Cipro is an antibiotic fluoroquinolone prescribed for treating certain bacterial illnesses. It is an FDA approved medication. The Food and Drug Administration (FDA) granted Cipro approval to treat urinary tract infections in 2002. Its approval for treating various diseases in the United States began in 1987.
Related Read: Cipro for UTI
Drug interactions with Ciprofloxacin
Certain drug interactions may trigger adverse reactions or increase your risks. In other cases, Ciprofloxacin prolongs the half-life of other medications, which can be dangerous sometimes (11).
Cipro & Heart Rhythm Related Drugs
These medications affect the heart rhythm, and using them with Cipro increases the risk of arrhythmia.
- Sotalol
- Quinidine
- Procainamide
- Dofetilide
- Amiodarone
- Some diuretic medications
Other Medications to Avoid
- Xanthines, caffeine
- Duloxetine
- Flibanserin
- Tasimelteon
Blood thinners
Taking Cipro with blood thinners like Coumadin (warfarin) might cause altered bleeding, though there aren’t many reported cases of this occurring (3).
Theophylline
When taking Theophylline at the same time as Cipro, you have a higher risk of developing central nervous system side effects.
Tizanidine
Cipro shouldn’t be taken with Tizanidine, a type of muscle relaxer. Taking these two medications together could cause low blood pressure, low heart rate, and intense sleepiness. Concomitant administration of tizanidine and Cipro is contraindicated due to the potentiation of hypotensive (low blood pressure) and sedative effects of tizanidine.
Methotrexate
Methotrexate is a type of drug used to calm your immune system and keep it from fighting healthy cells.
While only a few cases have been reported, taking Cipro with methotrexate might interfere with your kidneys’ ability to clear methotrexate from your body., which could lead to toxicity (2).
In their case, Ciprofloxacin slows down their clearance from the blood. This may be dangerous in some cases, especially if you’re taking warfarin. Drugs known to prolong QT Interval (an abnormal feature of the heart’s electrical system that can lead to a potentially life-threatening arrhythmia). Cipro may make the QT interval even longer in people who are already taking drugs that make the QT interval longer.
Drugs that impact the effectiveness of Ciprofloxacin
There’s another list of drugs that impact the effectiveness of Ciprofloxacin by reducing the bioavailability of quinolones.
In other words, they don’t allow quinolones to be absorbed or circulate freely in the blood. As such, taking these drugs along with Cipro can cause a therapeutic failure.
These drugs include:
- Sucralfate
- Aluminum and aluminum-containing drugs
- Magnesium zinc
- Iron and calcium supplements
- Antacids
Vitamins & Minerals to avoid
There’s another list of minerals that impact the effectiveness of Ciprofloxacin by reducing the bioavailability of quinolones, make it less absorbable.
- Zinc
- Calcium
- Copper
- Magnesium
- Manganese
Iron
Because of the formation of ciprofloxacin-iron complexes, which reduce ciprofloxacin absorption, iron supplements should not be used together with Cipro, as it potentially making Cipro less effective.
Forms of iron like ferrous fumarate and ferrous sulfate shouldn’t be taken at the same time as Cipro (10).
Fennel
Supplements containing fennel might interact with Cipro. According to an animal study, fennel significantly impacted the absorption and elimination of Cipro, while also impacting its effectiveness (5).
Disease interactions
Cipro might not be recommended if you have certain health conditions, such as:
Myasthenia gravis
Cipro may worsen myasthenia gravis, an autoimmune disease that causes nerve and muscular problems. There is a black box warning from the FDA advising patients with myasthenia gravis to avoid taking antibiotics like Cipro.
Tendon problems, including tendinitis
Cipro may cause inflammation and tearing of the tendons (6). You should be cautious when taking Cipro if you’re at risk of tendon problems, including using corticosteroids to treat tendon pain.
Blood sugar problems
If you have diabetes or have a history of non-diabetic hypoglycemia, Cipro might increase the risk of hypoglycemia (low blood sugar) (7).
Kidney problems
Taking high doses of Cipro might worsen kidney problems since Cipro is mainly removed from your body by your kidneys.
Liver problems
While rare, Cipro might cause liver injury, especially if it’s taken at high doses or if you have a history of liver problems.
Seizures
If you’re at risk of having seizures, Cipro might increase the likelihood of having more seizures (8).
