The absorption of ciprofloxacin following oral dosing may be decreased in the presence of calcium or other cations. This can result in decreased effectiveness of therapy.
Mechanism: formation of inactive quinolone-chelate complexes
Implicated cations:
(1) calcium
(2) magnesium (as antacid)
(3) aluminum (as antacid)
(4) zinc
(5) iron
Sources:
(1) dietary sources (dairy, etc)
(2) vitamin supplements
(3) medications
Problem resolution:
(1) Avoid taking oral ciprofloxacin with cations.
(2) If a cation cannot be avoided, then allow 2 or more hours between cation and ciprofloxacin intake.
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