Drug Interactions between ciprofloxacin and Medicidin-D

Ask your doctor before using acetaminophen together with ethanol (alcohol). This can cause serious side effects that affect your liver. Call your doctor immediately if you experience a fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, or yellowing of the skin or the whites of your eyes. If your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Do not take ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified foods (e.G., cereal, juice). You may eat or drink dairy products or calcium-fortified foods with a regular meal, but do not use them alone when taking ciprofloxacin. They could make the medication less effective. When ciprofloxacin tablets are given with enteral (tube) feedings, ciprofloxacin may not work as well. You could interrupt the feeding for 1 hour before and 2 hours after the ciprofloxacin dose, or your doctor may decide to switch to a different treatment. Ciprofloxacin oral suspension should not be given via nasogastric tubes or feeding tubes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Alcohol can increase the nervous system side effects of chlorpheniramine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with chlorpheniramine. Do not use more than the recommended dose of chlorpheniramine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Ciprofloxacin and multivitamin with minerals should not be taken orally at the same time. Products that contain magnesium, aluminum, calcium, iron, and/or other minerals may interfere with the absorption of ciprofloxacin into the bloodstream and reduce its effectiveness. If possible, it may be best to avoid taking multivitamin with minerals while you are being treated with ciprofloxacin. Otherwise, ciprofloxacin should be taken 2 to 4 hours before or 4 to 6 hours after a multivitamin with minerals dose, ciprofloxacin should be taken at least 2 hours before and not less than 6 hours after Suprep Bowel Prep (magnesium/potassium/sodium sulfates), or ciprofloxacin and multivitamin with minerals should be taken as directed by your healthcare provider. Talk to your healthcare provider if you are unsure whether your medications contain something that could potentially interact or if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Using caffeine together with ciprofloxacin may increase the effects of caffeine. Contact your doctor if you experience headache, tremor, restlessness, nervousness, insomnia, and increased blood pressure or heart rate. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Both phenylephrine and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects. Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Consumer information for this interaction is not currently available.

MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.

MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.