title: Iron-ovotransferrin preparation does not interfere with ciprofloxacin absorption.
abstract: Iron supplements can interfere with the bioavailability of a number of drugs, including thyroxine, tetracycline derivatives, penicillamine, methyldopa, levodopa, carbidopa, ciprofloxacin, and the newer fluoroquinolones. A new iron formulation was tested in which iron ions are bound to ovotransferrin, a protein that shares more than an 80% similarity with the sequence of human transferrin and apparently is less likely than the commonly used iron salts to reduce drug absorption. Ciprofloxacin was taken as a model drug, of wide use and restricted range of therapeutic levels, and its absorption was evaluated after the administration of the iron-ovotransferrin complex versus an iron-gluconate formulation in healthy volunteers. At variance with the iron gluconate formulation, which led to a reduction of about 50% of peak serum ciprofloxacin levels (Cmax; 1.0 +/- 0.2 versus 2.4 +/- 0.3 micrograms/ml; p < 0.01) and of the area under the serum concentration-time curve from time 0 to infinity [AUC(0 - infinity); 10.1 +/- 1.1 versus 18.3 +/- 1.0 mg.L-1.hr; p < 0.01], the iron-ovotransferrin complex caused only modest, non significant changes in absorption with a minimal reduction of the AUC[0 - infinity) (17.3 +/- 1.0 versus 18.3 +/- 1.0 mg.L-1.hr; difference not significant) and a nonsignificant decrease in the Cmax (2.2 +/- 0.3 versus 2.4 +/- 0.3 microgram/ml; difference not significant). Iron was also well absorbed from the formulation in the presence of a fatty meal. The very common drug interactions with oral iron preparations can be effectively prevented by the use of the iron-ovotransferrin complex interacting to a minimal extent with a sensitive drug with a reduced margin of efficacy, such as ciprofloxacin.
authors.affiliation: Center E. Grossi Paoletti, Ospedale Niguarda Cà Granda, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pazzucconi
authors.forename: S
authors.initials: S
authors.lastname: Barbi
authors.forename: D
authors.initials: D
authors.lastname: Baldassarre
authors.forename: N
authors.initials: N
authors.lastname: Colombo
authors.forename: F
authors.initials: F
authors.lastname: Dorigotti
authors.forename: C R
authors.initials: CR
authors.lastname: Sirtori
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000493:pharmacokinetics*; D002939:Ciprofloxacin / Q000493:pharmacokinetics*; D003207:Conalbumin / Q000494:pharmacology*; D004338:Drug Combinations; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D058085:Iron Compounds / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D012016:Reference Values
chemical_list: D000890:Anti-Infective Agents; D004338:Drug Combinations; D058085:Iron Compounds; D003207:Conalbumin; D002939:Ciprofloxacin