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Cipro (ciprofloxacin) Disease Interactions

There are 7 disease interactions with Cipro (ciprofloxacin):

Quinolones (Includes Cipro) ↔ Cns Disorders

Severe Potential Hazard, Moderate plausibility

Applies to: CNS Disorder

Quinolones may cause CNS stimulation manifested as tremors, agitation, restlessness, anxiety, confusion, hallucinations, paranoia, insomnia, toxic psychosis, and/or seizures. Benign intracranial hypertension has also been reported. Therapy with quinolones should be administered cautiously in patients with or predisposed to seizures or other CNS abnormalities. In addition, these patients should be advised to avoid the consumption of caffeine-containing products during therapy with some quinolones, most notably ciprofloxacin, enoxacin, and cinoxacin, since these agents can substantially reduce the clearance of caffeine and other methylxanthines, potentially resulting in severe CNS reactions.


  1. Schwartz MT, Calvert JF "Potential neurologic toxicity related to ciprofloxacin." Ann Pharmacother 24 (1990): 138-40
  3. Arcieri G, Griffith E, Gruenwaldt G, et al "A survey of clinical experience with ciprofloxacin, a new quinolone antimicrobial." J Clin Pharmacol 28 (1988): 179-89
View all 57 references

Quinolones (Includes Cipro) ↔ Qt Interval Prolongation

Severe Potential Hazard, Low plausibility

Applies to: Abnormal Electrocardiogram, Arrhythmias, Electrolyte Abnormalities, Hypokalemia, Ischemic Heart Disease, Magnesium Imbalance, Congestive Heart Failure

Quinolones have been reported to prolong the QT interval of the electrocardiogram in some patients. QT prolongation may potentiate the risk of ventricular arrhythmias including ventricular tachycardia, ventricular fibrillation, and torsade de pointes. The risk appears to be greatest with grepafloxacin and sparfloxacin (both are no longer marketed in the U.S.), although cardiovascular morbidity and mortality attributable to QT prolongation have also been reported rarely with others like gatifloxacin, levofloxacin, ciprofloxacin, and ofloxacin. Reported cases have primarily occurred in patients with advanced age, cardiac disease, electrolyte disturbances, and/or underlying medical problems for which they were receiving concomitant medications known to prolong the QT interval. Therapy with quinolones should be avoided in patients with known QT prolongation and/or uncorrected electrolyte disorders (hypokalemia or hypomagnesemia) and in patients treated concomitantly with class IA or III antiarrhythmic agents. Cautious use with ECG monitoring is advised in patients with other proarrhythmic conditions such as clinically significant bradycardia, congestive heart failure, acute myocardial ischemia, and atrial fibrillation. As QT prolongation may be a concentration-dependent effect, it is important that the recommended dosages or infusion rates of these drugs not be exceeded, particularly in patients with renal and/or hepatic impairment.


  1. "Product Information. Levaquin (levofloxacin)." Ortho Pharmaceutical Corporation, Raritan, NJ.
  2. Iannini PB "Cardiotoxicity of macrolides, ketolides and fluoroquinolones that prolong the QTc interval." Expert Opin Drug Saf 1 (2002): 121-8
  3. Demolis JL, Kubitza D, Tenneze L, Funck-Bretano C "Effect of a single oral dose of moxifloxacin (400 mg and 800 mg) on ventricular repolarization in healthy subjects." Clin Pharmacol Ther 68 (2000): 658-66
View all 29 references

Antibiotics (Includes Cipro) ↔ Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Colitis/Enteritis (Noninfectious)



View all 47 references

Quinolones (Includes Cipro) ↔ Crystalluria

Moderate Potential Hazard, Moderate plausibility

Applies to: Dehydration, Diarrhea, Vomiting

Crystalluria has been reported rarely during quinolone therapy. Although it is not expected to occur under normal circumstances with usual recommended dosages, patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk and should be encouraged to consume additional amounts of liquid or given intravenous fluid to ensure an adequate urinary output. Alkalinity of the urine should be avoided, since it may also increase the risk of crystalluria. Renal function tests should be performed periodically during prolonged therapy (> 2 weeks).


