Ciprofloxacin and dasatinib

Hi David,
You may already have seen this but just in case you haven't it seems that ciprofloxacin (an antibiotic) can cause moderately serious interaction with dasatinib.

Also it seems to have potential interactions with NSAIDs so if you are taking painkillers like aspirin or neurofen (ibuprofen) you should check that too.

Quote:
Using dasatinib together with ciprofloxacin can increase the risk of an irregular heart rhythm that may be serious. You may need a dose adjustment or special monitoring by your doctor to safely use both medications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats during treatment with these medications......

http://www.drugs.com/drug-interactions/ciprofloxacin-with-dasatinib-672-...

Sandy

Hi All
Two points
1.If you consider the Blood article by Haouala et al you will note that under Quinolones there is listed Cyprofloxacin in bold type with specific studies cited where there has been evidence of interaction between this drug and all the TKIs;"increased Imatinib exposure" and for both Dasatinib and Nilotinib "QT interval/monitor ECG".Ciproflocacin is a second generation fleuroquinolone or often referred to as a quinolone -these are a powerful family of drugs used in the past to treat anthrax I believe.Taken on their own there may be serious side effects such as tendinitis or at worst tendon rupture.
The Blood article lists Doxycyclin but there are no entries for interaction with TKIs.
2.Personal experience-a while ago I was prescribed Ofloxacin(Taravid) for a urinary issue-same family as cyprofloxacin.I took it at the same time as Imatinib and then on holiday in Thailand was affected by severe hip muscle inflammation which had to be treated with steroid injections to relieve the pain.Could not fly and had to return home later than planned.Travel insurance paid up fortunately.Took 3 months to clear up.The hospital suggested drug interaction as the cause.

Given my own experience I would not entertain taking any of the quinolones as well as a TKI unless it was a life threatening condition.
Final point you might check Epocrates the drug-drug interaction checker.
Trust this helps
John W

Thanks John,

Luckily, I do not appear to have suffered any adverse effects. I understand though that tendon problems can appear many months after taking these. I do suffer from tendon problems (Achilles) but these predated me taking ciprofloxacin and haven't got any worse since.

In my case, the other antibiotic (Augmentin) I took had no effect and I had lost 7kg at this point, so the GP was pretty keen to nuke whatever was causing the problem. It certainly did the trick and I've put back on 3kg of the 7kg I had lost. That took a bit of explaining at the weigh-in at my last clinic appointment!

Thanks,
David.

Hi David, why do you think that it was okay to take Cipro with Dasatinib?

I have a UTI and the doctor wants to prescribe Cipro. I have tried to ask my hematologist but have no response yet.

 Thanks.

Thanks David. You, sharing your experience is so helpful.

My hematologist finally answered me and said that the combination was okay for a short period 5-7 days. I am waiting for one more result to be sure that I have to take it....

Hi Eva,

I don't know anything about Trimethoprim but you are right, the drug interaction checker (https://www.rxlist.com/drug-interaction-checker.html) says it is OK with Sprycel.