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Ofloxacin

Also indexed as: Floxin, Ocuflox

Illustration

Ofloxacin is a “fluoroquinolone” antibiotic used to treat bacterial infections. Ofloxacin is available in special preparations to treat eye infections and ear infections.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Beneficial May Be Beneficial: Side effect reduction/prevention—Taking these supplements may help reduce the likelihood and/or severity of a potential side effect caused by the medication.

Bifidobacterium longum*

Lactobacillus acidophilus*

Lactobacillus casei*

Saccharomyces boulardii*

Saccharomyces cerevisiae*

Beneficial May Be Beneficial: Supportive interaction—Taking these supplements may support or otherwise help your medication work better.

Saccharomyces boulardii*

Avoid Avoid: Reduced drug absorption/bioavailability—Avoid these supplements when taking this medication since the supplement may decrease the absorption and/or activity of the medication in the body.

Calcium

Iron

Magnesium

Zinc

Check Check: Other—Before taking any of these supplements or eating any of these foods with your medication, read this article in full for details.

Vitamin K

Depletion or interference

None known

Adverse interaction

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Minerals
Minerals including calcium, iron, magnesium, and zinc can bind to fluoroquinolones, including ofloxacin, greatly reducing drug absorption.1 Ofloxacin should be taken four hours before or two hours after consuming antacids (Maalox®, Mylanta®, Tumms®, Rolaids® and others) that may contain these minerals and mineral-containing supplements.2

Probiotics
A common side effect of antibiotics is diarrhea, which may be caused by the elimination of beneficial bacteria normally found in the colon. Controlled studies have shown that taking probiotic microorganisms—such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii—helps prevent antibiotic-induced diarrhea.3

The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast—such as Saccharomyces boulardii4 or Saccharomyces cerevisiae (baker’s or brewer’s yeast)5 —helps prevent recurrence of this infection. In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection.6 Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.

Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as “dysbiosis”). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.7

Vitamin K
Unlike with most other antibiotics, preliminary research suggests that people taking ofloxacin do not need to supplement vitamin K to protect against possible drug-induced depletion.8

Interactions with Foods and Other Compounds

Food
Ofloxacin may be taken with or without food; food slows the absorption but not the total amount of ofloxacin absorbed from.9 10 Milk does not alter ofloxacin absorption.11

References:

1. Lomaestro BM, Bailie GR. Quinolone-cation interactions: a review. DICP 1991;25:1249–58.

2. Threlkeld DS, ed. Systemic Anti-Infectives, Fluoroquinolones. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1994, 340q–0r.

3. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870–6 [review].

4. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870–6 [review].

5. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer’s yeast. Lancet 1994;343:171–2.

6. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981–8.

7. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870–6 [review].

8. Verho M, Malerczyk V, Rosenkranz B, Grotsch H. Absence of interaction between ofloxacin and phenprocoumon. Curr Med Res Opin 1987;10:474–9.

9. Dudley MN, Marchbanks CR, Flor SC, Beals B. The effect of food or milk on the absorption kinetics of ofloxacin. Eur J Clin Pharmacol 1991;41:569–71.

10. Neuvonen PJ, Kivisto KT. Milk and yoghurt do not impair the absorption of ofloxacin. Br J Clin Pharmacol 1992;33:346–8.

11. Dudley MN, Marchbanks CR, Flor SC, Beals B. The effect of food or milk on the absorption kinetics of ofloxacin. Eur J Clin Pharmacol 1991;41:569–71.

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