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Cipro Iv Minibags and Pletal

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

Check result:
Cipro Iv Minibags <> Pletal
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:

Ciprofloxacin may increase the blood levels of cilostazol. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience increased side effects such as dizziness, lightheadedness, fainting, nausea, diarrhea. Bleeding, heart palpitations, or irregular heartbeat. 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:

MONITOR: Coadministration with inhibitors of CYP450 3A4 and/or 2C19 may increase the plasma concentrations of cilostazol and or its pharmacologically active metabolites, which are substrates of these isoenzymes. The possibility of prolonged and/or increased pharmacologic effects of cilostazol should be considered. In pharmacokinetic studies, pretreatment with a 400 mg priming dose of ketoconazole (a potent CYP450 3A4 inhibitor) one day prior to coadministration of single doses of ketoconazole 400 mg and cilostazol 100 mg resulted in a 94% increase in cilostazol peak plasma concentration (Cmax) and a 117% increase in cilostazol systemic exposure (AUC). Coadministration of the less potent inhibitor erythromycin (500 mg every 8 hours) with a single 100 mg dose of cilostazol resulted in a 47% and 73% increase in cilostazol Cmax and AUC, respectively, while AUC of 4-trans-hydroxycilostazol (an active metabolite with 1/5 the pharmacologic activity) increased by 141% as a result of the inhibition of cilostazol metabolism via CYP450 3A4. Coadministration with 180 mg of diltiazem, a moderate CYP450 3A4 inhibitor, decreased cilostazol clearance by 30% and increased its Cmax by 30% and AUC by 40%. In contrast, cilostazol metabolism was not significantly affected when coadministered with omeprazole, a potent CYP450 2C19 inhibitor, but the systemic exposure to 3,4-dehydrocilostazol (the most active metabolite of cilostazol) was increased by 69%.

MANAGEMENT: Close clinical and laboratory monitoring is advised whenever a CYP450 3A4 and/or 2C19 inhibitor is added to or withdrawn from cilostazol therapy, and the dosage adjusted as necessary. Patients should be advised to contact their physician if they experience adverse effects of cilostazol such as dizziness, nausea, diarrhea, bleeding, or irregular heartbeat.

References
  • Herrlin K, Segerdahl M, Gustafsson LL, Kalso E "Methadone, ciprofloxacin, and adverse drug reactions." Lancet 356 (2000): 2069-70
  • "Product Information. Pletal (cilostazol)." Otsuka American Pharmaceuticals, Rockville, MD.
  • McLellan RA, Drobitch RK, Monshouwer M, Renton KW "Fluoroquinolone antibiotics inhibit cytochrome P450-mediated microsomal drug metabolism in rat and human." Drug Metab Dispos 24 (1996): 1134-8
  • Suri A, Forbes WP, Bramer SL "Effects of CYP3A inhibition on the metabolism of cilostazol." Clin Pharmacokinet 37 (1999): 61-8
  • Suri A, Bramer SL "Effect of omeprazole on the metabolism of cilostazol." Clin Pharmacokinet 37 (1999): 53-9
  • Sriwiriyajan S, Samaeng M, Ridtitid W, Mahatthanatrakul W, Wongnawa M "Pharmacokinetic interactions between ciprofloxacin and itraconazole in healthy male volunteers." Biopharm Drug Dispos 32 (2011): 168-74
  • Hedaya MA, El-Afify DR, El-Maghraby GM "The effect of ciprofloxacin and clarithromycin on sildenafil oral bioavailability in human volunteers." Biopharm Drug Dispos 27 (2006): 103-10
  • Sawant RD "Rhabdomyolysis due to an uncommon interaction of ciprofloxacin with simvastatin." Can J Clin Pharmacol 16 (2009): e78-9
  • Shahzadi A, Javed I, Aslam B, et al. "Therapeutic effects of ciprofloxacin on the pharmacokinetics of carbamazepine in healthy adult male volunteers." Pak J Pharm Sci 24 (2011): 63-8
Cipro Iv Minibags

Generic Name: ciprofloxacin

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

Synonyms: Cipro I.V. (injection)

Pletal

Generic Name: cilostazol

Brand name: Pletal

Synonyms: n.a.

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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