Based on FDA | Is it true that I should avoid dairy products like milk or yogurt when taking ciprofloxacin, and how many hours before and after a dose should I separate them?

You’re right to be careful with dairy when taking ciprofloxacin. Dairy products such as milk or yogurt can lower how much ciprofloxacin your body absorbs, which may reduce its effectiveness; this effect has been shown in human studies and is reflected in official prescribing guidance. ^{[1] [2]}

What to do with dairy and ciprofloxacin

• Avoid taking ciprofloxacin together with dairy (like milk or yogurt) or calcium‑fortified juices “alone.” When ciprofloxacin is swallowed at the same time as these products, absorption can drop substantially. ^{[2] [1]}
• It is acceptable to take ciprofloxacin with a meal that contains small amounts of dairy (for example, a mixed meal that includes cheese or yogurt as part of the meal), because the interaction is most pronounced when dairy is the primary co‑administered item. ^[2]

How many hours to separate

• For products that contain mineral cations (calcium supplements, iron, zinc, magnesium/aluminum antacids, sucralfate, didanosine), take ciprofloxacin at least 2 hours before or 6 hours after those products. ^{[3] [4]}
• Guidance for dairy in official labeling is to not take ciprofloxacin with dairy alone; practically, many clinicians recommend using the same separation rule (2 hours before or 6 hours after) if you plan to drink a glass of milk or eat yogurt by itself near your dose. ^{[5] [6]}
• One controlled study found that when calcium carbonate was taken 2 hours before ciprofloxacin, overall bioavailability was not reduced, supporting the 2‑hour “before” window as generally sufficient for calcium. ^[7]

Why dairy interferes

• Ciprofloxacin (a fluoroquinolone) can bind to calcium and other metals (chelation), forming complexes that don’t absorb well. ^[8]
• Milk proteins (especially casein) can also adsorb ciprofloxacin, further cutting absorption beyond the calcium effect alone. ^[9]

What the evidence shows

• In a randomized crossover study in healthy volunteers, taking ciprofloxacin with milk or yogurt reduced blood levels and urinary recovery by about 30–36%, with early concentrations dropping by 70–92%, and peak levels reduced by 36–47%. ^[1]
• These reductions may increase the risk of treatment not working well, especially when the bacteria are only moderately sensitive to ciprofloxacin. ^[1]

Practical tips

• Best practice: Take ciprofloxacin with water, either on an empty stomach or with a non‑dairy snack. ^[2]
• If you want dairy: Have it as part of a mixed meal rather than by itself at dosing time, or separate dairy by ~2 hours before or ~6 hours after your ciprofloxacin dose to be conservative. ^{[2] [5]}
• Separate mineral products: Keep calcium/iron/zinc supplements, magnesium/aluminum antacids, and sucralfate 2 hours before or 6 hours after ciprofloxacin. ^{[3] [4]}
• Hydration: Drink plenty of fluids while on ciprofloxacin. ^[10]

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Quick reference

Item co‑administered with ciprofloxacin	Effect on absorption	What to do	Suggested timing
Milk or yogurt by itself	Significantly decreases absorption	Avoid taking together	Preferably separate; if needed, use 2 h before or 6 h after as a conservative rule
Dairy within a mixed meal	Absorption may be less affected	Acceptable	Take ciprofloxacin with the meal if needed
Calcium/iron/zinc supplements	Decrease absorption via chelation	Do not take together	2 h before or 6 h after ciprofloxacin
Magnesium/aluminum antacids, sucralfate, didanosine	Strongly reduce absorption	Do not take together	2 h before or 6 h after ciprofloxacin
Calcium carbonate taken 2 h before	No reduction in overall bioavailability in one study	If needed, can be taken 2 h before	2 h before ciprofloxacin

In summary, avoid taking ciprofloxacin at the same time as dairy alone, and separate mineral-containing products by 2 hours before or 6 hours after to help ciprofloxacin work as intended. ^{[2] [3]}