Authors: Mika J Jokinen Klaus T Olkkola Jouni Ahonen Pertti J Neuvonen
Publish Date: 2003/01/29
Volume: 58, Issue: 10, Pages: 653-657
Abstract
In a doubleblind randomised crossover study nine healthy volunteers were treated for 25 days with 500 mg oral ciprofloxacin or placebo twice daily On day 3 they received a single dose of 06 mg/kg ropivacaine intravenously over 30 min Ropivacaine 3hydroxyropivacaine 3OHropivacaine and S2′6′pipecoloxylidide PPX in venous plasma and urine were measured for up to 12 h and 24 h respectivelyCiprofloxacin decreased the mean clearance CL of ropivacaine by 31 P005 with a considerable interindividual variation range from −52 to +39 It also decreased the area under the plasma concentration–time curve AUC of 3OHropivacaine by 38 P005 and urinary excretion of 3OHropivacaine by 27 P005 Ciprofloxacin increased the AUC of PPX by 71 P001 and urinary excretion of PPX by 97 P001Ciprofloxacin modestly decreased the mean ropivacaine CL by inhibiting the CYP1A2mediated formation of 3OHropivacaine At the same time the CYP3A4mediated formation of PPX was increased There was a marked interindividual variation in the extent of the interaction and for some individuals the concomitant use of ciprofloxacin with ropivacaine might produce toxic symptomsWe thank Jouko Laitila Kerttu Mårtensson Mikko Neuvonen and Lisbet Partanen for the skilful determination of plasma and urine drug concentrations and Pirkko Herranen Anne Karhu Minna Korvenpää and Anja Liukko for excellent technical assistance This study was supported by grants from the Helsinki University Central Hospital Research Fund and the National Technology Agency of Finland TEKES and it complies with the current laws of Finland
Keywords: