Ciprofloxacin (Cipro) can interact with other medications, some supplements, and certain foods. For example, ciprofloxacin can interact with some antidepressants, calcium supplements, and milk.
Ciprofloxacin oral tablet is a generic prescription drug used in adults and some children to treat certain bacterial infections. Examples of these infections include:
- urinary tract infections (UTIs)
- skin and soft tissue infections
- bone and joint infections
- lower respiratory infections, such as bronchitis
- gonorrhea
- chronic bacterial prostatitis
Ciprofloxacin is available as the brand-name drug Cipro.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions. Keep reading to learn about ciprofloxacin’s possible interactions. For a detailed overview, check out this in-depth ciprofloxacin article.
Before you start taking ciprofloxacin, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether ciprofloxacin interacts with herbs, vitamins, or supplements, see the “Are there other interactions with ciprofloxacin?” section.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The following table lists drugs that may interact with ciprofloxacin. Keep in mind that this table does not include all drugs that may interact with ciprofloxacin. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| antacids | • aluminum hydroxide/magnesium hydroxide (Maalox) • calcium carbonate (TUMS) • magnesium hydroxide/calcium carbonate (Rolaids) | can make ciprofloxacin less effective |
| corticosteroids | • hydrocortisone (Cortef) • methylprednisolone (Medrol) • prednisone | can increase the risk of tendon problems* |
| nonsteroidal anti-inflammatory drugs (NSAIDs) | • celecoxib (Celebrex) • ibuprofen (Advil, Motrin) • naproxen (Naprosyn, Aleve) | can increase the risk of seizures |
| certain antidepressants | • citalopram (Celexa) • duloxetine (Cymbalta) • fluoxetine (Prozac) • venlafaxine (Effexor XR) | can increase the risk of QT prolongation |
| certain antipsychotics | • aripiprazole (Abilify, others) • clozapine (Clozaril, Versacloz) • haloperidol (Haldol) • quetiapine (Seroquel) | can increase the risk of side effects from ciprofloxacin and certain antipsychotics |
| antiarrhythmics (drugs for an irregular heartbeat) | • amiodarone (Nexterone, Pacerone) • quinidine • procainamide | can increase the risk of an irregular heartbeat |
| certain diabetes medications (sulfonylureas) | • glimepiride (Amaryl) • glipizide (Glucotrol XL) • glyburide (Diabeta, Glynase) | can cause hypoglycemia (low blood sugar) |
| sildenafil (Viagra) | — | can increase the risk of side effects from sildenafil (Viagra) |
| theophylline (Theo-24, Theochron, Elixophyllin) | — | can increase the risk of side effects from theophylline |
| tizanidine (Zanaflex)† | — | can increase the risk of side effects from tizanidine |
| warfarin (Jantoven) | — | can increase the risk of side effects from warfarin |
| zolpidem (Ambien, others) | — | can increase the risk of side effects from zolpidem |
* Ciprofloxacin has a boxed warning about the risk of serious side effects, including tendon problems. This is a serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warnings” at the top of this article.
† Ciprofloxacin should not be used with this drug. For more information, see the following section: “When should I avoid ciprofloxacin?”
Certain health conditions or other factors could raise your risk of harm if you take ciprofloxacin. In such cases, your doctor may not prescribe ciprofloxacin for you. These are known as contraindications. The following list includes contraindications of ciprofloxacin.
If you take tizanidine (Zanaflex): If you take tizanidine, your doctor likely won’t prescribe ciprofloxacin for you. This is because taking the drug could increase the risk of side effects from tizanidine. Examples include low blood pressure and severe sleepiness. You can ask your doctor about other treatments that may be better options for you.
If you’ve had an allergic reaction: If you’ve had an allergic reaction to ciprofloxacin, any of its ingredients, or similar antibiotics called quinolones, your doctor likely won’t prescribe ciprofloxacin for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Before you start taking ciprofloxacin, talk with your doctor if any of these factors apply to you. Your doctor can determine whether ciprofloxacin is safe for you to take.
Ciprofloxacin is not known to interact with alcohol. But ciprofloxacin and alcohol can cause some similar side effects, such as headache, nausea, and vomiting. So you may be more likely to experience these side effects if you drink alcohol during your ciprofloxacin treatment.
If you have questions about consuming alcohol while taking ciprofloxacin, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with ciprofloxacin.
Interaction with certain antidepressants
Ciprofloxacin and certain antidepressants can both cause a type of abnormal heart rhythm called long QT syndrome. Taking ciprofloxacin with one of these antidepressants can raise your risk of this side effect or make it worse. Long QT syndrome can cause a dangerous irregular heartbeat.
Having electrolyte disturbances, such as low potassium or magnesium levels, can raise your risk of this side effect.
Ciprofloxacin can also slow the action of an enzyme (type of protein) that helps clear certain antidepressants from your body. Taking ciprofloxacin with one of these antidepressants can make the antidepressant build up in your body. This can raise your risk of side effects from the antidepressant.
