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Related Experiment Videos

Does ciprofloxacin interact with cyclosporine?

L L Hoey1, K D Lake

  • 1University of Minnesota/St. Paul Ramsey Medical Center.

The Annals of Pharmacotherapy
|January 1, 1994
PubMed
Summary

Ciprofloxacin and cyclosporine drug interactions are unlikely. Studies show no significant pharmacokinetic or pharmacodynamic interaction, suggesting safe co-administration at recommended doses.

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Area of Science:

  • Pharmacology
  • Nephrology
  • Drug Interactions

Background:

  • Cyclosporine is a crucial immunosuppressant, particularly in organ transplant recipients.
  • Cyclosporine is known to cause nephrotoxicity, a significant clinical concern.
  • Ciprofloxacin is a broad-spectrum antibiotic frequently used to treat infections in transplant patients.

Purpose of the Study:

  • To evaluate the scientific literature for evidence of pharmacokinetic or pharmacodynamic interactions between ciprofloxacin and cyclosporine.
  • To determine the safety and necessity of increased monitoring when these two drugs are used concurrently.

Main Methods:

  • A comprehensive MEDLINE search was conducted to identify relevant literature, including review articles, pharmacokinetic studies, and case reports.
  • Data extraction focused on prospective human studies, particularly those examining cyclosporine pharmacokinetic profiles.
  • All available sources were reviewed due to the limited number of pharmacokinetic trials and case reports.

Main Results:

  • While a few case reports suggested potential interactions (e.g., additive nephrotoxicity or altered cyclosporine levels), numerous pharmacokinetic studies have refuted these claims.
  • Controlled studies analyzing cyclosporine pharmacokinetic profiles demonstrated no significant increase in cyclosporine concentrations when co-administered with ciprofloxacin.
  • Anecdotal reports of ciprofloxacin-induced acute renal failure, often linked to interstitial nephritis, were noted but lacked clear correlation with drug interaction.

Conclusions:

  • Current evidence from controlled pharmacokinetic studies does not support a significant drug interaction between ciprofloxacin and cyclosporine.
  • The risk of synergistic nephrotoxicity appears low, and clear correlations are not established.
  • Ciprofloxacin and cyclosporine can likely be used together safely at recommended dosages without the need for enhanced cyclosporine monitoring.

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