Cipro (ciprofloxacin) is a prescription drug that’s used to treat certain bacterial infections. This drug can interact with other medications and some supplements. For example, Cipro can interact with certain antidepressants and antacids.
Cipro is used in adults and some children to treat many different bacterial infections. A few examples include:
- sinusitis
- urinary tract infection
- certain bone and skin infections
Cipro comes as an oral tablet and an oral liquid suspension (a type of liquid mixture). This drug contains the active ingredient ciprofloxacin. (An active ingredient is what makes a drug work.)
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Cipro’s possible interactions. And for more information about Cipro, including details about its uses, see this article.
Certain health conditions or other factors could raise your risk of harm if you take Cipro. In such cases, your doctor may not prescribe Cipro for you. These are known as contraindications. The list below includes contraindications of Cipro.
If you take tizanidine. If you take tizanidine (Zanaflex), your doctor likely won’t prescribe Cipro. Tizanidine is a muscle relaxer used to provide relief for muscle spasms.
Taking Cipro with tizanidine could increase your risk of certain side effects from tizanidine. These include excessive sleepiness, low heart rate, and low blood pressure.
Before starting Cipro treatment, tell your doctor if you take tizanidine. They can recommend a different treatment that may be a better option for you than Cipro.
If you’ve had an allergic reaction. If you’ve had an allergic reaction to Cipro or any of its ingredients, your doctor likely won’t prescribe Cipro. This is because taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better options for you.
Before you start taking Cipro, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Cipro is safe for you to take.
It should be safe to drink alcohol during Cipro treatment. The drug is not known to interact with alcohol.
But keep in mind that drinking alcohol while taking Cipro could make certain side effects of the drug worse. Examples include nausea and vomiting. (For more information about Cipro’s side effects, see this article.)
If you drink alcohol, talk with your doctor about how much is safe to drink while you’re taking Cipro.
Before you start taking Cipro, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Cipro interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Cipro?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The chart below lists drugs that may interact with Cipro. Keep in mind that this chart does not include all drugs that may interact with Cipro. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
| certain antidepressants | • duloxetine (Cymbalta) • venlafaxine (Effexor XR) • sertraline (Zoloft) • citalopram (Celexa) • fluoxetine (Prozac) | can increase the risk of side effects from Cipro* and antidepressants |
| certain antiarrhythmics | • lidocaine (Xylocaine) • sotalol (Betapace, Sorine) • amiodarone (Nexterone, Pacerone) • quinidine • procainamide | can increase the risk of side effects from Cipro and antiarrhythmics |
| macrolide antibiotics | • azithromycin (Zithromax) • erythromycin (E.E.S., Ery-Tab, EryPed) • clarithromycin | can increase the risk of side effects from Cipro and macrolides |
| sulfonylureas | • glyburide (Diabeta, Glynase) • glimepiride (Amaryl) • glipizide (Glucotrol XL) | can increase the risk of side effects from Cipro and sulfonylureas |
| antipsychotics | • aripiprazole (Abilify, Aristada) • quetiapine (Seroquel, Seroquel XR) • brexpiprazole (Rexulti) • clozapine (Clozaril, Versacloz) • haloperidol (Haldol) | can increase the risk of side effects from Cipro and antipsychotics |
| nonsteroidal anti-inflammatory drugs (NSAIDs) | • meloxicam (Mobic) • ibuprofen (Advil, Motrin) • naproxen (Aleve, Naprosyn) | can increase the risk of side effects from Cipro |
| certain antacids | • aluminum hydroxide/ magnesium hydroxide (Maalox) • calcium carbonate (Tums) | can make Cipro less effective than usual |
| sildenafil (Viagra, Revatio) | — | can increase the risk of side effects from sildenafil |
| theophylline (Elixophyllin, Theo-24) | — | can increase the risk of side effects from theophylline |
| warfarin (Jantoven) | — | can increase the risk of side effects from warfarin |
| tizanidine (Zanaflex)† | — | can increase the risk of side effects from tizanidine |
| zolpidem (Ambien, Edluar, Zolpimist) | — | can increase the risk of side effects from zolpidem |
| omeprazole (Prilosec) | — | can make Cipro less effective than usual |
* Cipro has a
† To learn more about this interaction, see the “When should I avoid Cipro?” section above.
Learn more about certain drug interactions that can occur with Cipro.
Interaction with certain antidepressants
Taking Cipro with certain antidepressants could increase the risk of side effects from Cipro and antidepressants.
