Drug interactions
Ciprofloxacin + Quinine
Severity: Major
Ciprofloxacin and Quinine: 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
Quinine can prolong the QT interval and ciprofloxacin may add to this effect, increasing the risk of serious ventricular arrhythmias. Ciprofloxacin may also reduce quinine clearance, which could raise quinine exposure.
What this interaction means in plain words
Ciprofloxacin and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Additive hERG channel blockade, with possible ciprofloxacin inhibition of CYP1A2/CYP3A4-mediated quinine metabolism.
What to do
Avoid the combination when an alternative antibiotic is available. If used, obtain an ECG, correct electrolytes and monitor for arrhythmia and quinine toxicity such as cinchonism.
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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine Contraindicated
Frequently asked questions
Can I take Ciprofloxacin with Quinine?
MediHelp rates the interaction as major. Ciprofloxacin and Quinine 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. Quinine can prolong the QT interval and ciprofloxacin may add to this effect, increasing the risk of serious ventricular arrhythmias. Ciprofloxacin may also reduce quinine clearance, which could raise quinine exposure.
How serious is the interaction between Ciprofloxacin and Quinine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination when an alternative antibiotic is available. If used, obtain an ECG, correct electrolytes and monitor for arrhythmia and quinine toxicity such as cinchonism.
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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