Here are some antidepressants that may interact with ciprofloxacin:
- citalopram (Celexa)
- duloxetine (Cymbalta)
- fluoxetine (Prozac)
- venlafaxine (Effexor XR)
What you can do
Your doctor may avoid prescribing ciprofloxacin with certain antidepressants, especially duloxetine. If you take one of these antibiotics, you can ask your doctor about other antibiotics that may be safer for you.
If you take ciprofloxacin with certain antidepressants, your doctor may monitor you more closely. For example, they may order blood tests to check your electrolyte levels or an EKG to check your heartbeat. Tell your doctor right away if you have symptoms of an abnormal heart rhythm. These may include heart palpitations, dizziness, and fainting.
If you have questions about taking ciprofloxacin with an antidepressant, talk with your doctor or pharmacist.
Interaction with NSAIDs such as ibuprofen
NSAIDs are used to relieve pain and inflammation (swelling).
Taking ciprofloxacin with NSAIDs can increase your risk of seizures*, which are a possible side effect of ciprofloxacin. This interaction may be more likely if you take a high dose of ciprofloxacin.
Here are some NSAIDs that may interact with ciprofloxacin:
- celecoxib (Celebrex)
- ibuprofen (Advil, Motrin)
- naproxen (Naprosyn, Aleve)
* Ciprofloxacin has a boxed warning about the risk of serious side effects, including seizures. A boxed warning is a serious warning from the FDA. For more information, see “Boxed Warnings” at the start of this article.
What you can do
If you regularly take an NSAID, be sure to tell your doctor before taking ciprofloxacin. Your doctor may want to monitor you more closely if you take these drugs together.
You should talk with your doctor before taking an over-the-counter NSAID, such as ibuprofen, with ciprofloxacin. Your doctor can recommend whether this type of pain reliever is right for you.
If you take ciprofloxacin and an NSAID together, stop taking ciprofloxacin and contact your doctor right away if you experience a seizure.
If you have questions about taking ciprofloxacin with NSAIDs, talk with your doctor or pharmacist.
Interaction with antacids
Antacids are used to relieve indigestion and heartburn. Taking an antacid around the same time of day as ciprofloxacin can prevent your body from absorbing ciprofloxacin correctly. This can make ciprofloxacin less effective at treating your infection.
Here are some antacids that may interact with ciprofloxacin:
- aluminum hydroxide/magnesium hydroxide (Maalox)
- calcium carbonate (TUMS)
- magnesium hydroxide/calcium carbonate (Rolaids)
What you can do
To avoid this interaction, you should not take antacids in the 6 hours before and 2 hours after taking a dose of ciprofloxacin.
If you have questions about taking ciprofloxacin with antacids, talk with your doctor or pharmacist.
Ciprofloxacin may have other interactions. They could occur with supplements, foods, vaccines, or lab tests.
Here are additional interactions that may occur with ciprofloxacin. Note that this information does not include all other possible interactions with ciprofloxacin.
Does ciprofloxacin interact with supplements?
Before you start taking ciprofloxacin, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Ciprofloxacin and herbs
There are currently no reports of ciprofloxacin interacting with herbs. But this doesn’t mean interactions with herbs won’t be recognized in the future.
For this reason, it’s important to check with your doctor or pharmacist before taking any of these products while taking ciprofloxacin.
Ciprofloxacin interactions with vitamins and minerals
Ciprofloxacin can interact with certain mineral supplements, such as:
- calcium
- calcium and vitamin D
- chromium
- iron
- magnesium
- zinc
Taking these supplements around the same time of day as ciprofloxacin can prevent your body from absorbing ciprofloxacin correctly. This can make ciprofloxacin less effective at treating your infection.
To avoid this interaction, you should not take these supplements in the 6 hours before and 2 hours after taking a dose of ciprofloxacin.
Keep in mind that some multivitamins also contain minerals such as iron and calcium. You should not take these multivitamins in the 6 hours before and 2 hours after taking ciprofloxacin.
If you have questions about taking ciprofloxacin with vitamins or minerals, talk with your doctor or pharmacist.
Does ciprofloxacin interact with food?
Yes, ciprofloxacin can interact with certain foods. Examples include:
- dairy products, such as milk and yogurt
- juices that contain calcium
- products containing caffeine, such as coffee, tea, energy drinks, and dark chocolate
You should not take ciprofloxacin oral tablets with calcium-containing juices or dairy products, for example, with a glass of milk. This can stop your body from absorbing ciprofloxacin correctly. You should not consume these products in the 6 hours before and 2 hours after taking ciprofloxacin. However, you can take ciprofloxacin with meals that contain dairy products.
Your doctor may recommend avoiding caffeine or reducing your intake while taking ciprofloxacin. Ciprofloxacin can stop your body from breaking down caffeine, which raises your risk of side effects from caffeine, such as heart palpitations.
If you have questions about consuming other foods or drinks with ciprofloxacin, talk with your doctor or pharmacist.
Does ciprofloxacin interact with vaccines?
