Drug Interaction Report

Using norfloxacin together with azithromycin can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Taking norfloxacin with food or products that contain minerals like calcium, iron, magnesium and zinc can interfere with its absorption and reduce its levels in the blood and urinary tract. This may make the medication less effective in treating your infection. You should take norfloxacin on an empty stomach at least one hour before or two hours after eating a meal or consuming milk or other dairy products. Do not use mineral supplements, multivitamins, antacids, or other products that may contain calcium, iron, magnesium or zinc within the two-hour period before or after taking norfloxacin. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

Norfloxacin and multivitamin with minerals should not be taken orally at the same time. Products that contain magnesium, aluminum, calcium, iron, and/or other minerals may interfere with the absorption of norfloxacin into the bloodstream and reduce its effectiveness. If possible, it may be best to avoid taking multivitamin with minerals while you are being treated with norfloxacin. Otherwise, norfloxacin should be taken 2 to 4 hours before or 4 to 6 hours after a multivitamin with minerals dose, norfloxacin should be taken at least 2 hours before and not less than 6 hours after Suprep Bowel Prep (magnesium/potassium/sodium sulfates), or norfloxacin and multivitamin with minerals should be taken as directed by your healthcare provider. Talk to your healthcare provider if you are unsure whether your medications contain something that could potentially interact or if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Using caffeine together with norfloxacin may increase the effects of caffeine. Contact your doctor if you experience headache, tremor, restlessness, nervousness, insomnia, and increased blood pressure or heart rate. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

The recommended maximum number of medicines in the 'quinolones' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'quinolones' category:

• azithromycin / trovafloxacin
• norfloxacin

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.