Quinolone antibiotics and Iron preparations
Posted on September 1, 2009
by Sandy PowersLouise Rossberg had nearly a thousand beehives in 2006. Today, she has 200.In February 2005, John Miller lost almost half of his 13,000 hives, which translated into the loss of 300 million bees. Miller is an experience beekeeper. His great-grandfather began the family’s beekeeping enterprise in 1894. The West Coast of the United
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Some preliminary evidence shows that iron preparations can reduce the absorption of cipro and ofloxacin front the gut. The auinolone-iron complexes formed have reduced antibacterial effects.
Clinical evidence
A cross-over trial in 12 normal subjects given single doses of 500 mg cipro or 400 mg ofloxacin showed that the concurrent use of 200 mg iron (in the form of an rron-glycine-sulphate complex) reduced the bioavailability of the cipro by 48% and that of ofloxacin by 36%. Another study found that 325 mg ferrous sulphate three times a day reduced the absorption of cipro in normal subjects by 65%. Reduced serum levels of cipro (peak levels reduced from 5 2 to 0.3-0.5) were recorded in another patient while taking ferrous sulphate.
Mechanism
Uncertain, but the suggestion is that a quinolone-iron complex (chelation between the metal and the 4-oxo- and adjacent carboxyl groups) is formed which is less easily absorbed. An m vitro study also showed that antibacterial effects of cipro, ofloxacin and norfloxacin are markedly reduced by ferric chloride or ferrous sulphate when tested against Salmonella typhimunum and Shigella sonnet.
Importance and management
Information is limited but it seems possible that these interactions are of clinical importance. Until more is known, separate the dosages of cipro or ofloxacin and iron as much as possible to avoid mixing in the gut, and monitor the effectiveness of the antibiotic treatment. There seems to be no direct information about other quinolones but many of them interact with the metal ions found in a number of antacids and therefore possibly similarly interact with iron.
Tags: Antibiotics, cipro
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