Pharmacokinetic interaction of ciprofloxacin with diclofenac: a single-dose, two-period crossover study in healthy adult volunteers.
OBJECTIVE
Ciprofloxacin is a broad-spectrum, synthetic antibacterial used for the treatment of various bacterial infections. In multidrug therapy, ciprofloxacin is commonly prescribed with analgesics for the management of infection, pain and inflammation. The objective of this study was to evaluate the pharmacokinetic properties of ciprofloxacin tablets with concurrent administration of diclofenac tablets in healthy adult human volunteers.


METHODS
The disposition pharmacokinetics of a single oral dose of ciprofloxacin 500 mg alone and with co-administration of a diclofenac 50 mg tablet in 12 healthy male volunteers was investigated using a two-period, crossover design. The blood samples were collected at 0 (predose), 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16 and 24 hours after administration of the drugs and the concentration of ciprofloxacin in serum was determined using reversed phase high-performance liquid chromatography. The pharmacokinetic parameters were calculated using a noncompartmental model and a two-compartment model.


RESULTS
The maximum plasma concentration (C(max)) of ciprofloxacin increased from 2.48 +/- 0.33 microg/mL when administered alone to 3.91 +/- 0.8 microg/mL with co-administration of diclofenac. Time to reach C(max) (t(max)) with ciprofloxacin reduced from 2.02 +/- 0.3 hours when administered alone to 1.49 +/- 0.2 h with co-administration of diclofenac. Significant increases in ciprofloxacin area under the serum concentration-time curve (AUC) and elimination half-life, together with a significant decrease in total body clearance of ciprofloxacin, were observed with concurrent administration of diclofenac.


CONCLUSIONS
Oral co-administration of ciprofloxacin tablets with diclofenac tablets increased ciprofloxacin AUC and C(max), and reduced ciprofloxacin t(max) and total body clearance.
Iqbal
Zafar
Z
Department of Pharmacy, University of Peshawar, Peshawar, North Western Frontier Province, Pakistan. zafar_iqbal@upesh.edu.pk
Khan
Abbas
A
Naz
Attiqa
A
Khan
Jamshaid A
JA
Khan
Ghulam S
GS
D000890:Anti-Infective Agents / Q000493:pharmacokinetics*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000493:pharmacokinetics*; D019540:Area Under Curve; D001682:Biological Availability; D002851:Chromatography, High Pressure Liquid; D002939:Ciprofloxacin / Q000493:pharmacokinetics*; D018592:Cross-Over Studies; D004008:Diclofenac / Q000493:pharmacokinetics*; D004338:Drug Combinations; D004347:Drug Interactions; D006207:Half-Life; D006801:Humans; D008657:Metabolic Clearance Rate; D013607:Tablets; D014018:Tissue Distribution; D055815:Young Adult
D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D013607:Tablets; D004008:Diclofenac; D002939:Ciprofloxacin