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Effects of Paracetamol on the Pharmacokinetics of Ciprofloxacin in Plasma Using a Microbiological Assay

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Abstract

Background and objective: Pharmacokinetic drug interactions may result in a decrease or increase in the oral bioavailability of some drugs. Therefore, coadministration of drugs should be avoided, or at least undertaken only when careful therapeutic drug monitoring is possible. Because of the common practice of coadministering paracetamol (acetaminophen) for fever in patients taking the antibacterial ciprofloxacin for infection, we investigated the influence of paracetamol on the pharmacokinetics of ciprofloxacin.

Methods: In a randomised, two-way crossover study, 10 healthy male volunteers received a single oral dose of ciprofloxacin 500mg or ciprofloxacin 500mg plus paracetamol 500mg. Pharmacokinetic parameters were measured in plasma samples using a microbiological assay.

Results: No significant differences were found as a result of concomitant administration of paracetamol in the ciprofloxacin pharmacokinetic parameters oral clearance (CL/F) and apparent volume of distribution (Vd/F). However, the ratio of the area under the concentration-time curves (AUCs) suggested that paracetamol increases ciprofloxacin concentrations on average by 16%. Concomitant administration of paracetamol slightly increased ciprofloxacin AUC∞ from 14.37 ± 0.91 to 16.71 ± 0.99 μg · h/mL (p = 0.073) and ciprofloxacin maximum plasma concentration (Cmax) from 2.52 ± 0.18 to 2.61 ± 0.24 μg/mL (p = 0.113), while slightly decreasing time to ciprofloxacin Cmax from 1.5 to 1.3 hours (p = 0.376).

Conclusion: The results confirm an increased concentration-time profile of ciprofloxacin when the latter is coadministered with paracetamol. We believe that a pharmacokinetic interaction may have occurred.

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  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgements

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Pharmaceutical Analytical Chemistry Department, Alaqsa University, Gaza, Palestine

    Mahmoud Mohamed Issa

  2. Analytical Chemistry Department, Alaqsa University, PO Box 4051, Gaza, Palestine

    R’afat Mahmoud Nejem

  3. Organic Chemistry Department, Alaqsa University, Gaza, Palestine

    Naser Said El-Abadla

  4. Microbiology Department, Alaqsa University, Gaza, Palestine

    Mohamed Khamis El-Naby

  5. Microbiology Department, Ain Shams University, Cairo, Egypt

    Abeer Ahmed Roshdy & Zainab Assan Kheiralla

Authors
  1. Mahmoud Mohamed Issa
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  2. R’afat Mahmoud Nejem
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  3. Naser Said El-Abadla
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  4. Mohamed Khamis El-Naby
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  5. Abeer Ahmed Roshdy
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  6. Zainab Assan Kheiralla
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Correspondence to R’afat Mahmoud Nejem.

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Issa, M.M., Nejem, R.M., El-Abadla, N.S. et al. Effects of Paracetamol on the Pharmacokinetics of Ciprofloxacin in Plasma Using a Microbiological Assay. Clin. Drug Investig. 27, 463–467 (2007). https://doi.org/10.2165/00044011-200727070-00003

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  • DOI: https://doi.org/10.2165/00044011-200727070-00003

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