Examples of these antidepressant medications include:
- duloxetine (Cymbalta)
- venlafaxine (Effexor XR)
- sertraline (Zoloft)
- citalopram (Celexa)
- fluoxetine (Prozac)
What could happen
Both Cipro and certain antidepressants have a risk of abnormal heart rhythm as a side effect. Taking Cipro with such antidepressants could further increase the risk of this side effect.
What you can do
Before taking Cipro, tell your doctor if you take an antidepressant. They’ll determine whether it’s safe to take these drugs together.
If you do take Cipro with an antidepressant, your doctor will advise you on your risk of abnormal heart rhythm as a side effect. If you develop an abnormal heart rhythm, you may not have any symptoms of this condition. But possible symptoms include:
- heart rate that feels faster or slower than usual
- fluttering sensation in your chest or neck
- the feeling of your heart skipping a beat
Tell your doctor if you have these symptoms. They’ll check your heart rhythm and recommend what to do if you have this side effect.
Interaction with omeprazole
Taking Cipro with omeprazole (Prilosec) could make Cipro less effective than usual.
Omeprazole is a proton pump inhibitor. The drug is used to treat conditions such as heartburn and gastroesophageal reflux disease (GERD).
What could happen
Taking Cipro with omeprazole could lower the level of Cipro in your body. Having a low level of Cipro could make the drug less effective for treating your condition.
What you can do
Before starting Cipro treatment, tell your doctor if you take omeprazole. They can recommend whether it’s safe for you to take these medications together.
If you take Cipro with omeprazole, your doctor may monitor you for symptoms of the infection you’re using Cipro to treat.
If your infection isn’t getting better, they may recommend that you stop taking omeprazole. This would allow the level of Cipro in your body to increase. And having a higher level of Cipro could make the drug more effective. Alternatively, your doctor may give you a different antibiotic.
Interaction with sildenafil (Viagra, Revatio)
Taking Cipro with sildenafil (Viagra, Revatio) could increase the risk of side effects from sildenafil.
The brand-name versions of sildenafil treat different conditions in adults: Viagra is used to treat erectile dysfunction (ED), and Revatio is used to treat pulmonary arterial hypertension (PAH).
What could happen
Taking Cipro with sildenafil could increase the level of sildenafil in your body. Having a high level of sildenafil could increase your risk of side effects from the drug.
What you can do
Before taking Cipro, tell your doctor if you take sildenafil or its brand-name versions. They’ll determine whether it’s safe to take these drugs together.
If you take Cipro with sildenafil, your doctor will tell you how to watch for sildenafil’s side effects. And they’ll recommend what to do if you have them.
Cipro may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Cipro.
Does Cipro interact with supplements?
Before you start taking Cipro, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Cipro and herbs
There are currently no reports of Cipro interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before using any of these products while taking Cipro.
Cipro interactions with minerals and vitamins
Cipro may interact with mineral supplements such as magnesium, calcium, zinc, and iron. Taking these mineral supplements with Cipro can lower the level of Cipro in your body. This could make Cipro less effective than usual for treating your condition.
Due to this risk, be sure to take Cipro at least 2 hours before or 6 hours after consuming magnesium, calcium, zinc, or iron supplements. Doing this should help prevent these supplements from affecting the Cipro level in your body.
There are currently no reports of Cipro interacting with vitamins. But multivitamins often contain magnesium, calcium, zinc, or iron, which are known to interact with Cipro. So it’s still important to check with your doctor or pharmacist before taking any vitamin products during Cipro treatment.
Does Cipro interact with food?
Cipro may interact with certain foods and drinks. These include dairy products, such as yogurt and milk, as well as juices that have calcium added to them.
Taking Cipro with these products may lower the level of Cipro in your body. Having a lower level of Cipro could make the drug less effective than usual at treating your condition.
Due to this risk, be sure to take Cipro at least 2 hours before or 6 hours after consuming any dairy products or juices that have calcium. Doing this should help prevent these foods and drinks from affecting the Cipro level in your body.
To learn more about how specific foods or drinks may affect Cipro, talk with your doctor or pharmacist.
Does Cipro interact with vaccines?
Cipro may interact with vaccines for cholera and tuberculosis (TB). Getting a cholera or TB vaccine while taking Cipro could make these vaccines less effective.
