Joe asked
I was prescribed cipro and was wondering if ibuprofen was safe to take with it?
Answer
Cipro (Ciprofloxacin) is a fluoroquinolone antibiotic used in the treatment of bacterial infections. Ibuprofen is a non-steroidal anti-inflammatory (NSAID) medication used in the treatment of pain and inflammation. For most people, taking Cipro (Ciprofloxacin) and Ibuprofen together poses no problem.
However, there have been several reports of an increased risk of seizures when patients take NSAIDs (Ibuprofen) with quinolone antibiotics (Cipro). Patients with renal (kidney) disease, history of seizures or other neurological disorder may have additional risk and should discuss with his or her doctor before taking both together.
More information about both drugs is available below.
Cipro (Ciprofloxacin)
As stated above, Cipro (Ciprofloxacin) is a fluoroquinolone antibiotic used to treat infections. It is indicated in the treatment of the following infections:
- Urinary tract infections
- Cystitis
- Chronic prostatitis
- Bone and joint infections
- Intra-abdominal infections
- Infectious diarrhea
- Thyphoid fever
- Hospital acquired pneumonia
Cirpo is generally well tolerated but can cause the following side effects:
- Dizziness
- Insomnia
- Nervousness
- Somnolence
- Skin rash
- Diarrhea, vomiting or nausea
- Abdominal pain
- Upset stomach
- Fever
There are a couple of warnings with fluoroquinolone antibiotics that patients should be aware of. Should any of the following reactions occur, the patient's doctor or other health care provider should immediately be contacted. These warnings include:
- CNS Side Effects of seizures, nervousness, agitation, nightmares, confusion, tremors, paranoia, hallucinations, depression or suicidal thoughts.
- Peripheral neuropathy: Weakness, numbness or pain involving the nerves. Usually found in the hands and feet
- Tendinitis or tendon rupture: Medication should be discontinued at first sign of swelling, pain, inflammation or rupture. Can occur within hours of taking first dose or months after completion of therapy. Patients over the age of 60, on corticosteroid therapy or organ transplant patients may have an increased risk.
Ibuprofen
Ibuprofen is a non-steroidal anti-inflammatory (NSAID) pain reliever used for the treatment of aches, pain, fever and headache. It is typically dosed every 4 to 6 hours. Ibuprofen can be hard on the stomach. Taking with food or milk may help decrease stomach upset. Some other possible side effects include:
- Dizziness
- Headache
- Skin rash
- Fluid retention
- Abdominal pain
- Diarrhea, nausea, vomiting, constipation
- Tinnitus (ringing in the ears)
NSAID medications, like Ibuprofen, have the risk of causing stomach bleeding. Patients with stomach ulcers, bleeding risks, on anti-coagulants (blood thinners) are at a higher risk of having this complication when taking this drug. Patients who consume 3 or more alcoholic drinks a day, also are at a higher risk of complications.
Also, the FDA has a label warning for all NSAIDs stating NSAIDs cause an increased risk of cardiovascular events including life threatening myocardial infarction (MI) and stroke, even in patients with no risk factors.
Conclusion
Taking Cipro (Ciprofloxacin) and Ibuprofen together has a low risk of seizure. Patients with renal (kidney) disease, seizure history or other neurological disorder should discuss taking both medication with his or her doctor or other health care provider. Otherwise, for most patients, short term use of both medications should be fine.
Resources
Lexi-Comp, Inc. (Interact and Lexi-Drugs). Lexi-Comp, Inc; April 3, 2018.
