Ciprofloxacin with Alosetron Interaction Details

Brand Names Associated with Ciprofloxacin

Brand Names Associated with Alosetron

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Nov 19, 2023

Interaction Effect

Increased plasma concentration and half-life of alosetron

Interaction Summary

Concomitant use of alosetron, a CYP1A2 substrate, and fluvoxamine, a strong CYP1A2 inhibitor, resulted in increased plasma concentrations and a prolonged half-life of alosetron. The probable mechanism of this interaction is inhibition of CYP1A2-mediated alosetron metabolism by fluvoxamine. Although not studied, coadministration of alosetron and moderate CYP1A2 inhibitors, such as fluoroquinolones, may also result in an increased concentration and half-life of alosetron. Therefore, coadministration of alosetron and moderate CYP1A2 inhibitors, including ciprofloxacin, should be avoided unless clinically necessary. If coadministration is clinically necessary, consider monitoring patients for increased alosetron adverse effects such as constipation, increased abdominal discomfort, and ischemic colitis.

Severity

Major

Onset

Delayed

Evidence

Theoretical

How To Manage Interaction

Concomitant use of alosetron and ciprofloxacin should be avoided. Concomitant use of alosetron and fluvoxamine, a strong CYP1A2 inhibitor, resulted in increased plasma concentrations and a prolonged half-life of alosetron. Although not studied, coadministration of alosetron and moderate CYP1A2 inhibitors, such as fluoroquinolones, may result in an increased concentration and half-life of alosetron. If coadministration is clinically necessary, consider monitoring patients for increased alosetron adverse effects such as constipation, increased abdominal discomfort, and ischemic colitis.

Mechanism Of Interaction

Inhibition of CYP1A2-mediated alosetron metabolism by ciprofloxacin

Literature Reports

A) Concomitant use of alosetron, a CYP1A2 substrate, and fluvoxamine, a strong CYP1A2 inhibitor, resulted in increased plasma concentrations and a prolonged half-life of alosetron. Healthy female volunteers (n=40) were given escalating doses of fluvoxamine (50 to 200 mg/day) for 16 days, with concomitant use of alosetron 1 mg on day 16. Mean alosetron plasma concentrations increased approximately 6-fold while the alosetron half-life increased approximately 3-fold .

Ciprofloxacin Overview

• Ciprofloxacin is used to treat or prevent certain infections caused by bacteria such as pneumonia; gonorrhea (a sexually transmitted disease); typhoid fever (a serious infection that is common in developing countries); infectious diarrhea (infections that cause severe diarrhea); and infections of the skin, bone, joint, abdomen (stomach area), and prostate (male reproductive gland), Ciprofloxacin is also used to treat or prevent plague (a serious infection that may be spread on purpose as part of a bioterror attack) and inhalation anthrax (a serious infection that may be spread by anthrax germs in the air on purpose as part of a bioterror attack). Ciprofloxacin may also be used to treat bronchitis, sinus infections, or urinary tract infections but should not be used for bronchitis and sinus infections, or certain types of urinary tract infections if there are other treatment options. Ciprofloxacin extended-release (long-acting) tablets are used to treat kidney and urinary tract infections; however, some types of urinary tract infections should only be treated with ciprofloxacin extended release tablets if no other treatment options are available. Ciprofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections.

• Antibiotics such as ciprofloxacin will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

Alosetron Overview

• Alosetron is used to treat diarrhea, pain, cramps, and the feeling of an urgent need to have bowel movements caused by irritable bowel syndrome (IBS; a condition that causes stomach pain, bloating, constipation, and diarrhea) in women who have diarrhea as their main symptom and have not been helped by other treatments. Alosetron is in a class of medications called 5-HT₃ receptor antagonists. Alosetron works by slowing the movement of stool (bowel movements) through the intestines.

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.

Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.

Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.

Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.