Ciprofloxacin oral tablet interactions: Alcohol, medications, and other factors

Ciprofloxacin interactions with other drugs

Before you start treatment with ciprofloxacin, tell your doctor and pharmacist about any prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

To learn whether ciprofloxacin interacts with supplements, herbs, or vitamins, see the “Ciprofloxacin and other interactions” section.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with ciprofloxacin. Keep in mind that this table doesn’t include all drugs that may interact with ciprofloxacin. Some of these interactions are described in detail in “Drug interactions in depth.”

* To learn more about this interaction, see the “When to avoid ciprofloxacin” section.

When to avoid ciprofloxacin

In some cases, factors or conditions could prevent your doctor from prescribing ciprofloxacin due to the risk of harm. These are known as contraindications. Here are the contraindications of ciprofloxacin.

Note: Before you start treatment with ciprofloxacin, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe ciprofloxacin.

Taking tizanidine

Doctors typically will not prescribe ciprofloxacin in combination with a muscle relaxer such as tizanidine. This is because taking ciprofloxacin and tizanidine can increase your risk of low blood pressure and sedation as a side effect of tizanidine.

If you’re taking tizanidine, your doctor will likely prescribe an antibiotic other than ciprofloxacin for your infection.

Having had an allergic reaction to ciprofloxacin or any of its ingredients

If you have had an allergic reaction to ciprofloxacin or any of its ingredients, your doctor will likely not prescribe ciprofloxacin. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Ciprofloxacin interaction with alcohol

If you drink alcohol, your doctor may advise you to avoid or limit it during ciprofloxacin treatment.

This is because drinking alcohol while taking the drug may increase your risk of ciprofloxacin’s side effects or worsen them. For example, you may experience:

• low blood sugar
• headache
• migraine
• dizziness
• nausea and vomiting
• abdominal pain
• CNS effects*, including hallucinations and seizures

Consuming large amounts of alcohol can cause liver damage. Ciprofloxacin may also cause liver damage as a side effect. So, drinking alcohol during ciprofloxacin treatment may increase the risk of liver problems.

If you consume alcohol during ciprofloxacin treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking ciprofloxacin, talk with your doctor.

* Ciprofloxacin has a boxed warning about the risk of CNS effects. To learn more, see the “Boxed warnings” section at the top of this article.

Drug interactions in depth

Here’s a closer look at certain drug interactions of ciprofloxacin.

Certain antidepressants

Ciprofloxacin interacts with certain antidepressants, which are used to treat mental health conditions, including depression and anxiety disorders.

Certain antidepressants and ciprofloxacin can cause QT prolongation (a type of irregular heart rhythm) as a side effect. Taking them together can increase the risk of this side effect further.

Here are some antidepressants that may interact with ciprofloxacin:

• citalopram (Celexa)
• escitalopram (Lexapro)
• venlafaxine (Effexor XR)
• duloxetine (Cymbalta)
• amitriptyline

Steps you or your doctor may take

If you’re taking an antidepressant that can cause QT prolongation, your doctor may prescribe a different antibiotic other than ciprofloxacin to treat your infection. Or if your doctor prescribes ciprofloxacin, they may want to closely monitor your heart rhythm until you finish your treatment course.

Antacids

Ciprofloxacin interacts with antacids, which are used to treat heartburn and acid reflux.

Taking an antacid and ciprofloxacin at the same time can make ciprofloxacin less effective. Antacids can bind (attach) to ciprofloxacin and prevent your body from absorbing it properly.

Here are some antacids that may interact with ciprofloxacin:

• calcium carbonate (Tums)
• magnesium/aluminum hydroxide (Maalox, others)
• aluminum hydroxide/magnesium carbonate (Gaviscon)
• calcium carbonate/magnesium hydroxide (Rolaids)

Steps you or your doctor may take

To lower the risk of this interaction, take your ciprofloxacin dose at least two hours before or six hours after taking an antacid. This helps ensure ciprofloxacin is properly absorbed.

Your doctor or pharmacist can also recommend other medications for heartburn that don’t interact with ciprofloxacin.

Phosphate binders

Ciprofloxacin interacts with phosphate binders. These medications are used to treat a high level of phosphate in the blood.

Taking a phosphate binder and ciprofloxacin at the same time can interfere with how well your body absorbs ciprofloxacin. This can make ciprofloxacin less effective.

