Sucralfate and Ofloxacin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Sucralfate
Ofloxacin
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Decreased ofloxacin effectiveness
Interaction Deep Dive
Pharmacokinetic studies have shown that concurrent use of some quinolones (ofloxacin, norfloxacin, ciprofloxacin) and sucralfate results in decreased quinolone serum concentrations1234. There is a lack of clinical information on the therapeutic outcome of this interaction; one case report details a ciprofloxacin-sucralfate interaction 5. It is recommended to administer ciprofloxacin at least 2 hours before or 6 hours after sucralfate 6. Although this recommendation has not been specifically made for ofloxacin, the same administrative delay may be appropriate for other quinolones.
Why it happens (mechanism)
Decreased ofloxacin absorption due to chelation
Literature reports
1 report — tap to read
a) A randomized, 3-period crossover, pharmacokinetic, single-dose study in eight healthy subjects found that administration of ofloxacin 400 mg two hours before sucralfate 1 g minimized the interaction of the two drugs. Ofloxacin was given alone, simultaneously with sucralfate, and two hours before sucralfate with a 7-day washout period between treatments. When ofloxacin was given simultaneously with sucralfate, mean ofloxacin AUC decreased from 29.5 +/- 7.4 to 11.5 +/- 2.7 mcg/mL/h (a decrease of 61%, P less than 0.001) and mean Cmax decreased from 3 +/- 0.7 to 0.9 +/- 0.2 mcg/mL (a decrease of 70%, P less than 0.001) compared with ofloxacin alone. When ofloxacin was given two hours before sucralfate, there were no significant differences in any of the pharmacokinetic parameters. Absorption of ofloxacin was probably completed before the administration of sucralfate; a mean Tmax of less than two hours was seen in the ofloxacin alone and ofloxacin preceding sucralfate treatment periods 1.
Common questions
Can I take Sucralfate and Ofloxacin together?
Decreased ofloxacin effectiveness Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sucralfate and Ofloxacin interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Sucralfate or Ofloxacin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (6)
- Lehto P & Kivisto KT: Effect of sucralfate on absorption of norfloxacin and ofloxacin. Antimicrob Agents Chemother 1994; 38:248-251. PubMed
- Parpia SH, Nix DE, Hejmanowski LG, et al: Sucralfate reduces the gastrointestinal absorption of norfloxacin. Antimicrob Agents Chemother 1989; 33:99-102. DOI
- Nix DE, Watson WA, Handy L, et al: The effect of sucralfate pretreatment on the pharmacokinetics of ciprofloxacin. Pharmacotherapy 1989; 9:377-380. PubMed
- Van Slooten AD, Nix DE, Wilton JH, et al: Combined use of ciprofloxacin and sucralfate. DICP 1991; 25:578-582. DOI
- Yuk JH, Nightingale CN, & Quintiliani R: Ciprofloxacin levels when receiving sucralfate (letter). JAMA 1989; 262:901. DOI
- Product Information: CIPRO(R) oral tablets, oral suspension, ciprofloxacin hydrochloride oral tablets, oral suspension. Schering-Plough, Kenilworth, NJ, 2005. DailyMed
Keep reading about Sucralfate
Keep reading about Ofloxacin
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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