fluoroquinolones

Sucralfate contains aluminum which chelates fluoroquinolones in the GI tract, reducing absorption by 85-90% and rendering the antibiotic ineffective.

Separate administration by at least 6 hours. Give fluoroquinolone 2 hours BEFORE or 6 hours AFTER sucralfate. Monitor clinical response to antibiotic.

Source: Kimi deep-research + Cla · p656

Decreased absorption of fluoroquinolones.

Stagger administration of antacids and fluoroquinolones by 2 hours.

Source: KDT 7e · p656

Increased risk of hypoglycemia.

Not explicitly stated, but implies close monitoring of blood glucose.

Source: G&G 14e · p571

Increased risk of cardiotoxicity and arrhythmias.

Monitor QTc.

Source: Harrison 22e · p1172

Decreased oral absorption of fluoroquinolones.

Administer fluoroquinolone 2 h before or 6 h after interacting drug.

Source: Harrison 22e · p1172

Additive tendon toxicity

Avoid combination, esp. elderly

Source: Kimi deep-research + Cla

Iron-quinolone chelation

Separate by ≥2 h

Source: Kimi deep-research + Cla

Reduced absorption of fluoroquinolones

Administer fluoroquinolones at least 2-4 hours before or after oral iron. This interaction is less relevant for IV iron sucrose but important if oral iron is also being used.