Drug General Information (ID: DDIUXTF87Z)
  Drug Name Ciprofloxacin Drug Info Ethotoin Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Quinolones/Antibiotics Anticonvulsants
  Structure

 Mechanism of Ciprofloxacin-Ethotoin Interaction (Severity Level: Moderate)
     Antagonize the effect of antiepileptic agents Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Ciprofloxacin Ethotoin
      Mechanism Lower seizure threshold Antiepileptic agent
      Key Mechanism Factor 1
Factor Name Antiepileptic agents
Factor Description The beneficial effects of antiepileptic drugs may be reduced, leading to an increase in seizure frequency or duration.
      Mechanism Description
  • Antagonize the effect of Ethotoin when combined with Ciprofloxacin 

Recommended Action
      Management Clinical monitoring of patient response, including serum hydantoin concentrations, is recommended when initiating or discontinuing ciprofloxacin. Patients should be advised to notify their physician if they experience a loss of seizure control or possible symptoms of hydantoin toxicity such as nausea, vomiting, tremors, ataxia, lethargy, slurred speech, visual disturbances, or changes in mental status. Adjustment of hydantoin dosages may be required.

References
1 Hull RL "Possible phenytoin-ciprofloxacin interaction." Ann Pharmacother 27 (1993): 1283
2 McLeod R, Trinkle R "Comment: unexpectedly low phenytoin concentration in a patient receiving ciprofloxacin." Ann Pharmacother 32 (1998): 1110-1
3 Otero MJ, Moran D, Valverde MP, DominguezGil A "Interaction between phenytoin and ciprofloxacin." Ann Pharmacother 33 (1999): 251-2