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Cipro Iv Minibags and Didanosine

Determining the interaction of Cipro Iv Minibags and Didanosine and the possibility of their joint administration.

Check result:

Cipro Iv Minibags <> Didanosine

Relevance: 14.09.2022 Reviewer: Shkutko P.M., M.D., in

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:

Patients taking didanosine buffered tablets or pediatric oral solution should not take ciprofloxacin orally at the same time. These formulations of didanosine contain buffering agents or antacids that may interfere with the absorption of ciprofloxacin into the bloodstream, which may reduce the medication's effectiveness. You should take ciprofloxacin at least 2 before or 6 hours after the didanosine dose. Talk to a healthcare professional if you are not sure whether a product contains something that could potentially interact with your medication or if you have questions on how to take this or other medications you are prescribed. 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:

ADJUST DOSING INTERVAL: Coadministration with didanosine buffered tablets or pediatric oral solution may significantly reduce the oral bioavailability of ciprofloxacin and other quinolone antibiotics. The mechanism is reduced quinolone absorption due to chelation with metallic cations from buffering agents and antacids used in certain formulations of didanosine. In a randomized, crossover study consisting of 12 healthy volunteers, simultaneous administration of didanosine placebo tablets (buffering agents without didanosine) reduced the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of ciprofloxacin by 93% and 98%, respectively. In eight HIV-infected patients, the steady-state AUC of ciprofloxacin decreased an average of 26% when it was administered 2 hours prior to didanosine tablets. In a single subject given one dose of ciprofloxacin 2 hours after didanosine placebo tablets, ciprofloxacin AUC was reduced by more than 50%.

MANAGEMENT: Quinolones such as ciprofloxacin should be administered at least 2 hours before or 6 hours after didanosine buffered tablets or pediatric oral solution, and patients should be monitored for potentially decreased antimicrobial efficacy during concomitant therapy. Didanosine buffered powder for oral solution, which uses a citrate-phosphate buffer, and the delayed-release capsules, which are not buffered, are not expected to cause this interaction.

References

Hoffken G, Lode H, Wiley R, et al "Pharmacokinetics and bioavailability of ciprofloxacin and ofloxacin: effect of food and antacid intake." Rev Infect Dis 10(Suppl) (1988): S138-9
Sahai J, Gallicano K, Oliveras L, Khaliq S, Hawley-Foss N, Garber G "Cations in the didanosine tablet reduce ciprofloxacin bioavailability." Clin Pharmacol Ther 53 (1993): 292-7
Deppermann KM, Lode H "Fluoroquinolones: interaction profile during enteral absorption." Drugs 45 Suppl 3 (1993): 65-72
Sahai J "Avoiding the ciprofloxacin-didanosine interaction." Ann Intern Med 123 (1995): 394-5
Shiba K, Sakamoto M, Nakazawa Y, Sakai O "Effects of antacid on absorption and excretion of new quinolones." Drugs 49(Suppl 2) (1995): 360-1
Polk RE "Drug-drug interactions with ciprofloxacin and other fluoroquinolones." Am J Med 87 (1989): s76-81
Knupp CA, Barbhaiya RH "A multiple-dose pharmacokinetic interaction study between didanosine (videx(r)) and ciprofloxacin (cipro(r)) in male subjects seropositive for HIV but asymptomatic." Biopharm Drug Dispos 18 (1997): 65-77
Marchbanks CR "Drug-drug interactions with fluoroquinolones." Pharmacotherapy 13 (1993): s23-8
"Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Lincolnshire, IL.
"Product Information. Cipro (ciprofloxacin)." Bayer, West Haven, CT.
Damle BD, Mummaneni V, Kaul S, Knupp C "Lack of Effect of Simultaneously Administered Didanosine Encapsulated Enteric Bead Formulation (Videx EC) on Oral Absorption of Indinavir, Ketoconazole, or Ciprofloxacin." Antimicrob Agents Chemother 46 (2002): 385-91
Nix DE, Watson WA, Lener ME, et al "Effects of aluminum and magnesium antacids and ranitidine on the absorption of ciprofloxacin." Clin Pharmacol Ther 46 (1989): 700-5
"Product Information. Videx (didanosine)." Bristol-Myers Squibb, Princeton, NJ.
Mizuki Y, Fujiwara I, Yamaguchi T "Pharmacokinetic interactions related to the chemical structures of fluoroquinolones." J Antimicrob Chemother 37 Suppl A (1996): 41-55

Cipro Iv Minibags

Generic Name: ciprofloxacin

Brand name: Cipro IV, Cipro, Cipro XR, Proquin XR

Synonyms: Cipro I.V. (injection)

What is Cipro Iv Minibags?

Didanosine

Generic Name: didanosine

Brand name: Videx, Videx EC

Synonyms: n.a.

What is Didanosine?

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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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