Cipro and Zanaflex Tablets
Determining the interaction of Cipro and Zanaflex Tablets and the possibility of their joint administration.
In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.
Consumer:Using ciprofloxacin and tiZANidine is not recommended. Taking these drugs together can cause symptoms of drowsiness, dizziness, slurred speech, confusion, weakness, or low blood pressure. Do not drive or operate machinery until you know how your body will respond to these drugs. 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.
Professional:CONTRAINDICATED: Coadministration with ciprofloxacin may significantly increase the plasma concentrations and pharmacologic effects of tizanidine. The proposed mechanism is ciprofloxacin inhibition of tizanidine metabolism via CYP450 1A2. In 10 healthy volunteers, pretreatment with ciprofloxacin (500 mg orally twice daily for 3 days) increased the peak plasma concentration (Cmax) and total area under the concentration-time curve (AUC) of tizanidine (4 mg single oral dose) by an average of 7- and 10-fold, respectively, compared to placebo. The mean elimination half-life of tizanidine was slightly prolonged, from 1.5 to 1.8 hours, by ciprofloxacin. Pharmacologic effects of tizanidine as measured by changes in blood pressure, heart rate, performance testing, subjective drug effect, and drowsiness were significantly greater with ciprofloxacin.
MANAGEMENT: Given the magnitude of the interaction, use of tizanidine with ciprofloxacin is considered contraindicated. Other quinolones such as gatifloxacin, gemifloxacin, levofloxacin, lomefloxacin, or moxifloxacin may be safer alternatives in tizanidine-treated patients, since they are generally believed to have little, if any, effect on CYP450 1A2.
- Granfors MT, Backman JT, Laitila J, Neuvonen PJ "Tizanidine is mainly metabolized by cytochrome P450 1A2 in vitro." Br J Clin Pharmacol 57 (2004): 349-53
- "Product Information. Cipro (ciprofloxacin)." Bayer, West Haven, CT.
- Granfors MT, Backman JT, Neuvonen M, Neuvonen PJ "Ciprofloxacin greatly increases concentrations and hypotensive effect of tizanidine by inhibiting its cytochrome P450 1A2-mediated presystemic metabolism." Clin Pharmacol Ther 76 (2004): 598-606
- "Product Information. Zanaflex (tizanidine)." Acorda Therapeutics, Hawthorne, NY.
Generic Name: ciprofloxacin
Brand name: Cipro, Cipro XR, Proquin XR, Cipro IV
Synonyms: n.a.
Generic Name: tizanidine
Brand name: Zanaflex
Synonyms: Zanaflex
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
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