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Drug interactions with quinolones.

H Lode1

  • 1Medical Department, Klinikum Steglitz, Freie Universität Berlin, Federal Republic of Germany.

Reviews of Infectious Diseases
|January 1, 1988
PubMed
Summary
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New quinolone drug interactions can alter drug efficacy and bioavailability. Key interactions involve pH, magnesium, probenecid, and antacids, impacting drug metabolism and elimination.

Area of Science:

  • Pharmacology
  • Drug Interactions
  • Antimicrobial Agents

Background:

  • Drug interactions are classified as pharmacokinetic or pharmacodynamic.
  • Pharmacokinetic interactions involve changes in absorption, distribution, metabolism, and elimination.
  • New quinolones exhibit specific interactions affecting their efficacy and safety.

Purpose of the Study:

  • To elucidate the pharmacokinetic mechanisms underlying new quinolone drug interactions.
  • To highlight clinically significant interactions involving new quinolones.
  • To inform therapeutic strategies for managing quinolone co-administration.

Main Methods:

  • Review of existing literature on quinolone drug interactions.
  • Analysis of pharmacokinetic parameters affected by co-administered substances.

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  • Evaluation of clinical relevance based on reported outcomes.

    • Main Results:

    • New quinolone efficacy can decrease at low pH and is reduced by magnesium (Mg++).
    • Probenecid decreases the tubular secretion of ciprofloxacin.
    • Quinolones metabolized in the liver (e.g., enoxacin, ciprofloxacin) reduce theophylline clearance.
    • Co-administration with Mg++-containing antacids significantly reduces quinolone bioavailability.

    Conclusions:

    • Understanding these pharmacokinetic interactions is crucial for optimizing quinolone therapy.
    • Clinically relevant interactions necessitate careful consideration of co-administered drugs and substances.
    • Management strategies should aim to mitigate reduced efficacy and bioavailability.