Pharmacokinetic Interaction of Ciprofloxacin with Diclofenac

Iqbal, Zafar; Khan, Abbas; Naz, Attiqa; Khan, Jamil; Khan, Ghulam Sarwar

doi:10.2165/00044011-200929040-00006

Cited by 15 publications

(6 citation statements)

References 20 publications

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“…There are different aspects of drug interaction at the pharmacokinetics and pharmacodynamics levels (17). In the present study, the pharmacokinetic parameters following intravenous administration of ciprofloxacin in quail were very similar to those reported previously conducted in humans and animals (18)(19)(20)(21). but there is no study on this type of interaction in quail birds, therefore we have conducted this study.…”

Section: Discussionsupporting

confidence: 86%

Effect of diclofenac on the pharmacokinetics of ciprofloxacin in quail

Alabdaly¹

2021

IJVS

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This study investigated the Pharmacokinetics of ciprofloxacin alone or with diclofenac sodium in adult Japanese quails. The quails divided into two groups, the first group was dosed intraperitoneally with 50 mg/kg of ciprofloxacin, the second group was injected by 50 mg/kg of ciprofloxacin intraperitoneally then directly injected intraperitoneally by diclofenac sodium at a dosage of 5 mg/kg. Plasma concentrations of ciprofloxacin were determined by the spectrophotometer at wavelength 290 nm. Co-admiration of ciprofloxacin with diclofenac lead to appearing ciprofloxacin in plasma at 12.02, 6.4, 5.3, 3.30, 1.36, 0.60 μg/ml in the periods of 0.25, 0.50, 1, 2, 4 and 8 hours post-injection. A significantly increased in the concentration of ciprofloxacin at times of 0.25, 0.50, 1, and 2 hours post-injection and appeared at a concentration of 6.96, 3.09, 2.2, and 0.72 μg/ml. The pharmacokinetics of ciprofloxacin when given with diclofenac sodium was represented by 91% decrease in elimination constant rate, 53% decrease in elimination half-life t1/2, 64% decrease in volume of distribution to steady-state, 22% decrease in clearance, 28% increase area under curve, 41% decrease in area under moment curve, 53% decrease in mean residence time and 37% increase in maximum plasma concentration. Our study concludes that co-administration of ciprofloxacin with diclofenac sodium lead to alteration in some pharmacokinetic data of ciprofloxacin like effect on the plasma concentration and volume of distribution and clearance. This effect must be considered when therapy by ciprofloxacin with diclofenac, the co-administration of diclofenac with ciprofloxacin decrease the elimination of ciprofloxacin.

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Section: Discussionsupporting

confidence: 86%

Effect of diclofenac on the pharmacokinetics of ciprofloxacin in quail

Alabdaly¹

2021

IJVS

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“…Administration of 30 mg/kg bw DCF sodium for 30 days to male rats caused hepatorenal like injuries that recorded in the present study [20]. Similarly, hepatorenal and the area under the curve (AUC) while decreases the total body clearance of CIP [34]. This may explain that co-administration of CIP could attenuate enterohepatic circulation of DCF and alleviated DCF-induced enteropathy.…”

Section: Figure 4kidney Tissues Of Group a Show Normal Glomeruli (White Arrows) Normal Renal Tubules (Black Arrows) With Intact Well Orgasupporting