  1. "Product Information. Trovan (trovafloxacin)." Pfizer US Pharmaceuticals, New York, NY.
  2. "Product Information. NegGram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. "Product Information. Penetrex (enoxacin)." Rhone-Poulenc Rorer, Collegeville, PA.
View all 16 references

Quinolones (Includes Cipro) ↔ Diabetes

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus

The use of certain quinolones such as clinafloxacin, gatifloxacin, temafloxacin, levofloxacin, and moxifloxacin has been associated with disturbances in blood glucose homeostasis possibly stemming from effects on pancreatic beta cell ATP-sensitive potassium channels that regulate insulin secretion. Hypoglycemia and, less frequently, hyperglycemia have been reported, although the latter may also occur due to infection alone. Hypoglycemia has usually occurred in patients with diabetes receiving concomitant oral hypoglycemic agents and/or insulin. Administration of ciprofloxacin, levofloxacin, norfloxacin, and especially gatifloxacin in patients treated with sulfonylureas or other oral hypoglycemic agents has resulted in severe, refractory hypoglycemia and hypoglycemic coma. Elderly patients and patients with reduced renal function are particularly susceptible. Blood glucose should be monitored more closely whenever quinolones are prescribed to patients with diabetes. Gatifloxacin has been known to cause hypoglycemic episodes generally within the first 3 days of therapy and sometimes even after the first dose, while hyperglycemia usually occurs 4 to 10 days after initiation of therapy. Patients should be counseled to recognize symptoms of hypoglycemia such as headache, dizziness, drowsiness, nausea, tremor, weakness, hunger, excessive perspiration, and palpitations. If hypo- or hyperglycemia occur during quinolone therapy, patients should initiate appropriate remedial therapy immediately, discontinue the antibiotic, and contact their physician.


  1. Park-Wyllie LY, Juurlink DN, Kopp A, et al. "Outpatient gatifloxacin therapy and dysglycemia in older adults." N Engl J Med 354 (2006): 1352-61
  2. Saraya A, Yokokura M, Gonoi T, Seino S "Effects of fluoroquinolones on insulin secretion and beta-cell ATP-sensitive K(+) channels." Eur J Pharmacol 497 (2004): 111-7
  3. Gajjar DA, LaCreta FP, Kollia GD, et al. "Effect of multiple-dose gatifloxacin or ciprofloxacin on glucose homeostasis and insulin production in patients with noninsulin-dependent diabetes mellitus maintained with diet and exercise." Pharmacotherapy 20 (6 Pt 2) (2000): s76-86
View all 25 references

Quinolones (Includes Cipro) ↔ Hemodialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

The following quinolones are known to be partially removed by hemodialysis and should be administered after dialysis: ciprofloxacin, enoxacin, gatifloxacin, levofloxacin, lomefloxacin, and ofloxacin.


  1. Singlas E, Taburet AM, Landru I, Albin H, Ryckelinck JP "Pharmacokinetics of ciprofloxacin tablets in renal failure: infuluence of haemodialysis." Eur J Clin Pharmacol 31 (1987): 389-93
  2. Thalhammer F, Kletzmayr J, ElMenyawi I, Kovarik J, Rosenkranz AR, Traunmuller F, Horl WH, Burgmann H "Ofloxacin clearance during hemodialysis: A comparison of polysulfone and cellulose acetate hemodialyzers." Am J Kidney Dis 32 (1998): 642-5
  3. "Product Information. Tequin (gatifloxacin)" Bristol-Myers Squibb, Princeton, NJ.
View all 13 references

Quinolones (Includes Cipro) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Quinolones (except trovafloxacin, moxifloxacin, and nalidixic acid) and their metabolites are eliminated by the kidney. Patients with renal impairment may be at greater risk for adverse effects from quinolones, including nephrotoxicity, due to decreased drug clearance. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment and severity of infection in accordance with the individual product package labeling. Renal function tests should be performed periodically during therapy.


  1. Rastogi S, Atkinson JLD, McCarthy JT "Allergic nephropathy associated with ciprofloxacin." Mayo Clin Proc 65 (1990): 987-9
  2. Nix DE, Schultz RW, Frost RW, et al "The effect of renal impairment and haemodialysis on single dose pharmacokinetics of oral enoxacin." J Antimicrob Chemother 21 (1988): 87-95
  3. Alestig K "The pharmacokinetics of oral quinolones (norfloxacin, ciprofloxacin, ofloxacin)." Scand J Infect Dis 68 (1990): 19-22
View all 50 references

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Cipro (ciprofloxacin) drug Interactions

There are 718 drug interactions with Cipro (ciprofloxacin)

Cipro (ciprofloxacin) alcohol/food Interactions

There are 3 alcohol/food interactions with Cipro (ciprofloxacin)

Drug Interaction Classification



Do not stop taking any medications without consulting your healthcare provider.
