Sucralfate with Ofloxacin Interaction Details
Brand Names Associated with Sucralfate
- Carafate®
- Sucralfate
Brand Names Associated with Ofloxacin
- Floxin®
- Ofloxacin
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 25, 2023
Interaction Effect
Decreased ofloxacin effectiveness
Interaction Summary
Pharmacokinetic studies have shown that concurrent use of some quinolones (ofloxacin, norfloxacin, ciprofloxacin) and sucralfate results in decreased quinolone serum concentrations. There is a lack of clinical information on the therapeutic outcome of this interaction; one case report details a ciprofloxacin-sucralfate interaction . It is recommended to administer ciprofloxacin at least 2 hours before or 6 hours after sucralfate . Although this recommendation has not been specifically made for ofloxacin, the same administrative delay may be appropriate for other quinolones.
Severity
Moderate
Onset
Rapid
Evidence
Probable
How To Manage Interaction
Concurrent administration of ofloxacin and sucralfate is not recommended. If concurrent use cannot be avoided, ofloxacin 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 ofloxacin absorption due to chelation
Literature Reports
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 .
Sucralfate Overview
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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.
Ofloxacin Overview
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Ofloxacin is used to treat certain infections including pneumonia, and infections of the skin, bladder, reproductive organs, and prostate (a male reproductive gland). Ofloxacin may also be used to treat bronchitis and urinary tract infections but should not be used for bronchitis and some types of urinary tract infections if other treatments are available. Ofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections.
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Antibiotics such as ofloxacin 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.
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.