confidence: 70%

Hepatorenal Effects of Diclofenac and Ciprofloxacin in Rats

Abdelgadir

Alzaidi

Ramady³

et al. 2021

AJFSFM

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The toxic effect of diclofenac (DCF) sodium and Ciprofloxacin (CIP) on gene expression of cytochrome P450 oxidase (CYPs) and the histology of liver and kidney of male albino rat has been evaluated in this study. DCF and CIP were chosen since they are inhibitors for specific CYP enzymes. Thirty-five adult male albino rats were divided into 7 groups of 5 animals each (A, B, C, D, E, F and G) and were treated orally with drugs for 21 consecutive days. Group A served as the control while B and C were treated with 5.3, 10.6 mg/kg body weight (bw) DCF sodium and groups D and E were treated with 40 and 80 mg/kg bw CIP, respectively. Groups F and G were treated with a mixture of the low and the high doses of both drugs, respectively. Both drugs significantly downregulated the mRNA expression of CYP1a2, CYP3a4 and CYP2c9. They caused hepatorenal histological changes. In the liver, massive fibrosis, necrosis, inflammatory cell infiltration with hemorrhages and hydrophilic degeneration have been observed. A massive tissue injury with glomerular and tubular damages due to sever necrosis, degeneration of concomitant inflammatory cells and blood vessels congestion have been shown in renal tissues. Although DCF and CIP are still used as therapeutic drugs, their use should be limited as their chronic administration induces a toxic effect on human health.

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“…By contrast, 2 studies found a significant drug interaction increasing AUC. The study conducted by Sriwiriyajan et al 52 identified an interaction with itraconazole, while Iqbal et al 43 found an interaction with diclofenac. Both studies justified this effect by citing enzymatic inhibition of CYP3A4, which is related to the metabolism of ciprofloxacin.…”

Section: Resultsmentioning

confidence: 99%

“…The covariates of drug interaction, specifically the interactions with ferrous ions, calcium carbonate and diclofenac, were impactful. 39,43,45 Sriwiriyajana et al 52 found that ciprofloxacin decreased the metabolism of itraconazole, increasing its plasma concentration, which could potentially cause adverse drug reactions. The coadministration of these drugs should be approached with caution.…”

Section: Studies With Healthy Subjectsmentioning

confidence: 99%

Pharmacokinetics of oral ciprofloxacin in adult patients: A scoping review

Junkert,

Lazo,

Deffert

et al. 2023

Brit J Clinical Pharma

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AimTo map the literature on oral ciprofloxacin's pharmacokinetics and its implications for dose adjustments in specific populations.MethodsA scoping review was performed according to the Cochrane Collaboration and JBI and reported following the PRISMA‐ScR. Systematic searches on electronic databases were conducted to integrate the current evidence on ciprofloxacin's pharmacokinetics. The quality of the included studies was assessed using ClinPK's checklist.ResultsThe search yielded 55 relevant studies. Within the traditional pharmacokinetics studies (n=46), 86 profiles were examined (72 involving healthy patients and 14 with various clinical conditions). Oral ciprofloxacin's pharmacokinetics were influenced by covariates such as drug interactions (ferrous ions, calcium carbonate, diclofenac, and itraconazole), food interactions (calcium‐rich foods), elderly populations, and renal impairment. Notably, variability in pharmacokinetic parameters existed among subjects, regardless of their health status, underscoring the need for comprehensive population descriptions. Populational pharmacokinetics studies (n=9) identified significant covariates for hospitalized patients, such as creatinine clearance, plasma bicarbonate, estimated glomerular filtration rate, renal replacement therapy, age, sex, total bilirubin, fat‐free mass, dietary factors in renal disease, rifampicin for Cl models, and body weight for Vd models. Most pharmacokinetics/pharmacodynamics assessments concluded that 1200 mg/day provides a high Probability of Target Attainment for bacteria with MIC less than 0.5 mg. L‐1, aiming for an AUC0‐24/MIC > 125 h.ConclusionThis study offers a comprehensive overview regarding oral ciprofloxacin's pharmacokinetics across various health conditions. It highlights the complexities of ciprofloxacin's pharmacokinetics, emphasizing the importance of considering multiple factors in dose adjustments.

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Pharmacokinetic Interaction of Ciprofloxacin with Diclofenac

Abstract: Oral co-administration of ciprofloxacin tablets with diclofenac tablets increased ciprofloxacin AUC and C(max), and reduced ciprofloxacin t(max) and total body clearance.

Cited by 15 publications

References 20 publications

Effect of diclofenac on the pharmacokinetics of ciprofloxacin in quail

Effect of diclofenac on the pharmacokinetics of ciprofloxacin in quail

Hepatorenal Effects of Diclofenac and Ciprofloxacin in Rats

Pharmacokinetics of oral ciprofloxacin in adult patients: A scoping review

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