Ciprofloxacin Timing Relative to Chelating Agents

General Separation Recommendations

• Ciprofloxacin should be taken at least 1–2 hours before or 4 hours after any chelating agents—including antacids containing aluminum or magnesium, calcium supplements, iron supplements, magnesium supplements, aluminum‑containing preparations, and zinc supplements—to avoid a clinically significant reduction in absorption (Thorax 2017). 1

Interaction with Phosphate Binders

• When using phosphate binders such as sevelamer or lanthanum carbonate, ciprofloxacin must also be separated by ≥ 1 hour before or ≥ 4 hours after the binder to preserve drug bioavailability (Thorax 2017). 8