NutriStack
Aluminum/Magnesium Hydroxide and Levofloxacin, timing-sensitive.
Aluminum and magnesium in antacids form insoluble chelate complexes with levofloxacin in the gut, reducing antibiotic absorption by 50 percent or more. This is one of the most clinically significant absorption interactions for levofloxacin.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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What the row says.
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At a glance
- Substances
- Aluminum/Magnesium Hydroxide and Levofloxacin
- Pair type
- Timing Sensitive
- Evidence (highest tier)
- Strong
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored timing-sensitive row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Timing Sensitive · Strong evidence
Timing Sensitive
What is happening. Aluminum and magnesium in antacids form insoluble chelate complexes with levofloxacin in the gut, reducing antibiotic absorption by 50 percent or more. This is one of the most clinically significant absorption interactions for levofloxacin.
Mechanism. Polyvalent cations (Al3+, Mg2+) chelate the 4-oxo and 3-carboxyl groups on the fluoroquinolone core, forming nonabsorbable complexes that block intestinal uptake.
Recommendation. Take levofloxacin at least 2 hours before or 2 hours after any aluminum or magnesium hydroxide antacid. Do not co-administer in the same dose.
Minimum separation. 120
Sources (2)
- Fish DN, Chow AT. The clinical pharmacokinetics of levofloxacin. Clin Pharmacokinet. 1997;32(2):101-19. PMID 9068926
- Wiesner A, Zagrodzki P, Gawalska A, Paśko P. Together or Apart? Revealing the Impact of Dietary Interventions on Bioavailability of Quinolones: A Systematic Review with Meta-analyses. Clin Pharmacokinet. 2024;63(6):773-818. PMID 38807006
Stack Score
How this pair moves the number.
Effect on the composite score
If both Aluminum/Magnesium Hydroxide and Levofloxacin are in the same stack, this pair applies −5 to your Stack Score (per scored timing-sensitive row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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