For this reason, it’s best to wait to get these vaccines until at least 2 weeks after your last Cipro dose. Your doctor can tell you when it’s safe to get a cholera or TB vaccine after Cipro treatment ends.
Does Cipro interact with lab tests?
There are currently no reports of Cipro interacting with lab tests. If you have questions about getting certain lab tests during Cipro treatment, talk with your doctor.
Does Cipro interact with cannabis or CBD?There are currently no reports of Cipro interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Cipro.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Cipro. Before taking Cipro, talk with your doctor about your health history. They’ll determine whether Cipro is right for you.
Health conditions or other factors that might interact with Cipro include:
Tendon problems. Cipro may cause torn or swollen tendons. If you have tendon problems, taking Cipro might worsen them. In fact, Cipro has a
Myasthenia gravis. Cipro may worsen myasthenia gravis in people who already have the condition. In fact, Cipro has a boxed warning about this risk. This is a serious warning from the FDA. To learn more, see “Boxed warnings” at the beginning of this article.
Liver problems. If you have liver problems, such as liver failure, tell your doctor before starting Cipro treatment. Having liver problems may increase your risk of certain liver side effects from Cipro. Your doctor can recommend whether Cipro is the right treatment for your condition.
Kidney problems. If you have kidney problems, such as kidney failure, tell your doctor before starting Cipro treatment. They may have you take a lower Cipro dosage than usual.
Seizures. Cipro may cause seizures as a side effect. The risk of this side effect may be higher for people who have a seizure disorder, such as epilepsy. Before starting Cipro treatment, tell your doctor if you have a seizure disorder. They’ll let you know whether it’s safe for you to take Cipro.
Diabetes. Cipro may affect blood sugar levels, especially in people who have diabetes and are taking diabetes medications. In rare cases, taking Cipro can cause severely low blood sugar levels that may lead to coma or may even be fatal for people with diabetes. If you have diabetes, your doctor can tell you whether it’s safe to take Cipro.
Abnormal heart rhythm. Cipro may cause an abnormal heart rhythm as a side effect. Your risk may be higher if you already have a condition that affects your heart’s electrical activity. An example is long QT syndrome. If you have an abnormal heart rhythm, talk with your doctor about whether you can safely take Cipro.
Pregnancy. It’s not known whether Cipro is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Cipro.
Breastfeeding. Cipro can pass into breast milk, which may cause side effects in a breastfed child. If you’re considering breastfeeding while taking Cipro, talk with your doctor.
Allergic reaction. If you’ve had an allergic reaction to Cipro or any of its ingredients, your doctor will likely not prescribe Cipro. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Find answers to some frequently asked questions about Cipro and possible interactions.
Does Cipro interact with Macrobid?
No, Cipro isn’t known to interact with nitrofurantoin (Macrobid).
Cipro and Macrobid are antibiotics. Both are used to treat certain bacterial infections, including urinary tract infections. But doctors usually won’t prescribe Cipro and Macrobid together. Instead, they’ll prescribe one medication or the other to treat your infection.
If you have additional questions about Cipro and Macrobid, talk with your doctor or pharmacist.
Do Cipro and Synthroid interact?
No, Cipro is not known to interact with levothyroxine (Synthroid).
Synthroid is used to treat underactive thyroid and thyroid cancer in specific situations. The drug is a human-made version of a certain thyroid hormone found naturally in the body.
To learn more about Cipro and Synthroid, talk with your doctor or pharmacist.
Is it safe to take Cipro with Xarelto?
Yes, it should be safe to take Cipro with rivaroxaban (Xarelto). These drugs aren’t known to interact.
Xarelto is a blood thinner used to treat or help prevent blood clots in certain situations. Cipro does interact with a different blood thinner called warfarin (Jantoven). For more information about this interaction, see the “Does Cipro interact with other drugs?” section above.
To learn more about Cipro and Xarelto, talk with your doctor or pharmacist.
Taking certain steps can help you avoid interactions with Cipro. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Cipro treatment.
It’s also important to read Cipro’s
You may see colored stickers on the label that describe interactions. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Cipro, ask your pharmacist to print a copy for you.) If you have trouble understanding this information, your doctor or pharmacist can help.
Taking Cipro exactly as prescribed can also help prevent interactions.
If you still have questions about Cipro and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Does my Cipro dosage affect my risk of interactions?
- What should I do if I start a new medication while I’m taking Cipro?
- Do other antibiotics that treat my condition have similar interactions?
To learn more about Cipro, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.