Drug General Information (ID: DDIIGKWS0M)
Drug Name			Rosiglitazone		Drug Info		Ciprofloxacin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Thiazolidinediones				Quinolones/Antibiotics
Structure

Mechanism of Rosiglitazone-Ciprofloxacin Interaction (Severity Level: Moderate)
Increased risk of hypoglycemia Click to Show/Hide Mechanism Graph
Drug Name		Rosiglitazone				Ciprofloxacin
Mechanism 1		Hypoglycemic effects				Hypoglycemic effects
Key Mechanism Factor 1
		Factor Name		Hypoglycemia
		Factor Description		Hypoglycemia is a condition in which your blood sugar (glucose) level is below the standard range. It causes irregular or rapid heartbeat, pale skin, numbness of the lips, tongue or cheeks, and sweating.
Mechanism Description		Increased risk of hypoglycemia by the combination of Rosiglitazone and Ciprofloxacin
Antagonize the effect of antidiabetic agents Click to Show/Hide Mechanism Graph
Drug Name		Rosiglitazone				Ciprofloxacin
Mechanism 2		Antidiabetic agent				Hyperglycemia
Key Mechanism Factor 2
		Factor Name		Antidiabetic agents
		Factor Description		The hypoglycemic effect of antidiabetes may be reduced, leading to higher blood glucose, increased blood glucose fluctuations, and the possibility of hyperglycemic complications
Mechanism Description		Antagonize the effect of Rosiglitazone when combined with Ciprofloxacin
Mechanism 3		Antidiabetic agent				Hyperglycemic effects
Key Mechanism Factor 3
		Factor Name		Antidiabetic agents
		Factor Description		The hypoglycemic effect of antidiabetes may be reduced, leading to higher blood glucose, increased blood glucose fluctuations, and the possibility of hyperglycemic complications
Mechanism Description		Antagonize the effect of Rosiglitazone when combined with Ciprofloxacin

Recommended Action
Management		Blood glucose should be closely monitored whenever quinolones are prescribed to diabetic patients, especially if they are elderly, have renal impairment, or are severely ill. Patients should be apprised of the increased risk of dysglycemia and be particularly alert to potential signs and symptoms of hypoglycemia such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, palpitation, and tachycardia. If hypoglycemia occurs, patients should initiate appropriate remedial therapy immediately, discontinue the quinolone, and contact their physician. alternative antibiotics may need to be considered.

References
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23	Product Information. Baxdela (delafloxacin). Melinta Therapeutics, Lincolnshire, IL.
24	Product Information. Cipro (ciprofloxacin). Bayer, West Haven, CT.
25	Product Information. Factive (gemifloxacin). GeneSoft Inc, San Francisco, CA.
26	Product Information. Floxin (ofloxacin). Ortho Pharmaceutical Corporation, Raritan, NJ.
27	Product Information. Levaquin (levofloxacin). Ortho Pharmaceutical Corporation, Raritan, NJ.
28	Product Information. Noroxin (norfloxacin). Merck & Co, Inc, West Point, PA.
29	Product Information. Raxar (grepafloxacin). Glaxo Wellcome, Research Triangle Park, NC.
30	Product Information. Tequin (gatifloxacin) Bristol-Myers Squibb, Princeton, NJ.
31	Product Information. Trovan (trovafloxacin). Pfizer US Pharmaceuticals, New York, NY.
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