Moderate
Acetylsalicylic acid × Ciprofloxacin
Antiplatelet agents (low dose) / NSAIDs (analgesic dose)×Fluoroquinolone antibacterials
Mechanism
Old experimental data suggested NSAIDs combined with fluoroquinolones increase CNS excitability and seizure risk (via GABAergic suppression). Clinical data are very limited.
Symptoms
Mostly asymptomatic. In patients with prior epilepsy or head injury: rare seizure cases.
Management
The combination is acceptable in patients without prior epilepsy. In epilepsy or eating disorders: alternative antibiotics (a cephalosporin, nitrofurantoin) and paracetamol for analgesia.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Sources
- Lexicomp: Lexicomp Drug Interactions (2024)– Wolters Kluwer Clinical Drug Information, Inc. Lexi-Interact Online, 2024
- Pharmaceutical Press: Stockley's Drug Interactions, 12th edition (2024)– Preston CL (ed.). Stockley's Drug Interactions. 12th ed. London: Pharmaceutical Press; 2024