Quinolone Antibiotics - Interactions

Interactions

Theophylline, nonsteroidal anti-inflammatory drugs and corticosteroids enhance the toxicity of fluoroquinolones.

Products containing multivalent cations, such as aluminium- or magnesium-containing antacids and products containing calcium, iron, or zinc, invariably result in marked reduction of oral absorption of fluoroquinolones.

Other drugs that interact with fluoroquinolones include antacids, sucralfate, probenecid, cimetidine, warfarin, antiviral agents, phenytoin, cyclosporine, rifampin, pyrazinamide, and cycloserine.

Many fluoroquinolones, especially ciprofloxacin, inhibit the cytochrome P450 isoform CYP1A2. This inhibition causes an increased level of drugs that are metabolized by this enzyme. This includes antidepressants such as amitriptyline and imipramine, clozapine (an atypical antipsychotic), caffeine, olanzapine (an atypical antipsychotic), ropivacaine (a local anaesthetic), theophylline (a xanthine), and zolmitriptan (a serotonin receptor agonist).

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