Drug interactions
Ciprofloxacin + Tolbutamide
Severity: Moderate
Ciprofloxacin and Tolbutamide: moderate 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
Fluoroquinolones can cause serious hypoglycemia in patients taking sulfonylureas. Ciprofloxacin may potentiate tolbutamide's glucose-lowering effect, and the elderly or those with renal impairment are at greater risk.
What this interaction means in plain words
Ciprofloxacin and Tolbutamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Ciprofloxacin belongs to Anti Bacterial; Tolbutamide belongs to Endocrine.
Why it happens
Additive insulin secretion stimulation; ciprofloxacin may also modestly reduce sulfonylurea clearance.
What to do
Monitor blood glucose closely when starting ciprofloxacin and counsel on hypoglycemia symptoms. Reduce the tolbutamide dose if hypoglycemia occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Ciprofloxacin with Tolbutamide?
MediHelp rates the interaction as moderate. Ciprofloxacin and Tolbutamide can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fluoroquinolones can cause serious hypoglycemia in patients taking sulfonylureas. Ciprofloxacin may potentiate tolbutamide's glucose-lowering effect, and the elderly or those with renal impairment are at greater risk.
How serious is the interaction between Ciprofloxacin and Tolbutamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose closely when starting ciprofloxacin and counsel on hypoglycemia symptoms. Reduce the tolbutamide dose if hypoglycemia occurs.
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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