Sucralfate with Fleroxacin Interaction Details


Brand Names Associated with Sucralfate

  • Carafate®
  • Sucralfate

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Last updated Nov 25, 2023


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Interaction Effect

Decreased fleroxacin effectiveness


Interaction Summary

Studies have shown that norfloxacin and ciprofloxacin with sucralfate result in decreased quinolone concentrations. One pharmacokinetic study involving fleroxacin and sucralfate indicates that fleroxacin interacts with sucralfate to a lesser extent than other quinolones . There is a lack of clinical information on the therapeutic outcome of this interaction; one case report details a ciprofloxacin-sucralfate interaction . A manufacturer for ciprofloxacin recommends to administer ciprofloxacin at least 2 hours before or 6 hours after sucralfate. Although this recommendation has not been specifically made for fleroxacin, the same administrative delay may be appropriate for other quinolones .


Severity

Moderate


Onset

Rapid


Evidence

Probable


How To Manage Interaction

Concurrent administration of fleroxacin and sucralfate is not recommended. If concurrent use cannot be avoided, fleroxacin should be taken at least two hours before or six hours after sucralfate. Because staggered administration may not be completely reliable, aggressively monitor these patients for continued antibiotic efficacy.


Mechanism Of Interaction

Decreased fleroxacin absorption due to chelation


Literature Reports

A) In one study involving 20 volunteers, coadministration of fleroxacin and sucralfate resulted in a decrease in area under concentration-time curve (53.4 vs 70.3), a decrease in peak plasma concentration (3.9 vs 5.3) and an increase in time to peak plasma concentration (2.5 vs 1.7 hrs) for fleroxacin with sucralfate as compared to fleroxacin alone. These changes in fleroxacin pharmacokinetic parameters occurred to a lesser extent than changes seen with other quinolones and sucralfate. The relative bioavailability of fleroxacin given with sucralfate was 76% .

Sucralfate Overview

  • Sucralfate is used to treat and prevent the return of duodenal ulcers (ulcers located in first part of the small intestine). Treatment with other medications, such as antibiotics, may also be necessary to treat and prevent the return of ulcers caused by a certain type of bacteria (H. pylori) Sucralfate is in a class of medications called protectants. It sticks to damaged ulcer tissue and protects against acid and enzymes so healing can occur.

See More information Regarding Sucralfate

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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. 

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.