Why Must I Avoid Taking Ciprofloxacin with Milk?

Jillian O Keeffe

Oral medications like ciprofloxacin need to make their way past the gastrointestinal barrier and into the body to be effective. Some foods and drinks, if ingested at the same time as the medication, can interfere with the absorption of certain drugs. Ciprofloxacin with milk is one of these situations, and therefore doctors do not advise this combination.

Milk can interfere with the absorption of ciprofloxacin.
Milk can interfere with the absorption of ciprofloxacin.

Every drug has what is called "bioavailability." This is the percentage of the drug in the delivery method that manages to make its way into the blood circulation of the body. The percentage of the drug that is not included in the bioavailability may be broken down into other molecules, or may flush out of the body through urine or feces.

Doctors and pharmacists can offer specific recommendations, including avoiding taking it with milk, to make ciprofloxacin as effective as possible.
Doctors and pharmacists can offer specific recommendations, including avoiding taking it with milk, to make ciprofloxacin as effective as possible.

A 1991 study by the University of Turku in Finland analyzed the bioavailability of ciprofloxacin with milk, and other dairy products. Each participant in the study fasted overnight, and then ate yogurt, or drank milk or water along with a dose of ciprofloxacin. The researchers tested the plasma portion of the participants' blood over time. They found that those patients who only drank water had a higher concentration of drug circulation than those who ingested ciprofloxacin with milk or ate yogurt. The drug plasma concentrations of the milk drinkers were nearly half that of the water drinkers.

Casein is a major component of milk and other dairy products.
Casein is a major component of milk and other dairy products.

In 2010, researchers at Semmelweis University in Hungary found that the most likely culprit for this lack of absorption through the gastrointestinal tract was a protein called casein. Casein is a major component of milk and milk products like yogurt, and when it comes into contact with the drug it hampers absorption into the body. Manufacturers of ciprofloxacin products take this research into account when they write the product instructions for users.

Taking ciprofloxacin may cause some patients to experience sensitivity to light.
Taking ciprofloxacin may cause some patients to experience sensitivity to light.

All drugs, including antibiotics like ciprofloxacin, need to be present in the body at specific concentrations in order to do their job properly. Ciprofloxacin kills certain types of bacteria, such as those that cause legionellosis and some food poisonings, and low concentrations may not clear the infection. Doctors, therefore, need to know how much of a drug will do the job properly, and prescribe the dose accordingly.

Bacterial vaginosis does not typically respond to treatment that includes ciprofloxacin.
Bacterial vaginosis does not typically respond to treatment that includes ciprofloxacin.

Ciprofloxacin with milk together requires a patient to take more of the drug to cure an infection. As nearly all drugs have side effects, doctors do not wish to prescribe more medication than necessary. The risk of side effects from this particular drug include such dangerous complications as hallucinations, ruptured tendons or alterations in heartbeat. Possible complications for a patient who takes ciprofloxacin with milk can include a worsening of the infection.

Blurred vision is considered a non-serious side effect of taking ciprofloxacin.
Blurred vision is considered a non-serious side effect of taking ciprofloxacin.
Severe dizziness is considered a serious side effect of taking ciprofloxacin.
Severe dizziness is considered a serious side effect of taking ciprofloxacin.

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Discussion Comments

ddljohn

I heard that anti-acids should also be avoided with ciprofloxacin because anti-acids have calcium. Is this true?

literally45

@ankara-- Yes, this rule also applies to goat and sheep milk. Goat milk has a different type of casein than cow milk, but it still has casein. So it's going to limit the absorption of ciprofloxacin similarly.

I believe the half life of ciprofloxacin is four hours. So it takes four hours for half of the drug to be eliminated from the system. I don't know if this is the right way to calculate this, but I personally avoid milk products and calcium fortified foods for four hours before and after I take ciprofloxacin. Otherwise, the drug will be going to waste and it won't be effective.

bluedolphin

Does this also apply to goat milk or sheep milk?

I usually drink milk before or after medications because I have a very sensitive stomach and milk helps. I don't drink cow milk though, I drink goat milk.

Will this be a problem with ciprofloxacin?

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