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Letters |1 September 1995

Avoiding the Ciprofloxacin-Didanosine Interaction

Jan Sahai, PharmD

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  • Ottawa General Hospital; Ottawa, Ontario K1H 8L6; Canada
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TO THE EDITOR:
Because of multiple drug allergies and the emergence of drug-resistant mycobacterial infections, the fluoroquinolones are widely used in patients with human immunodeficiency virus infection. The absorption of ciprofloxacin is dramatically reduced when it is coadministered with didanosine [1]. The interaction is caused by complexation between the magnesium and aluminum cations and the ciprofloxacin molecule, which results in the formation of a nonabsorbable complex. Standard references and the package insert for recommendations for avoiding this interaction suggest separating the dosing schedules of the agents by 2 hours [2-4]. This suggestion is clearly incorrect. Nix and colleagues [5] have shown that ciprofloxacin must be administered 2 hours before antacids or at least 6 hours after antacids to avoid this drug interaction [5].
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Sahai J. Avoiding the Ciprofloxacin-Didanosine Interaction. Ann Intern Med. ;123:394–395. doi: 10.7326/0003-4819-123-5-199509010-00027

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Published: Ann Intern Med. 1995;123(5):394-395.

DOI: 10.7326/0003-4819-123-5-199509010-00027

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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