5 known interactions • 4 major • 1 moderate • 0 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Antacids / calcium / iron / zinc / sucralfate / dairy
Divalent/trivalent cations chelate ciprofloxacin, reducing oral absorption by 50–90%.
Management: Take ciprofloxacin 2 hours before or 6 hours after these products. Critical — missed interactions cause treatment failure.
Theophylline
Ciprofloxacin inhibits CYP1A2, significantly increasing theophylline levels. Theophylline toxicity (seizures, arrhythmias) can occur.
Management: Reduce theophylline dose by 50%; monitor levels closely; consider alternative antibiotic.
Warfarin
CYP1A2 inhibition increases warfarin (R-warfarin) levels; gut flora changes also increase INR.
Management: Monitor INR within 3–5 days of starting ciprofloxacin.
Corticosteroids
Concurrent corticosteroid use dramatically increases risk of fluoroquinolone-associated tendon rupture.
Management: If possible, use an alternative antibiotic in patients taking systemic corticosteroids.
NSAIDs
Additive lowering of seizure threshold. Fluoroquinolone + NSAID combination increases CNS seizure risk.
Management: Avoid combination when possible, especially in seizure-prone patients.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Ciprofloxacin. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.