Can you take Aleve with Ciprofloxacin? (3+ interactions)

In this article, we will discuss whether Aleve can be taken with Ciprofloxacin or not. Furthermore, we’ll explore the potential interactions between them, what research suggests on this, the potential risks and side effects of taking them together and precautionary measures for their safe and effective use. 

Can you take Aleve with Ciprofloxacin? 

Taking Aleve with Ciprofloxacin is generally not considered safe because of their interactions. Both Aleve and Ciprofloxacin are known to cause gastrointestinal irritation and their concurrent use may exacerbate the risk of these side effects. (1)

Aleve belongs to the class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). It is a brand name for Naproxen which is FDA-approved for treating pain, inflammation and fever. It exerts its effects by blocking the activity of COX1 and COX2 enzymes which are responsible for the synthesis of prostaglandins (an inflammatory mediator). (2)

Ciprofloxacin, on the other hand, is an antibiotic. It belongs to a class of drugs known as fluoroquinolones. It is widely used in treating a broad range of bacterial infections including UTIs, respiratory tract infections and certain types of gastrointestinal infections among others. It works by inhibiting certain bacterial enzymes which are essential for bacterial replication and multiplication in the body. These enzymes are called DNA gyrase and Topoisomerase IV. (1)

If you’re considering taking Aleve with Ciprofloxacin, consult your healthcare provider. He/she will assess your specific situation and prescribe the medications accordingly. 

What are the potential interactions between Aleve and Ciprofloxacin? 

Both Aleve (Naproxen) and Ciprofloxacin are found to have potential interactions which can increase the risk of side effects. There is also a possibility that NSAIDs may reduce the elimination of Ciprofloxacin from the body, leading to its higher concentrations which contribute to more side effects. Some of the key interactions to be aware of include: (2,4)

Gastrointestinal effects: 

Both ciprofloxacin and Aleve can cause gastrointestinal irritation individually and using them together may increase the risk of gastrointestinal discomfort including upset stomach, risk of bleeding and ulceration. It’s general advice to patients to take these medications with meal or milk to decrease the intensity of gastric reactions

Kidney function:

When Ciprofloxacin and Aleve are used in combination, the risk of kidney-related potential side effects is generally increased. Ciprofloxacin, particularly at higher doses may cause acute interstitial nephritis (inflammation of the kidney tissues) and crystalluria. Whereas, NSAIDS like Naproxen can contribute to changes in kidney blood flow. Hence, affecting kidney functions. 

Central nervous system effects:

It is rare but possible that Ciprofloxacin can cause central nervous system side effects including seizures and Naproxen (Avele) is also associated with CNS side effects. So their concomitant use might exacerbate the risk of these side effects. 

Blood sugar levels:

There have been reports of altered blood sugar levels (both increases and decreases) with Ciprofloxacin and NSAIDs like Aleve can also to some extent affect blood sugar levels. Individuals who have diabetes and are taking these medications must monitor their BGL closely, especially with the combination of both of them. 

What does research suggest?

According to a case study, a 68-year-old woman who was taking regular medications for arthritis (NSAIDs), started a new antibiotic called Ciprofloxacin as she had developed a bone infection. Soon after taking the antibiotic with NSAIDs, she experienced dizziness, anxiety and tremors. (3)

To manage the condition, doctors stopped her arthritis treatment for a while and found that her symptoms improved right after she stopped taking NSAIDs with the antibiotic. When she resumed with another arthritis medication called Indomethacin (also an NSAID), she started to develop the signs of nerve problems. These nerve issues got better after her antibiotic treatment with Ciprofloxacin. (3)

This study clearly shows that the combination of ciprofloxacin with NSAIDs including Aleve (Naproxen) may exacerbate the potential for nerve-related and other side effects. 

The researchers also concluded that this could be because the drugs together may reduce the effects of a chemical in the brain called gamma-aminobutyric acid (GABA) and these reduced effects of GABA may be responsible for CNS side effects like tremors and anxiety. (3)

What are the benefits of taking Aleve and Ciprofloxacin together?

Some potential benefits of taking Aleve and Ciprofloxacin are discussed in the table below: (1,2)

How to ensure the safety of using Aleve and Ciprofloxacin together?

It’s crucial to ensure the safety of using Aleve and Ciprofloxacin together as a combination therapy. The foremost step is to consult your healthcare provider before starting any medication and provide them with the list of your past and current medical conditions and medications including all prescribed, OTC and herbal supplements. This will help your doctor to assess your specific situation and recommend the treatment plan as needed. (1)

Make sure to stick to the recommended dosage regimen, timings and frequency of your medications as provided by your doctor. Don’t try to alter the dose on your own or stop the medication at all without your doctor’s approval. Your doctor may advise you to take Aleve and Ciprofloxacin at different times as the gap between doses is important to avoid and reduce possible interactions. (4)

Be vigilant and report any unusual symptoms or side effects you might experience to your doctor. Set regular follow-up appointments so that your doctor can keep monitoring you and adjust the treatment as needed Both Aleve and Ciprofloxacin may also affect kidney functions so keeping an eye on them is crucial. 

Limit or stop the consumption of alcohol as it can interact with Ciprofloxacin and Avele as well, leading to an increased risk of gastrointestinal bleeding. Keep yourself well hydrated to reduce the risk of kidney infections. (1,4)

As a pharmacist, in my opinion, I have seen a lot of instances where healthcare providers have prescribed Aleve with antibiotics to treat certain conditions. Most people, at appropriate doses and the time gap between the administration of medications, tolerate them well, especially when taking them with meals as these meds could be hard on the liver and kidneys. 

My advice to you is to ask your doctor to give you paracetamol alongside antibiotics if NSAIDs are optional. Otherwise, be careful to follow the instructions precisely and reach out to your doctor in case you experience any discomfort. 

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