Taking Iron With Antibiotics can be a serious problem, even a deadly one. If you are taking iron and are placed on antibiotics, particularly the fluoroquinolone class of antibiotics, then you must understand this very serious interaction in order to protect your health from this unwanted iron with antibiotics drug interaction. In fact, this is such a serious issue that it could even be deadly, let me explain.
First of all, if you are unaware of the serious dangers of the fluoroquinolone class of antibiotics, please read the excellent introduction to them on FQ Research’s Introduction to Fluoroquinolones page. Everyone should be aware of the potential health problems that can be caused by the fluoroquinolones, as well as the many Fluoroquinolone Drug Interactions so that you can avoid taking them unnecessarily whenever possible, and if you must take them, to avoid the many drug interactions that can do anything from reduce absorption of the drugs to causing permanent neurologic damage. They are really quite dangerous antibiotics and I hope that everyone reading will take a few minutes to become aware of the possible serious problems that can occur from taking them.
Second: the reason that taking iron with antibiotics can be a serious and even deadly problem is that mineral ions can bind to the antibiotics in a process known as chelation, and reduce the absorption of the antibiotics by excreting the new complex out through the body instead of allowing it to be absorbed by the digestive tract. 1 2. Naturally, this also causes the binding and excretion of the iron, which can lead to some unique disabling problems, and is explained in more detail on the Fluoroquinolones and Iron page over at the Fluoroquinolone Research Toxicity website.
“The absorption of all the fluoroquinolones
studied was significantly reduced when they
were co-administered with ferrous sulphate.” 3
There are many fluoroquinolone drugs including common ones you may have heard of, such as:
And many others. To see a full list of these drugs, again, see FQ Research’s page on the List of Fluoroquinolone and Quinolone Drugs. Each drug acts a little differently, but iron inhibited the absorption of all of the drugs from the smallest amount of 25% to the largest amount of 75%!
Other antibiotics that are also known to have reduced absorption when taking iron supplements are:
What this means to you is that if you were prescribed a drug like Cipro or Levaquin for a serious infection, if you were to take your iron with it, it could potentially cause it to not treat that infection. In the worst-case scenario, someone very sick could end up hospitalized or even die from the infection not being killed off, all because of the taking iron with antibiotics.
Need to Take Iron With Antibiotics?
If you end up needing to take iron and antibiotics, what should you do? Well, that’s a difficult choice. Some studies recommend spacing out the dosages of the drugs with a few hours in between the iron supplements and the antibiotics, but others show it’s unclear how long the spacing should be and recommend avoiding taking supplements or any other mineral-containing drugs, like antacids or acid blockers, while taking antibiotics, is that option is possible. 6
If it’s not possible to avoid taking iron with antibiotics because you simply must take the iron or other mineral containing supplements or drugs while you are on antibiotics, then space out the taking of these substances as far away from each other as possible, at least 3 hours with up to 6 hours or more between them being ideal. Also remember, though, that due to the actions of the hormone Hepcidin, taking iron supplements in the morning, rather than afternoon or evening, is critical for the best absorption of iron.
Additionally, if the iron supplementation is not absolutely critical, you may want to skip taking it when you have an infection for other reasons as well. Bacteria rely on iron for their reproduction, and having less iron available to them may make it more difficult for them to reproduce. So skipping the iron (if that is possible for you) when you have an infection can help to fight the infection by depriving pathogens of a vital nutrient they require to reproduce. 7 8 9.
While this may sound complicated, it’s extremely important to be aware of this iron and antibiotics interaction, and to understand how best to avoid complications when you are already taking iron and you end up on antibiotics. If you can stop taking your iron during an infection or while taking antibiotics of any kind, that is best, but if that is not possible, be sure to space the two substances out as far apart as possible to allow the antibiotics to work at their maximum effectiveness.
- Drug-drug interactions with ciprofloxacin and other fluoroquinolones ↩
- Fluoroquinolones: Interaction Profile during Enteral Absorption ↩
- The effect of ferrous sulphate on the absorption of norfloxacin,
ciprofloxacin and ofloxacin ↩
- Interactions with the Absorption of Tetracyclines ↩
- Iron supplements: a common cause of drug interactions ↩
- Effects of Ferrous Sulfate and Zinc on the Absorption of Ciprofloxacin ↩
- Iron Homeostasis Affects Antibiotic-mediated Cell Death in Pseudomonas Species ↩
- Role of Iron in Microbe-Host Interactions ↩
- Iron in Infection and Immunity ↩