Ciprofloxacin can interact with vaccines for tuberculosis and cholera. You should not get these vaccines while you’re taking ciprofloxacin. Ciprofloxacin can make these vaccines less effective.
You should not get the cholera vaccine for at least 2 weeks after completing a course of ciprofloxacin. Your doctor can recommend when to get a tuberculosis vaccine after stopping ciprofloxacin.
If you have questions about getting certain vaccines during your ciprofloxacin treatment, talk with your doctor.
Does ciprofloxacin interact with lab tests?
There are currently no reports of ciprofloxacin interacting with lab tests. If you have questions about having certain lab tests during your treatment with ciprofloxacin, talk with the healthcare professional ordering the test.
Does ciprofloxacin interact with cannabis or CBD?There are currently no reports of ciprofloxacin interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with ciprofloxacin.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with ciprofloxacin. Before taking ciprofloxacin, talk with your doctor about your health history. They’ll determine whether ciprofloxacin is right for you.
Health conditions or other factors that might interact with ciprofloxacin include:
Tendon problems: Ciprofloxacin has a boxed warning for the risk of serious side effects, including tendon problems. A boxed warning is a serious warning from the FDA. For more information, see “Boxed Warnings” at the start of this article.
You may have a higher risk of tendon problems if you’re age over 60 years, take corticosteroid medications, or have had a heart, kidney, or lung transplant. You may also have a higher risk if you have kidney failure or you’ve had past tendon problems. If you have any of these risk factors, talk with your doctor about whether ciprofloxacin is right for you.
Myasthenia gravis: Ciprofloxacin has a boxed warning for the risk of serious side effects, including worsening myasthenia gravis. For more information, see “Boxed Warnings” at the start of this article.
If you have myasthenia gravis, your doctor will likely avoid prescribing ciprofloxacin for you. You can ask them about other treatment options that may be safer for you.
Heart problems: Ciprofloxacin can cause a type of abnormal heart rhythm called long QT syndrome. This side effect can cause a dangerous irregular heartbeat. If you have a heart problem, such as heart failure or a slow or irregular heartbeat, talk with your doctor about whether ciprofloxacin is safe for you.
Seizure disorders: Ciprofloxacin can cause seizures. If you have a seizure disorder such as epilepsy, you may have a higher risk of this side effect. Ciprofloxacin has a boxed warning for the risk of serious side effects, including seizures. For more information, see “Boxed Warnings” at the start of this article.
Diabetes: Ciprofloxacin can cause changes in blood sugar levels. If you have diabetes, you may have a higher risk of severe hypoglycemia (dangerously low blood sugar) while taking ciprofloxacin. Talk with your doctor about whether ciprofloxacin is right for you.
Liver problems: In rare cases, ciprofloxacin may cause liver damage. If you have a liver problem, you may have a higher risk of this side effect. Talk with your doctor about whether ciprofloxacin is right for you.
Kidney problems: Your kidneys help clear ciprofloxacin from your system. If you have kidney problems, ciprofloxacin can build up in your body. As this can raise your risk of side effects, your doctor will likely prescribe a dosage of ciprofloxacin that’s lower than usual.
Pregnancy: It’s not known whether ciprofloxacin is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking ciprofloxacin.
Breastfeeding: It may not be safe to take ciprofloxacin while breastfeeding. The drug passes into breast milk and may cause side effects in a child who is breastfed. Your doctor will likely recommend that you do not breastfeed while taking ciprofloxacin and for 2 days after stopping treatment. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to ciprofloxacin oral tablet, any of its ingredients, or similar antibiotics (called quinolones), your doctor will likely not prescribe ciprofloxacin. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better for you.
Find answers to some frequently asked questions about ciprofloxacin and possible interactions.
Can I eat bananas with ciprofloxacin?
Yes, you can eat bananas while taking ciprofloxacin. Bananas are not known to interact with this medication.
If you have questions about eating other foods while taking ciprofloxacin, talk with your doctor or pharmacist.
Can I take Tylenol with ciprofloxacin?
Yes, it’s usually considered safe to take acetaminophen (Tylenol) with ciprofloxacin. It’s not known to interact with ciprofloxacin. Acetaminophen is an over-the-counter pain reliever that also reduces fever. Your doctor may recommend taking acetaminophen to ease symptoms of the infection you’re taking ciprofloxacin to treat.
Keep in mind that some over-the-counter forms of acetaminophen also contain caffeine. You should avoid taking these products with ciprofloxacin. Ciprofloxacin can stop your body from breaking down caffeine as well as usual. So it can raise your risk of caffeine-related side effects, such as heart palpitations.
If you have questions about taking acetaminophen with ciprofloxacin, talk with your doctor or pharmacist.
Taking certain steps can help you avoid interactions with ciprofloxacin. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- the
list of medications you take, as well as any vitamins, supplements, and herbs - what to do if you start taking a new drug during your ciprofloxacin treatment
It’s also important to understand ciprofloxacin’s
If you did not get paperwork with ciprofloxacin, ask your pharmacist to print a copy for you. If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking ciprofloxacin exactly as prescribed can also help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.