Drug interactions
Ciprofloxacin + Pirfenidone
Severity: Major
Ciprofloxacin and Pirfenidone: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ciprofloxacin inhibits CYP1A2, the main enzyme metabolizing pirfenidone, and can substantially increase pirfenidone exposure. This raises the risk of nausea, photosensitivity rash, dizziness and other dose-related adverse effects.
What this interaction means in plain words
Ciprofloxacin and Pirfenidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Ciprofloxacin belongs to Anti Bacterial; Pirfenidone belongs to Miscellaneous.
Why it happens
Inhibition of CYP1A2-mediated pirfenidone metabolism by ciprofloxacin.
What to do
Reduce the pirfenidone dose as recommended in labeling when ciprofloxacin is required, and monitor tolerability. Consider a non-CYP1A2-inhibiting antibiotic if possible.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Ciprofloxacin
- Agomelatine + Ciprofloxacin Contraindicated
- Ciprofloxacin + Fezolinetant Contraindicated
- Ciprofloxacin + Thioridazine Contraindicated
- Ciprofloxacin + Tizanidine Contraindicated
- Ciprofloxacin + Vandetanib Contraindicated
- Alosetron + Ciprofloxacin Major
Other interactions of Pirfenidone
Frequently asked questions
Can I take Ciprofloxacin with Pirfenidone?
MediHelp rates the interaction as major. Ciprofloxacin and Pirfenidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ciprofloxacin inhibits CYP1A2, the main enzyme metabolizing pirfenidone, and can substantially increase pirfenidone exposure. This raises the risk of nausea, photosensitivity rash, dizziness and other dose-related adverse effects.
How serious is the interaction between Ciprofloxacin and Pirfenidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the pirfenidone dose as recommended in labeling when ciprofloxacin is required, and monitor tolerability. Consider a non-CYP1A2-inhibiting antibiotic if possible.
What other medicines interact with Ciprofloxacin?
MediHelp also lists interactions of Ciprofloxacin with, for example, Agomelatine, Fezolinetant, Thioridazine. The full list is on the Ciprofloxacin page.
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