Antibiotics to Treat IBD

Antibiotics help kill bacteria in the GI tract. Learn about the three types of antibiotics used to treat IBD.

Metronidazole

What Is Metronidazole and What Is It Used For?

Metronidazole is an antibiotic that kills bacteria in the GI tract and is used to treat Crohn’s disease.

What Do I Need to Know Before Taking Metronidazole?

Metronidazole may be taken with or without food. It can be taken with milk to avoid an upset stomach.

What Are the Food and Drink Interactions?

• There are no known food interactions.
• Do not consume alcohol while taking metronidazole and for ~3 days afterward. This can cause severe upset stomach and headaches. Read the ingredients in your other medications that might contain alcohol (cough medicines and mouthwashes).

Are There Any Drug Interactions with Metronidazole?

Metronidazole may increase or decrease the effects of the following drugs:

• Birth control pills
• Phenobarbital
• Antacids
• Coumadin
• Cholestyramine
• Cimetidine (Tagamet®)
• Lithium
• Phenytoin (Dilantin®)

Is It Safe to Take Metronidazole for Long Periods of Time?

Yes, it appears to be safe for long term use.

What Are the Side Effects?

Minor

• Headache
• Fatigue
• Dry mouth
• Dark urine
• Dizziness or drowsiness
• Metallic taste in mouth
• Stomach cramps
• Nausea and vomiting
• Diarrhea

Major

• Mood changes
• Seizures
• Fever
• Unsteadiness
• Sore throat
• Numbness, pain or weakness in hands or feet

Ciprofloxacin

What is Ciprofloxacin and What is it Used For?

Ciprofloxacin is an antibiotic that kills bacteria. It can be helpful in controlling symptoms of Crohn’s disease.

What Do I Need to Know Before Taking Ciprofloxacin?

• Antibiotics work best when taken the same time each day.
• The best time to take ciprofloxacin is about 2 hours after a meal.
• Drink plenty of fluids to avoid kidney crystals from forming.
• Tablets may be crushed.
• If you are taking antacids (or supplements with iron, calcium or zinc), take Ciprofloxacin 2 hours before or 6 hours after taking these other medicines because they will affect the absorption of Ciprofloxacin.
• Limit your exposure to the sun while taking Ciprofloxacin.

What Are the Food or Drink Interactions?

Ciprofloxacin may increase the effects of caffeine.

Are There Any Drug Interactions with Ciprofloxacin?

Ciprofloxacin may increase the effects of the following drugs:

• Coumadin
• Phenytoin (Dilantin)
• Cyclosporine
• Glyburide

What Are the Side Effects?

Minor

• Headaches
• Indigestion
• Nausea
• Diarrhea
• Constipation
• High sensitivity to sunlight

Major

• Sore throat
• Fever
• Visual disturbances
• Risk of Achilles tendon rupture in athletes (rare)

Rifaximin (Xifaxan®)

What is Rifaximin and What is it Used For?

Rifaximin is an antibiotic that kills bacteria. The intestines absorb very little of rifaximin (less than 1%), so the effects are mostly found just inside the intestines. It can be effective for people with Crohn’s disease and people with irritable bowel syndrome.

Are There Any Drug Interactions with Rifaxamin?

Rifaximin does not appear to have any strong interactions with other medicines.

Is It Safe to Take Rifaxamin for Long Periods of Time?

Rifaximin is FDA-approved for short-term use of traveler’s diarrhea. Studies have shown it can be effective in Crohn’s disease for longer periods of time.

What Are the Side Effects?

Minor

• Fatigue
• Nausea
• Dizziness

Major

• C. diff infection

Rev. 11/2013