Hopeful asked
I have been prescribed Cipro antibiotic for a cyst that was lanced and drained. I am currently taking Lexapro for anxiety. I checked the drug interaction checker and see that there is a possibility of a major drug interaction for irregular heart rhythm. Is there a safe antibiotic that doesn’t have this risk that is safe to take with Lexapro? I don’t have any heart problems, but I do have palpitations most likely due to anxiety.
Answer
You are correct that there is the potential for a major interaction between Lexapro (escitalopram) and Cipro (ciprofloxacin). Both drugs can cause QT-prolongation, increasing the risk of potentially life threatening arrhythmias.
In general, the concomitant use of drugs that cause QT prolongation should be avoided, especially in those with pre-existing conditions or risk factors, such as:
- Old age
- Slow heart rate
- Electrolyte imbalances (e.g. low potassium)
It should be noted that the actual incidence of the QT prolongation is relatively uncommon, but is serious when it does happen. If Cipro is the best course of therapy in your situation, it may be prudent to be closely monitored for evidence of QT prolongation or alterations of cardiac rhythm if you have risk factors.
In terms of antibiotics that are not associated with QT prolongation, there are certainly other options but you should speak to your doctor first regarding what antibiotic your infection will be susceptible too. Other options may include:
- Penicillin family antibiotics (e.g. amoxicillin)
- Cephalosporin family antibiotics (e.g. cephalexin)
- Sulfonamides (e.g. sulfamethoxazole)
- Tetracycline family antibiotics (e.g. doxycycline)
