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Norfloxacin and Food

Result of checking the interaction of Norfloxacin and Food for safety when used together.

Check result:
Norfloxacin <> Food
Relevance: 03.07.2019 Reviewer: Shkutko P.M., M.D., in

When checking interaction based on authoritative sources Drugs.com, Rxlist.com, Webmd.com, Medscape.com there are contraindications or side effects that may cause harm or increase the negative effect from drug interaction with food or lifestyle.

Consumer:

Taking norfloxacin with food or products that contain minerals like calcium, iron, magnesium and zinc can interfere with its absorption and reduce its levels in the blood and urinary tract. This may make the medication less effective in treating your infection. You should take norfloxacin on an empty stomach at least one hour before or two hours after eating a meal or consuming milk or other dairy products. Do not use mineral supplements, multivitamins, antacids, or other products that may contain calcium, iron, magnesium or zinc within the two-hour period before or after taking norfloxacin. Talk to your doctor or pharmacist 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 medication without first talking to your doctor.

Professional:

ADJUST DOSING INTERVAL: Concurrent ingestion of meals, dairy products (milk, yogurt) or calcium-fortified foods (i.e., cereal, orange juice) may decrease the absorption of oral norfloxacin. The mechanism is chelation of calcium and the quinolone, resulting in decreased bioavailability. In the case of orange juice, inhibition of intestinal transport mechanisms (P-glycoprotein or organic anion-transporting polypeptides) by flavones may also be involved.

MANAGEMENT: Oral norfloxacin should be taken at least one hour before or two hours after a meal, milk, or other dairy products or calcium-fortified foods.

References:
  • Yuk JH, Nightingale CH, Sweeney KR, Quintiliani R, Lettieri JT, Forst RW "Relative bioavailability in healthy volunteers of ciprofloxacin administered through a nasogastric tube with and without enteral feeding." Antimicrob Agents Chemother 33 (1989): 1118-20
  • Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67
  • "Product Information. Cipro (ciprofloxacin)." Bayer, West Haven, CT.
  • Noer BL, Angaran DW "The effect of enteral feedings on ciprofloxacin pharmacokinetics." Pharmacotherapy 10 (1990): 254
  • Neuhofel AL, Wilton JH, Victory JM, Hejmanowsk LG, Amsden GW "Lack of bioequivalence of ciprofloxacin when administered with calcium-fortified orange juice: a new twist on an old interaction." J Clin Pharmacol 42 (2002): 461-6
  • Wallace AW, Victory JM, Amsden GW "Lack of bioequivalence of gatifloxacin when coadministered with calcium-fortified orange juice in healthy volunteers." J Clin Pharmacol 43 (2003): 92-6
  • Yuk JH, Nightingale CH, Quintiliani R "Absorption of ciprofloxacin administered through a nasogastric or a nasoduodenal tube in volunteers and patients receiving enteral nutrition." Diagn Microbiol Infect Dis 13 (1990): 99-102
Norfloxacin

Generic Name: norfloxacin

Brand Name:

Synonyms: n.a.

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