Cipronat Drug Interactions

Concurrent administration of Cipronat and theophylline may cause undesired increase of blood plasma concentration of the latter and development of side effects. Accordingly, blood plasma theophylline concentration must be monitored, and its dose appropriately adjusted downwards.
Combined administration of very large doses of quinolones (gyrase inhibitors) and certain non-steroid anti-inflammatory drugs (including acetylsalicylic acid) may cause convulsions.
Concurrent administration of Cipronat and cyclosporine has in some cases caused increase of serum creatinine; in such patients, this parameter must be monitored frequently (twice per week).
In case of concurrent administration of Cipronat and warfarin, the latter's effect may be intensified. The interaction of Ciprofloxacin and glibenclamide may intensify the effect of the latter, causing hypoglycemia.
Concurrent administration of Cipronat and probenecid increases blood plasma ciprofloxacin concentrations.
Concurrent administration of Cipronat and methotrexate may slow down tubular transport (renal metabolism) of the latter which may cause increased blood plasma methotrexate concentrations and increase the probability of methotrexate-related side effects. Due to this,
patients, receiving combined therapy of methotrexate and Cipronat, require close monitoring.
Metoclopramide accelerates ciprofloxacin absorption, therefore shortening the time required to reach maximal blood plasma ciprofloxacin concentration (this does not impact the bioavailability of the latter).
Clinical trial with healthy volunteers receiving Cipronat and tizanidine simultaneously demonstrated increase of blood plasma tizanidine concentration (Cmax increasing 7 times, the range-4-21 times; concentration-time AUC-10 times, the range-6-24 times).
Increase of blood serum tizanidine concentration is associated with hypotensive and sedative side effects. Therefore, concurrent administration of Cipronat and tizanidine is contraindicated.
Clinical trials showed that concurrent administration of duloxetine and powerful CYP450 1A2 enzyme inhibitors (such as fluvoxamine) may cause increase of duloxetine AUC and Cmax. Despite the lack of clinical data on interaction with Cipronat, the possibility of interaction is anticipated in case of ciprofloxacin and duloxetine concurrent administration.
Cipronat may be used in combination with azlocillin and ceftazidime against infections caused by Pseudomonas; with mezlocillin, azlocillin and other effective beta-lactam antibiotics against streptococcal infections; with isoxazole penicillins and vancomycin against staphylococcal infections; with metronidazole and clindamycin against anaerobic infections.