Moxifloxacin with Dandelion Interaction Details
Brand Names Associated with Moxifloxacin
- Avelox®
- Moxifloxacin
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jan 04, 2024
Interaction Effect
Decreased fluoroquinolone effectiveness
Interaction Summary
Asian dandelion reduced oral absorption of ciprofloxacin in rats. Other fluoroquinolones may be similarly affected. Asian dandelion extract was found to contain magnesium, calcium, iron, manganese, zinc, and copper . Fluoroquinolones are capable of forming chelate complexes with metal ions, resulting in reduced bioavailability of the antibiotic with the potential of antibiotic treatment failure. High doses of Asian dandelion decoction, and possibly common dandelion leaf in equivalent amounts, may provide sufficient mineral content to interfere with quinolone antibiotic absorption.
Severity
Moderate
Onset
Rapid
Evidence
Theoretical
How To Manage Interaction
If possible, avoid concomitant use of Asian dandelion and fluoroquinolones. If Asian dandelion and a fluoroquinolone are taken together, Asian dandelion should be taken either 2 hours before or 4 to 6 hours after the fluoroquinolone.
Mechanism Of Interaction
Cation content of Asian dandelion may chelate the fluoroquinolone and impair absorption
Literature Reports
A) In rats dosed orally with an aqueous extract of Asian dandelion (Taraxacum mongolicum) 2 gram/kilogram, followed by an oral dose of ciprofloxacin (20 milligrams/kilogram (mg/kg)), ciprofloxacin pharmacokinetics were altered. Blood samples were taken every 30 minutes for 6 hours after dosing, and urine samples were collected over 24 hours. The plasma concentration-time data of ciprofloxacin were assessed by noncompartmental analysis. Maximum plasma concentration (Cmax) of ciprofloxacin was lowered by 73% from 1.31 milligrams/liter (mg/L) to 0.35 mg/L (p less than 0.005) with Tmax slightly prolonged by 16% (p less than 0.05) from 0.42 hours to 0.50 hours, suggesting reduced oral absorption of ciprofloxacin. Apparent drug distribution volume and terminal elimination half-life were increased 3-fold (p less than 0.005). Area under the curve (AUC) was not significantly different between Asian dandelion treatment and control. Relative bioavailability of ciprofloxacin as compared to control was estimated to be 0.96. However, the secondary effects on drug distribution and elimination induced by Asian dandelion may have complicated the estimator used for bioavailability .
B) Asian dandelion (T. mongolicum) extract was found to contain large amounts of cations including magnesium 5800 mcg/gram, calcium 4900 mcg/gram, iron 2300 mcg/gram, manganese 100 mcg/gram, zinc 60 mcg /gram, and copper 20 mcg/gram . The mineral content of Taraxacum officinale (common dandelion) leaves (converted to mcg/g) is: magnesium 1500 mcg/g, calcium 9600 mcg/g, iron 520 mcg/g, manganese 45 mcg/g, zinc 43 mcg/g, and copper 12 mcg/g. This is approximately one fourth the amount of magnesium and iron as is found in the T. mongolicum plant, one half the manganese, two thirds the amount of zinc, equivalent copper, and 2 times the calcium in comparison to T. mongolicum: magnesium 5760 mcg/g, calcium 4941 mcg/g, iron 2311 mcg/g, manganese 111.3 mcg/g, zinc 62.4 mcg/g, and copper 15.3 mcg/g. T. mongolicum plant has 13,200 mcg/g compared to 11,720 mcg/g for T. officinale leaves for these minerals alone .
C) Asian dandelion extract was found to contain large amounts of cations including magnesium 5800 mcg/gram, calcium 4900 mcg/gram, iron 2300 mcg/gram, manganese 100 mcg/gram, zinc 60 mcg /gram, and copper 20 mcg/gram .
Moxifloxacin Overview
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Moxifloxacin is used to treat certain infections caused by bacteria such as pneumonia, and skin, and abdominal (stomach area) infections. Moxifloxacin is also used to prevent and treat plague (a serious infection that may be spread on purpose as part of a bioterror attack. Moxifloxacin may also be used to treat bronchitis or sinus infections but should not be used for these conditions if there are other treatment options available. Moxifloxacin is in a class of antibiotics called fluoroquinolones. It works by killing the bacteria that cause infections.
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Antibiotics such as moxifloxacin 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.
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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:
The prescribing information for each drug, as published on DailyMED, is also used.
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