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What Are the Possible Ciprofloxacin Interactions?

By Deneatra Harmon
Updated May 17, 2024
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The oral antibiotic ciprofloxacin, also known as cipro, treats several bacterial infections such as strep, pneumonia, and staph. Doctors advise against drinking caffeine, or taking other prescription and over-the-counter medications because of possible ciprofloxacin interactions. Other drugs may make the antibiotic less effective or too powerful and can cause side effects. Hundreds of drugs can interfere with ciprofloxacin, but some of the most common include painkillers, corticosteroids, and blood thinners. Even certain vitamins and supplements may affect how this medication treats bacterial illnesses.

Ciprofloxacin reportedly interacts with caffeine, which is commonly found in soda, coffee, and chocolate. The strong effects of caffeine may intensify if taking ciprofloxacin, causing the patient to feel anxious or restless. Ciprofloxacin interactions with caffeine may also cause the patient to experience nausea or dizziness, so the doctor may recommend reducing or eliminating caffeine altogether.

Over-the-counter and other prescription medications may also interfere with the effects of ciprofloxacin. Pain and anti-inflammatory medications like acetaminophen, NSAIDs, and ibuprofen are a few examples where the patient must exercise caution when taking these with ciprofloxacin. Sometimes, acetaminophen may be taken with the more potent pain reliever tramadol. Possible ciprofloxacin interactions with the acetaminophen/tramadol combo include the risk of seizures, especially in patients with head trauma or a history of epilepsy. NSAIDs like naproxen and ibuprofen may also pose the risk of seizures, as well as hallucinations, tremors, and muscle spasms.

Corticosteroids, which treat conditions like rheumatoid arthritis, can cause possible ciprofloxacin interactions when taken together. For instance, medications in this category, such as hydrocortisone or prednisone, reportedly increase the risk of a patient developing tendinitis when combined with ciprofloxacin. Medical experts also note that caution should be taken if the patient happens to be a kidney, lung, or heart transplant recipient, as this medication may disrupt organ functioning.

Blood thinners used to treat blood clots reportedly cause adverse reactions when combined with ciprofloxacin as well. Warfarin is a common blood thinner that a patient should take with caution if also taking this or other medications. Possible interactions can possibly increase the blood-thinning effects of warfarin, leading to bleeding of the brain or other organs if left untreated.

Certain vitamins and other supplements can also alter the way ciprofloxacin works in the body. Iron, zinc, and magnesium supplements, as well as calcium-based foods or products, may bind to the antibiotic and make it ineffective. Doctors recommend taking ciprofloxacin two hours before vitamin or supplement consumption, or waiting six hours afterward.

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Discussion Comments

By burcidi — On Jan 01, 2013

Oh wow. I had no idea about cipro and caffeine, thanks for the information. No wonder I've been so anxious lately.

By ddljohn — On Dec 31, 2012

@burcinc-- Ciprofloxacin can be taken without food so you can take cipro two hours before your meal and then you can have your antacid after the meal.

If you decide to take the cipro after meals and you take an antacid around that time, you will need to wait around six hours to take the cipro. Cipro can interact with antacids, antacids can affect the absorption of the medication in the digestive system. So it's best not to take these two together at the same time.

It's not a good idea to take cipro with any other medication or supplement at the same time in general like the article also said.

By burcinc — On Dec 31, 2012

Does ciprofloxacin interact with antacids?

I spoke to my doctor about ciprofloxacin's interaction with my other medication but I forgot to ask about antacids.

I do use antacids almost daily because I get stomach acidity after meals. Right now, I'm taking 1000mg of ciprofloxacin per day, half in the morning and half at night. Can I keep taking my antacids?

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