Advertisement

Pharmacy World and Science

, Volume 27, Issue 2, pp 81–82 | Cite as

Treatment failures secondary to drug interactions with divalent cations and fluoroquinolone

  • K. W. GareyEmail author
  • Katie J. Suda
  • L. H. Danziger
Article

Abstract

We observed four cases of therapeutic failures while patients were simultaneously taking medications that contained divalent cations and oral fluoroquinolones. Patients improved after conversion to the intravenous formulation of the same antibiotics, proper spacing of the divalent cation, or conversion to a different antibiotic class. Patients prescribed oral fluoroquinolones should receive instructions on proper separations of these antibiotics with divalent cations. Health care professionals should be cognizant of these interactions and educated on their potential deleterious effect.

Keywords

Antacids Ciprofloxacin Divalent cations Drug interactions Fluoroquinolones Levofloxacin 

References

  1. Zhanel, GG, Ennis, K, Vercaigne, L,  et al. 2002A critical review of the fluoroquinolones: focus on respiratory infectionsDrugs621359PubMedGoogle Scholar
  2. Garey, K., Rodvold, K. 2000Drug-Food InteractionsPiscitelli, SCRodvold, KA eds. Drug Interactions in Infectious DiseasesHumana PressTotowa. NJISBN 0-89603-750-9.Google Scholar
  3. Kara, M, Hasinoff, BB, McKay, DW, Campbell, NR. 1991Clinical and chemical interactions between iron preparations and ciprofloxacinBr J Clin Pharmacol3125761PubMedGoogle Scholar
  4. Mizuki, Y, Fujiwara, I, Yamaguchi, T. 1996Pharmacokinetic interactions related to the chemical structures of fluoroquinolonesJ Antimicrob Chemoth374155Google Scholar
  5. Frost, RW, Lasseter, KC, Noe, AJ, Shamblen, EC, Lettieri, JT. 1992Effects of aluminum hydroxide and calcium carbonate antacids on the bioavailability of ciprofloxacinAntimicrob Agents Chemoth368302Google Scholar
  6. Garrelts, JC, Godley, PJ, Peterie, JD, Gerlach, EH, Yakshe, CC. 1990Sucralfate significantly reduces ciprofloxacin concentrations in serumAntimicrob Agents Chemoth349313Google Scholar
  7. Lee, LJ, Hafkin, B, Lee, ID, Hoh, J, Dix, R. 1997Effects of food and sucralfate on a single oral dose of 500 mg of levofloxacin in healthy subjectsAntimicrob Agents Chemother412196200PubMedGoogle Scholar
  8. Lober, S, Ziege, S, Rau, M,  et al. 1999Pharmacokinetics of gatifloxacin and interaction with an antacid containing aluminum and magnesiumAntimicrob Agents Chemoth43106771Google Scholar
  9. Nix, DE, Watson, WA, Handy, L, Frost, RW, Rescott, DL, Goldstein, HR. 1989The effect of sucralfate pretreatment on the pharmacokinetics of ciprofloxacinPharmacotherapy937780PubMedGoogle Scholar
  10. Nix, DE, Watson, WA, Lener, ME,  et al. 1989Effects of aluminum and magnesium antacids and ranitidine on the absorption of ciprofloxacinClin Pharmacol Ther467005PubMedGoogle Scholar
  11. Wallace, AW, Victory, JM, Amsden, GW. 2003Lack of bioequivalence when levofloxacin and calcium-fortified orange juice are coadministered to healthy volunteersJ Clin Pharmacol4353944CrossRefPubMedGoogle Scholar
  12. Wallace, AW, Victory, JM, Amsden, GW. 2003Lack of bioequivalence of gatifloxacin when coadministered with calcium-fortified orange juice in healthy volunteersJ Clin Pharmacol43926CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  1. 1.Department of Clinical Sciences and AdministrationUniversity of Houston College of PharmacyHoustonUSA
  2. 2.Metro Pharmacy AdministrationBaptist Memorial Health CareMermphisUSA
  3. 3.Department of Pharmacy Practice, College of PharmacyUniversity of Illinois at ChicagoChicagoUSA

Personalised recommendations