Ofloxacin interacts with antacids, blood thinners, and more. Learn which drugs, supplements, and foods to avoid while taking this fluoroquinolone antibiotic.
Drug interactions can make a medication less effective — or dangerously more potent. Ofloxacin is a fluoroquinolone antibiotic that interacts with a surprisingly long list of medications, supplements, and even some foods. Some of these interactions are serious enough to require avoiding the combination entirely.
This guide covers the major and moderate drug interactions you need to know about, plus practical advice on what to tell your doctor before starting Ofloxacin.
Drug interactions happen in a few main ways:
With Ofloxacin, all three types of interaction are in play. Let's go through them.
These interactions are the most clinically significant. Your doctor should be aware of all of them:
Common antacids like Maalox, Mylanta, Tums, and calcium carbonate supplements bind to Ofloxacin in your stomach, dramatically reducing absorption. This can make the antibiotic ineffective.
What to do: Take Ofloxacin at least 2 hours before or 2 hours after any antacid.
Sucralfate, used to treat stomach ulcers, significantly reduces Ofloxacin absorption through the same binding mechanism as antacids.
What to do: Take Ofloxacin at least 2 hours before Sucralfate.
Iron supplements (including multivitamins with iron) and zinc supplements chelate (bind to) Ofloxacin, reducing its absorption and effectiveness.
What to do: Separate doses by at least 2 hours.
Ofloxacin can increase the anticoagulant effect of Warfarin, raising the risk of bleeding — including serious internal bleeding.
What to do: If you take Warfarin, your doctor should monitor your INR (blood clotting levels) more frequently while you're on Ofloxacin. Report any unusual bruising or bleeding immediately.
Ofloxacin can increase Theophylline levels in your blood, raising the risk of Theophylline toxicity — symptoms include nausea, vomiting, tremors, and seizures.
What to do: Your doctor may need to reduce your Theophylline dose or monitor blood levels during treatment.
Non-steroidal anti-inflammatory drugs like Ibuprofen (Advil, Motrin), Naproxen (Aleve), and prescription NSAIDs can increase the risk of CNS stimulation and seizures when combined with Ofloxacin.
What to do: Use Acetaminophen (Tylenol) for pain relief instead if possible. If you must take an NSAID, discuss the risk with your doctor.
Taking corticosteroids with Ofloxacin significantly increases the risk of tendon rupture — one of the most serious fluoroquinolone side effects. This risk is especially high in patients over 60.
What to do: Tell your doctor if you take any corticosteroid, including inhaled steroids for asthma. They may choose a different antibiotic.
Ofloxacin can prolong the QT interval on an electrocardiogram, which increases the risk of a dangerous heart rhythm called torsades de pointes. Combining it with other QT-prolonging medications amplifies this risk. Common QT-prolonging drugs include:
What to do: Inform your doctor about all heart medications and psychiatric medications you take.
Ofloxacin can cause severe hypoglycemia (dangerously low blood sugar) when combined with diabetes medications like Insulin, Glipizide (Glucotrol), or Glyburide (Micronase).
What to do: Monitor your blood sugar more frequently while taking Ofloxacin. Know the signs of hypoglycemia: shakiness, sweating, confusion, dizziness, rapid heartbeat. Carry a fast-acting sugar source.
Ofloxacin may increase Cyclosporine levels, which can raise the risk of kidney damage and other toxicity.
Buffered Didanosine contains antacids that reduce Ofloxacin absorption. If both are needed, separate doses by at least 2 hours.
Probenecid decreases the renal clearance of Ofloxacin, meaning the antibiotic stays in your system longer at higher levels. Your doctor may need to adjust dosing.
Ofloxacin may increase Methotrexate levels, raising the risk of Methotrexate toxicity — including bone marrow suppression, liver damage, and kidney damage.
Beyond prescription drugs, several over-the-counter products interact with Ofloxacin:
A good rule of thumb: if it contains a metal ion (iron, calcium, magnesium, zinc, aluminum), take it at least 2 hours apart from Ofloxacin.
Dairy products (milk, yogurt, cheese) and calcium-fortified foods (orange juice, cereals) can reduce Ofloxacin absorption, though this effect is less pronounced than with Ciprofloxacin. To be safe, avoid consuming large amounts of dairy within 2 hours of taking your dose.
Unlike some other fluoroquinolones (particularly Ciprofloxacin), Ofloxacin has minimal effect on caffeine metabolism. You generally don't need to restrict caffeine intake while taking Ofloxacin, but be aware that caffeine can worsen insomnia — a common side effect.
Before starting Ofloxacin, make sure your doctor and pharmacist know about:
Don't assume your doctor knows about every OTC product you take. Be thorough — it could prevent a dangerous interaction.
Ofloxacin is an effective antibiotic, but it interacts with a wide range of medications, supplements, and foods. The most important interactions to remember are:
When in doubt, ask your pharmacist. They can check for interactions quickly and recommend timing adjustments or alternatives.
For more on Ofloxacin's side effects or how to save money on your prescription, check out our other guides. And if you need help finding Ofloxacin at a pharmacy near you, try Medfinder.
You focus on staying healthy. We'll handle the rest.
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