Here are some phosphate binders that may interact with ciprofloxacin:

• calcium acetate
• lanthanum carbonate (Fosrenol)
• sevelamer carbonate (Renvela, Renagel)
• sucroferric oxyhydroxide (Velphoro)
• ferric citrate (Auryxia)

Steps you or your doctor may take

To avoid this interaction, take your ciprofloxacin dose at least two hours before or six hours after taking a dose of a phosphate binder. This helps ensure ciprofloxacin is properly absorbed.

Alternatively, your doctor may prescribe an antibiotic besides ciprofloxacin that doesn’t interact with phosphate binders.

Ciprofloxacin and other interactions

Ciprofloxacin may have other interactions, such as with supplements, foods, vaccines, or lab tests.

Here are some potential interactions with ciprofloxacin. Keep in mind that the following information does not include all other possible ciprofloxacin interactions.

Ciprofloxacin interactions with supplements

Before you start treatment with ciprofloxacin, tell your doctor and pharmacist about any supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

In addition to the interactions discussed in the following sections, ciprofloxacin also interacts with caffeine found in supplements such as pre-workout supplements and caffeine tablets. To learn more about ciprofloxacin and caffeine, see the “Ciprofloxacin interactions with food” section. While you’re taking ciprofloxacin, your doctor may advise you to avoid or limit caffeine consumption, including from supplements.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Ciprofloxacin interactions with herbs

There are no specific reports of herbs interacting with ciprofloxacin. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during ciprofloxacin treatment.

Ciprofloxacin interactions with vitamins and minerals

Ciprofloxacin interacts with several minerals, including:

• calcium
• chromium
• iron
• magnesium
• zinc

Most, if not all, multivitamins contain one or more of these minerals. So ciprofloxacin can also interact with many, if not all, multivitamin products.

Taking ciprofloxacin and a dose of a product containing one or more of these minerals can prevent your body from absorbing ciprofloxacin properly. This can make ciprofloxacin less effective. However, you can lower the effect of this interaction by taking your ciprofloxacin dose at least two hours before or six hours after taking a dose of this type of product.

Talk with your doctor or pharmacist if you have questions about taking ciprofloxacin and any supplement containing these minerals.

Ciprofloxacin interactions with food

Ciprofloxacin interacts with milk and other dairy products, such as yogurt. Dairy products contain a high amount of calcium. And calcium can block ciprofloxacin’s absorption in your body, which can make ciprofloxacin less effective. Due to this interaction, you shouldn’t take ciprofloxacin doses with milk, other dairy products, or drinks with added calcium. However, you can still consume dairy in meals, even at the same time you take ciprofloxacin.

Ciprofloxacin also interacts with caffeine found in drinks, such as coffee and green tea. The drug can block your body’s ability to break down caffeine. This can increase the effect of caffeine on your body. So if you consume caffeine while taking ciprofloxacin, you may have an increased risk of side effects from excessive caffeine. Your doctor may advise you to avoid or limit caffeine consumption while you’re taking ciprofloxacin.

If you’d like to learn more about consuming certain foods or drinks during treatment with ciprofloxacin, talk with your doctor or pharmacist.

Ciprofloxacin interactions with vaccines

Ciprofloxacin interacts with the cholera vaccine. Ciprofloxacin is an antibiotic that can kill the bacteria that cause cholera. Vaxchora, the only approved cholera vaccine in the United States, contains a live version of this bacteria. So, ciprofloxacin can kill the bacteria if you take it too close to receiving the vaccine. This can make the vaccine less effective.

Due to this, your doctor will likely advise you not to receive the cholera vaccine within at least 14 days before or after ciprofloxacin treatment.

Ciprofloxacin interactions with lab tests

Ciprofloxacin isn’t known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

CIPROFLOXACIN INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with ciprofloxacin. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with ciprofloxacin. The impact of cannabis may affect how well you stick to your ciprofloxacin treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Ciprofloxacin and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with ciprofloxacin. Before you take this drug, be sure to talk with your doctor about your health history. Ciprofloxacin may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with ciprofloxacin include:

• Diabetes: Ciprofloxacin can cause changes in blood sugar, including high or low blood sugar. If you have diabetes, your doctor may want you to monitor your blood sugar more often while you’re taking ciprofloxacin. They may also adjust the dosage of any medications you take for diabetes.
• Kidney condition: If you have chronic kidney disease (CKD) or another kidney condition, your doctor may prescribe a lower ciprofloxacin dosage. CKD and other kidney conditions can affect your body’s ability to break down ciprofloxacin, raising your risk of side effects.
• Allergic reaction: If you’ve had an allergic reaction to ciprofloxacin or any of its ingredients, your doctor will likely not prescribe ciprofloxacin. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be a better option for you.
• Breastfeeding: You should not breastfeed while taking ciprofloxacin or for at least 2 days after your last dose. The drug passes into breast milk and may cause side effects in a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking ciprofloxacin. They can talk with you about treatment options and other ways to feed a child.
• Pregnancy: There haven’t been enough clinical trials to determine whether ciprofloxacin is safe to take while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting ciprofloxacin. They can advise you on the right treatment plan for you.
• Past tendon rupture or other tendon problems: Ciprofloxacin has a boxed warning about the risk of tendon problems as a side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). You may be at higher risk if you’ve had a tendon rupture or other tendon problems in the past. To learn more, see the “Boxed warnings” section at the top of this article.
• Joint problems, such as rheumatoid arthritis: Having rheumatoid arthritis or another joint problem may raise your risk of tendon problems as a side effect of ciprofloxacin.
• Liver condition: Ciprofloxacin can cause liver damage as a side effect. If you have cirrhosis or another liver condition, taking ciprofloxacin could worsen your condition. Your doctor can determine whether treatment with ciprofloxacin is safe for you based on your liver health.
• Long QT syndrome: Ciprofloxacin can cause QT prolongation as a side effect. If you have long QT syndrome, taking ciprofloxacin may worsen your condition. Your doctor can determine whether treatment with ciprofloxacin is safe for you. They may prefer prescribing a different antibiotic besides ciprofloxacin, depending on the severity of your condition and other medications you may take.
• Low blood potassium or low blood magnesium: You may have an increased risk of QT prolongation as a side effect of ciprofloxacin if you have low blood potassium or low blood magnesium levels. Your doctor can determine whether treatment with ciprofloxacin is safe for you. They may prefer prescribing a different antibiotic besides ciprofloxacin.
• Mental health condition: Ciprofloxacin has a boxed warning about the risk of CNS effects, including psychosis, paranoia, and depression. If you have a mental health condition such as depression or schizophrenia, you may be at higher risk of these side effects. Taking ciprofloxacin may also worsen your existing condition. To learn more, see the “Boxed warnings” section at the top of this article.
• Myasthenia gravis: Taking ciprofloxacin can worsen myasthenia gravis if you already have this condition. Ciprofloxacin has a boxed warning about this risk. To learn more, see the “Boxed warnings” section at the top of this article.
• Past heart, kidney, or lung transplant: You may have an increased risk of tendon problems as a side effect of ciprofloxacin if you’ve received a heart, kidney, or lung transplant in the past. Ciprofloxacin has a boxed warning about the risk of tendon problems as a side effect. To learn more, see the “Boxed warnings” section at the top of this article.
• Peripheral neuropathy or other nerve problems: Ciprofloxacin has a boxed warning about the risk of peripheral neuropathy as a side effect. If you already have peripheral neuropathy or another nerve problem, taking ciprofloxacin could worsen your condition. To learn more, see the “Boxed warnings” section at the top of this article.
• Seizures: Ciprofloxacin has a boxed warning about the risk of CNS effects, including seizures. Taking ciprofloxacin could worsen your seizures. To learn more, see the “Boxed warnings” section at the top of this article.
• Risk of suicidal thoughts and behaviors: Ciprofloxacin has a boxed warning about the risk of CNS effects, which can include suicidal thoughts and behaviors. To learn more, see the “Boxed warnings” section at the top of this article.

FAQ about ciprofloxacin and interactions

Here are some frequently asked questions about ciprofloxacin and possible interactions.

Can I eat bananas with ciprofloxacin?

Yes, you can eat bananas with ciprofloxacin. Bananas aren’t known to interact with ciprofloxacin.

To learn about foods that interact with ciprofloxacin, such as milk, see “Ciprofloxacin interactions with food” in the “Ciprofloxacin and other interactions” section. You can also talk with your doctor or pharmacist.

Does ciprofloxacin interact with famotidine?

No, ciprofloxacin is not known to interact with famotidine (Pepcid). Ciprofloxacin can interact with antacids, which are used to treat heartburn and acid reflux. Famotidine is also used to treat heartburn symptoms but isn’t expected to interact with ciprofloxacin.

That said, famotidine has its own precautions and interactions to be aware of. So you should still talk with your doctor or pharmacist before taking the drug. They can check if famotidine interacts with any other medications you take or any other medical conditions you have.

Preventing interactions

You can take certain steps to help prevent interactions with ciprofloxacin. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the ciprofloxacin label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. The paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If ciprofloxacin doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with ciprofloxacin by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.