CIPROFLOXACIN HCL-FLUOCINOLONE (Generic for OTOVEL)

Ciprofloxacin 0.3%, Fluocinolone Acetonide 0.025%, Otic drops, solution

Caffeine-containing Foods/Beverages

· Severity: Moderate

· Notes for Consumers: Although an interaction is possible, these drugs can be used together. Side effects from Caffeine may get worse if you take these drugs together. Too much Caffeine can cause effects like nausea, nervousness, or sleeplessness. You may need to limit your Caffeine intake. Common foods and beverages containing caffeine include coffee, teas, colas and chocolate. Many non-prescription drugs and diet aids may also contain caffeine.

· Notes for Professionals: Reduction or limitation of the caffeine dosage in medications and limitation of caffeine in beverages and food may be necessary during concurrent ciprofloxacin therapy. Ciprofloxacin can decrease the clearance of caffeine. Caffeine toxicity may occur and can manifest as nausea, vomiting, anxiety, tachycardia, or seizures. Ciprofloxacin is a CYP1A2 inhibitor and caffeine is a CYP1A2 substrate.

Ciprofloxacin 0.3%, Fluocinolone Acetonide 0.025%, Otic drops, solution

Calcium-containing foods

· Severity: Major

· Notes for Consumers: Foods or beverages high in Calcium may reduce the effectiveness of your antibiotic therapy. Avoid taking oral Ciprofloxacin with dairy products (milk, yogurt) or calcium-fortified juices alone. However, you can take Ciprofloxacin with a meal that contains these products.

· Notes for Professionals: Do not administer oral ciprofloxacin with dairy products (e.g., milk, yogurt) or calcium-fortified juices alone; however, oral ciprofloxacin may be taken with a meal that contains these products. The absorption of oral ciprofloxacin may be decreased if taken with calcium-containing foods or beverages.

Ciprofloxacin 0.3%, Fluocinolone Acetonide 0.025%, Otic drops, solution

Enteral Feedings

· Severity: Major

· Notes for Consumers: Enteral feedings, such as Ensure or Sustacal, may decrease the actions of Ciprofloxacin, by decreasing its absorption from the stomach. Ciprofloxacin should be taken 2 hours before or 6 hours after any enteral feedings to limit an interaction. Let your health care provider know you are using Enteral Feedings. Contact your health care provider if your condition being treated by Ciprofloxacin does not improve.

· Notes for Professionals: Enteral feedings may decrease the serum concentrations of quinolone antimicrobials. The enteral formulation Ensure significantly decreased the serum concentrations of ciprofloxacin, levofloxacin, and ofloxacin tablets by 83%, 61%, and 46%, respectively, when they were crushed and mixed with 240 ml of Ensure. One study showed that enteral feedings given concurrently with ciprofloxacin via the oral or jejunostomy routes decreased the mean bioavailability of ciprofloxacin by 27 to 67%; however, ciprofloxacin serum concentrations after coadministration with enteral feedings via a gastrostomy tube were similar to concentrations following administration of ciprofloxacin on an empty stomach. Administration of ciprofloxacin and enteral feedings together through a nasogastric (NG) tube decreased the gastrointestinal absorption of ciprofloxacin minimally; MIC values remained high for many pathogenic bacteria. Ciprofloxacin should be taken either 2 hours before or 6 hours after enteral feedings.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>