Possible Interaction: Ciprofloxacin and Quinine

“Because of rising parasitemia (threefold higher at 36 h … admission) and deterioration of clinical status, three individuals required quinine treatment 36 … commencing ciprofloxacin ; a fourth was given quinine at 54 h. The study was terminated early … safety reasons after only four ciprofloxacin and four control patients had been enrolled.”

“ Ciprofloxacin may increase the adverse effects of concomitantly administered quinine , which can have serious consequences on the patient.”

“Thus, a downward dosage adjustment of quinine seems to be necessary when concurrently administered with ciprofloxacin.”

“… quinine … ciprofloxacin resulted in significant increases (P < 0.05) in the total area under the concentration–time curve, maximum plasma concentration (Cmax), and terminal elimination half-…. 21.43 ± 3.22 hours), whereas the oral plasma clearance markedly decreased (23.17 ± 6.49 vs. 16.00 ± 5.27 L/h).”

“Millions of Africans have to take two or three of them simultaneously (e.g. quinine and ciprofloxacin or praziquantel).”