Alto, Calif.). The assay precision ranged from 1.40 to 5.2%. The limit of sensitivity was 0.80 ,ug/ml. Concentrations below this value were reported as...

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“…Rarely, hallucinations, delirium, and seizures have occurred, predominantly in patients who also were receiving theophylline or a nonsteroidal antiinflammatory drug. Ciprofloxacin and pefloxacin inhibit the metabolism of theophylline, and toxicity from elevated concentrations of the methylxanthine may occur [51]. Nonsteroidal antiinflammatory drugs may augment displacement of g-aminobutyric acid (GABA) from its receptors by the quinolones [52].…”

Section: Adverse Effectsmentioning

confidence: 99%

Role of quinolones and quinoxaline derivatives in the advancement of treatment of tuberculosis

Asif

2015

IJSW

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The need of new chemotherapeutic drugs to improve tuberculosis control and treatment particularly against multidrugresistant (MDR) and extensively drug resistant (XDR) strains of Mycobacterium. The atitubercular drugs are used in current chemotherapy have different chemical moieties. In this review, we provide an overview of the quinolone drugs as an antitubercular drug. Generally quinolone drugs are mainly used against many gram-positive and gram-negative bacterial infections including resistance strains also. Various quinolones are being used to control and treatment of tubercular infections including MDR, XDR and atypical Mycobacterium strains. Fluoroquinolones are an important quinolones, especially for strains that are resistant to first-line agents.

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Impact of ciprofloxacin on theophylline clearance and steady-state concentrations in serum

Cited by 92 publications

References 8 publications

Ciprofloxacin blocked enterohepatic circulation of diclofenac and alleviated NSAID-induced enteropathy in rats partly by inhibiting intestinal β-glucuronidase activity

Ciprofloxacin blocked enterohepatic circulation of diclofenac and alleviated NSAID-induced enteropathy in rats partly by inhibiting intestinal β-glucuronidase activity

Effect of lomefloxacin on theophylline pharmacokinetics

Role of quinolones and quinoxaline derivatives in the advancement of treatment of tuberculosis

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