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Ciprofloxacin – Drugs you must never combine with it

Ciprofloxacin – Drugs you must never combine with itTwo or more drugs given at the same time may interact with each other depending on their components. The interaction may be increasing the potency or inhibit the efficacy of one drug by another by reducing or increasing the amount of the drug available to give the desired pharmacological effects.

Badewo Olurogba John, a Public Health Enthusiast says that many drug interactions do not have serious consequences and many which are potentially harmful occur only in a small proportion of patient and a known interaction will not necessarily occur to the same extent in all patients. Some drugs may also reduce or increase the amount of another drug available to give the desired pharmacological effects.

Ciprofloxacin is an antibiotic belonging to the fluoroquinolones class. They exhibit potent activity against gram-negative bacilli and many gram-positive bacteria. It is also used to treat people who have been exposed to anthrax or certain types of plague, and commonly used in the treatment of typhoid. They are available both in oral and parenteral formulations. The oral formulations are well absorbed, as such used in the treatment of infectious diseases. But this drug has been known to interact negatively with your system or some group of drugs when taken concomitantly. You must refrain from such combinations experts warn.

8 drugs you shouldn’t take at the same time with ciprofloxacin.


Antacids are used to relieve the burning sensation symptoms associated with ulcer pains. They work by neutralising gastric PH thereby decreasing the exposure of the mucosa to gastric acidity. Antacids provide quick but brief symptomatic relief and as such may need to be administered multiple times. Antacids reduce absorption of ciprofloxacin when used at the same time. On a general note, it is advisable not to take oral drugs within 1-2 hours of taking an antacid because of its capacity to impair absorption of most drugs.


Artemether/lumefantrine is one of the most popular and very potent antimalarial combination therapies. The manufacturer of Artemether/lumefantrine advises you avoid concomitant use with Ciprofloxacin. Ciprofloxacin is usually used to treat conditions like typhoid which often times presents with malaria (co-morbidity) especially in countries where the two conditions are endemic.

Using Artemether/lumefantrine together with ciprofloxacin can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although relatively rare. You may be at more risk if you had/have heart diseases or electrolyte disturbances (e.g. magnesium or potassium loss due to severe or prolonged diarrhoea or vomiting). In a nutshell, try to avoid taking ciprofloxacin and Artemether/Lumenfantrine at the same time.


Calcium is necessary for many normal functions of our body, especially bone formation and maintenance. Calcium is usually taken orally and may be contained in some supplements.

Calcium reduces absorption of ciprofloxacin when used concomitantly.


Ferrous is an essential body mineral. Ferrous salts are used to treat iron deficiency anaemia. Some patients believe they must take blood capsule/syrup while using antibiotics (ferrous is a major component of blood capsule or syrup). Ferrous salts have been found to reduce absorption of ciprofloxacin when used at the same time. You are advised not to use ciprofloxacin within two hours of ferrous intake.


Ibuprofen belongs to the class of drug called NSAIDS which are popularly known as pain relievers. Pain is a symptom of so many diseases including infections where there may be need for an antibiotic like ciprofloxacin. However, using ibuprofen at the same time with ciprofloxacin poses an increased risk of convulsions. As such, it should be avoided in patients with convulsion or prone to convulsion.


Glibenclamide is an anti-diabetic agent of the sulfonylurea class. It is used to control blood sugar level in patients with type2 diabetes. The management therapy of diabetes necessitate that such drug as glibenclamide be used every day.

There is possibility of glibenclamide effect being enhanced when used at the same time with ciprofloxacin. This may lead to over reduction in the level of blood sugar which may have serious consequences.


The benefits of zinc to the human body are numerous. It’s important for growth, development and health of body tissues. Zinc sulfate is also used to treat and prevent the deficiency of zinc in the body. Zinc is lost in greater quantity during an episode of diarrhoea, thus the importance of zinc supplementation to restore the lost zinc and keep the body in shape.

There is reduced absorption of ciprofloxacin when used at the same time with Zinc.


Warfarin is used to reduce the formation of blood clots in the body. It’s classified as anticoagulant (blood thinner).

Warfarin is used to treat or prevent blood clots in veins or arteries, which can reduce the risk of stroke, heart attack, or other serious conditions.

Using ciprofloxacin with warfarin enhances the anticoagulant effect of warfarin increasing your risk of bleeding, which can be severe or life-threatening.


Always talk to your doctor or pharmacist before taking any medications. If ciprofloxacin is prescribed for you, inform your doctor or pharmacist about other medications you are taking (prescribed or not, herbal or supplements). Reduction in the absorption of ciprofloxacin can lead to treatment failure putting you at risk complications.

If you really have to use ciprofloxacin, your pharmacist or doctor can guide you on how to avoid the possible drug interactions.

Victoria Haruna

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