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Supplement × Prescription·Evidence index

Calcium and Levofloxacin: what the research found

PubMed indexes 8 records that name Calcium and Levofloxacin together, either in the title or in an interaction, co-administration, or pharmacokinetic context. The key findings come first, in the authors’ own words, followed by every study with its design and PubMed link.

A summary of published research, not medical advice. A pharmacist can check any combination against your full list of medicines and supplements.

Key findings

What the studies concluded.

Reviews and human studies first. Each quote is the authors’ own conclusion about their study, not a NutriStack assessment, and a single study is not a consensus.

“The activity of omadacycline against UTI organisms was lower in urine relative to standard medium and was negatively impacted by magnesium. Omadacycline displayed slightly reduced activity when excess calcium was present, but, overall, the differences were ≤2-fold. These observations should be considered along with the pharmacokinetics of the agent for clinical context.”

Pagano et al. · 2020 · Human study · details

“These results indicate that multivalent cations such as calcium should be maximally separated from oral levofloxacin administration in adult patients with cystic fibrosis to prevent this drug interaction, thereby better optimizing antibiotic efficacy and decreasing the potential for resistance development.”

Pai et al. · 2006 · Human study · details

“Due to the lack of change in overall exposure, it is thought that rather than a chelation interaction, levofloxacin and components of the orange juices competed for intestinal transport mechanisms such as P-glycoprotein and organic anion-transporting polypeptides, which resulted in the discovered interaction.”

The research

8 studies naming Calcium and Levofloxacin.

Strongest relevance first: papers naming both substances in the title, then human trials and systematic reviews.

Altered steady state pharmacokinetics of levofloxacin in adult cystic fibrosis patients receiving calcium carbonate.

Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society · 2006 · PMID 16481224

Randomized Controlled TrialResearch Support, N.I.H., Extramural

“These results indicate that multivalent cations such as calcium should be maximally separated from oral levofloxacin administration in adult patients with cystic fibrosis to prevent this drug interaction, thereby better optimizing antibiotic efficacy and decreasing the potential for resistance development.”

Pai et al. · Authors' conclusion

Names both Calcium and Levofloxacin in its title.

Lack of bioequivalence when levofloxacin and calcium-fortified orange juice are coadministered to healthy volunteers.

Journal of clinical pharmacology · 2003 · PMID 12751275

Clinical TrialRandomized Controlled Trial

“Due to the lack of change in overall exposure, it is thought that rather than a chelation interaction, levofloxacin and components of the orange juices competed for intestinal transport mechanisms such as P-glycoprotein and organic anion-transporting polypeptides, which resulted in the discovered interaction.”

Wallace et al. · From the abstract

Names both Calcium and Levofloxacin in its title.

Efficacy of Calcium Silicate-Based, Simvastatin, Levofloxacin and Calcium Hydroxide Intracanal Medicaments Against Mature Enterococcus faecalis Biofilm. An In Vitro Study.

Australian endodontic journal : the journal of the Australian Society of Endodontology Inc · 2026 · PMID 41782171

“The calcium silicate-based group recorded the highest median (IQR) percentage of dead bacteria at 56.33 (10.03), followed by Simvastatin 44.88 (7.30), CH 41.70 (12.53), Levofloxacin 35.99 (3.78), and the positive control group 3.61 (1.01). These findings suggest that these intracanal medicaments demonstrate promising antibiofilm activity, with further investigations needed.”

Hosny et al. · From the abstract

Names both Calcium and Levofloxacin in its title.

In vitro activity of omadacycline and levofloxacin against Escherichia coli, Klebsiella pneumoniae and Staphylococcus saprophyticus in human urine supplemented with calcium and magnesium.

The Journal of antimicrobial chemotherapy · 2020 · PMID 32428235

Human subjects

“The activity of omadacycline against UTI organisms was lower in urine relative to standard medium and was negatively impacted by magnesium. Omadacycline displayed slightly reduced activity when excess calcium was present, but, overall, the differences were ≤2-fold. These observations should be considered along with the pharmacokinetics of the agent for clinical context.”

Pagano et al. · Authors' conclusion

Names both Calcium and Levofloxacin in its title.

Novel doped calcium phosphate-PMMA bone cement composites as levofloxacin delivery systems.

International journal of pharmaceutics · 2015 · PMID 26002570

“Also, the lactose-modified BC matrix, with a more porous structure, has already proved to enhance antibiotic release from the BC inner matrix. This novel BC composite biomaterial has shown improved mechanical integrity, biocompatibility maintenance, and sustained release of levofloxacin, with concentrations over the minimum inhibitory concentration values after a 48h while maintaining antibacterial activity over an 8-week period against Staphyloccocus aureus and…”

Matos et al. · From the abstract

Names both Calcium and Levofloxacin in its title.

Limitations

What this evidence cannot tell you.

Search-based evidence indexes have real limits, and it is worth being explicit about them:

How to read this page

A literature summary, not guidance.

NutriStack

Track what you actually take.

NutriStack is a free iPhone app for organising a supplement routine: what you take, when, and what the published record says about it. Its exploratory interaction checker covers Calcium, Levofloxacin, and several hundred other substances.

Log your routine, get reminders at the times you choose, and scan a label to add a product. The checker is a research and organisation tool, not a clinical decision aid.

NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.