Drug Interaction Report

Ciprofloxacin may increase the blood levels of HYDROcodone. This may increase side effects such as drowsiness, dizziness, lightheadedness, difficulty concentrating, and impairment in thinking and judgment. In severe cases, low blood pressure, respiratory distress, fainting, coma, or even death may occur. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek medical attention if you experience dizziness, fainting, confusion, excessive drowsiness, slow heart rate, and/or shallow or difficult breathing. Do not drink alcohol during treatment with HYDROcodone, and do not use more than the dose prescribed by your doctor. Also, avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how these medications affect you, and use caution when getting up from a sitting or lying position. 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.

Do not use alcohol or medications that contain alcohol while you are receiving treatment with HYDROcodone. This may increase nervous system side effects such as drowsiness, dizziness, lightheadedness, difficulty concentrating, and impairment in thinking and judgment. In severe cases, low blood pressure, respiratory distress, fainting, coma, or even death may occur. If you are taking certain long-acting formulations of hydrocodone, consumption of alcohol may also cause rapid release of the drug, resulting in high blood levels that may be potentially lethal. Likewise, you should avoid consuming grapefruit and grapefruit juice, as this may increase the blood levels and effects of hydrocodone. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. Do not use more than the recommended dose of HYDROcodone, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. 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.

Do not take ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified foods (e.G., cereal, juice). You may eat or drink dairy products or calcium-fortified foods with a regular meal, but do not use them alone when taking ciprofloxacin. They could make the medication less effective. When ciprofloxacin tablets are given with enteral (tube) feedings, ciprofloxacin may not work as well. You could interrupt the feeding for 1 hour before and 2 hours after the ciprofloxacin dose, or your doctor may decide to switch to a different treatment. Ciprofloxacin oral suspension should not be given via nasogastric tubes or feeding tubes. 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.

Consumer information for this interaction is not currently available.

GENERALLY AVOID: The oral bioavailability of quinolone and tetracycline antibiotics may be reduced by concurrent administration of preparations containing polyvalent cations such as aluminum, calcium, iron, magnesium, and zinc. Therapeutic failure may result. The proposed mechanism is chelation of quinolone and tetracycline antibiotics by di- and trivalent cations, forming an insoluble complex that is poorly absorbed from the gastrointestinal tract. Reduced gastrointestinal absorption of the cations should also be considered.

MANAGEMENT: Concomitant administration of oral quinolone and tetracycline antibiotics with preparations containing aluminum, calcium, iron, magnesium, and/or zinc salts should generally be avoided. Otherwise, the times of administration should be staggered by as much as possible to minimize the potential for interaction. Quinolones should typically be dosed either 2 to 4 hours before or 4 to 6 hours after polyvalent cation preparations, depending on the quinolone and formulation. Likewise, tetracyclines and polyvalent cation preparations should typically be administered 2 to 4 hours apart. The prescribing information for the antibiotic should be consulted for more specific dosing recommendations.

Using caffeine together with ciprofloxacin 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.

Both pseudoephedrine and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects. Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. 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.