Abnormal heart rhythm
If you have heart problems or irregular heartbeat, Cipro might worsen these heart rhythm abnormalities by extending the QT wave, a part of your heart rhythm.
Cipro & Pregnancy
Cipro is a category C drug related to pregnancy safety, which means that risk cannot be ruled out for the growing baby. If you’re pregnant, your healthcare provider can recommend safer antibiotics for use during pregnancy if needed.
Breastfeeding
Taking Cipro while breastfeeding is “usually considered compatible,” according to a report by the FDA.
Allergic reaction
If you’re allergic to Cipro or its ingredients, you should avoid it.
Cipro – Foods to avoid
Milk / Dairy products
Taking Cipro with dairy products reduces their effectiveness by stopping them from being absorbed from your stomach.
Avoid consuming dairy products like milk, cheese, yogurt, and other dairy-based foods for at least two hours before and after taking your Cipro dose.
Caffeine
It’s not recommended to consume large amounts of caffeine while taking Cipro as it might exacerbate side effects like nervousness, sleeplessness, heart pounding, and anxiety that caffeine can cause.
Caffeine is found in some beverages like soda, coffee, energy drinks, and chocolate. While consuming low- to moderate levels of caffeine is likely safe, you should avoid increasing your caffeine intake while finishing a round of Cipro.
Alcohol
Unlike some antibiotics (like Flagyl), Cipro isn’t known to interact with alcohol. Even though there aren’t any known interactions with alcohol, it’s not advisable to consume large amounts of alcohol while taking antibiotics as it might interfere with your body’s efficiency at fighting the infection.
Low- to moderate amounts of alcohol are likely fine to consume while taking Cipro, but you should always contact your healthcare provider for guidance.
Foods to eat when taking Cipro
It is recommended to take Cipro with food. And a smart move would be to eat foods that help you control your infection.
For example, if you have a urinary tract infection, you may benefit from vitamin C-rich meals. Taking your daily dose of Cipro and vitamin C helps your body combat infections.
Another recommendation is probiotic foods and supplements. Non-dairy fermented foods may contribute to your gut microbiota and prevent diarrhea. Some ideas are sauerkraut, kimchi, tempeh, miso soup, and pickled vegetables.
Pineapple
Pineapples are rich in bromelain, a group of enzymes with anti-bacterial properties. While not specifically studied with Cipro, some studies using other antibiotics found that bromelain increased the absorption of the antibiotics, which can help make them more effective.
Probiotics
Fermented foods are among the best sources of probiotics. Yogurt, kefir, sauerkraut, buttermilk, tempeh, and sourdough bread are all good sources of probiotics.
You can also find probiotic supplements, which some people prefer to take during their course of antibiotics, sometimes for weeks and months afterward.
Fiber-rich foods
As long as you’re not suffering from severe diarrhea, fiber-rich foods act as prebiotics, which help feed the beneficial probiotics in your gut.
Some great sources of fiber include:
- Whole grains
- Nuts
- Seeds
- Legumes
- Fruits
- Vegetables
Bland foods
If you’re experiencing diarrhea from taking Cipro, consider eating a bland, soft diet until your body recovers. Drinking plenty of clear liquids can help prevent dehydration from persistent diarrhea.
A bland diet can include foods like:
- Refined grains (white toast, crackers, white rice, etc.)
- Applesauce and other soft fruits
- Well-cooked vegetables
- Well-cooked lean meats
Some side effects of Cipro
Although you are cautious of what to eat and avoid when taking Cipro, some of the most common side effects of Cipro might appear:
- nausea
- vomiting
- stomach pain
- heartburn
- diarrhea
- vaginal itching and/or discharge
- pale skin
- unusual tiredness
- sleepiness
If you experience severe or rare side effects while taking Cipro, you should seek medical attention immediately.
More rare and serious side effects can include:
- severe diarrhea (sometimes bloody) with or without fever and severe stomach pain
- Cipro rash
- frequent urination; trembling; blurred vision; or unusual anxiety
- fainting or loss of consciousness
- decreased urination
- sudden pain in the chest, stomach, or back
Conclusion
Cipro is a type of antibiotic drug used to treat a variety of bacterial infections. You should avoid dairy when taking Cipro. You also shouldn’t take certain mineral supplements like iron while taking Cipro, as they can reduce its effectiveness and absorption.
To help reduce potential negative side effects of Cipro, eat foods rich in probiotics to help replenish the depletion of healthy bacteria.
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