NutriStack
Ciprofloxacin and Manganese, timing-sensitive.
Manganese can form chelate complexes with fluoroquinolone antibiotics. An in vitro study using a manganese-containing gastrointestinal diagnostic product found complex formation with ciprofloxacin, and human studies with other multivalent mineral cations show reduced ciprofloxacin absorption. Taking manganese near ciprofloxacin could reduce antibiotic exposure and contribute to treatment failure.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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At a glance
- Substances
- Ciprofloxacin and Manganese
- Pair type
- Timing Sensitive
- Evidence (highest tier)
- Moderate
- Source citations
- 3 sources
- Stack Score effect
- −5 to your Stack Score (per scored timing-sensitive row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Timing Sensitive · Moderate evidence
Timing Sensitive
What is happening. Manganese can form chelate complexes with fluoroquinolone antibiotics. An in vitro study using a manganese-containing gastrointestinal diagnostic product found complex formation with ciprofloxacin, and human studies with other multivalent mineral cations show reduced ciprofloxacin absorption. Taking manganese near ciprofloxacin could reduce antibiotic exposure and contribute to treatment failure.
Mechanism. Ciprofloxacin chelates multivalent metal cations through quinolone functional groups, forming less absorbable complexes in the gut. Manganese is a multivalent cation and has demonstrated complex formation with ciprofloxacin under clinically relevant test conditions.
Recommendation. Separate manganese supplements from ciprofloxacin by at least 2 hours, and follow any stricter antibiotic instructions from your prescriber or pharmacist. Avoid taking ciprofloxacin with mineral stacks, multivitamins, or antacids. Contact your clinician if infection symptoms worsen or fail to improve.
Minimum separation. 120
Sources (3)
- Hosono M, Yokoyama H, Takayanagi R, Yamada Y. Interactions between new quinolone antibacterials and diagnostic drug containing manganese. Eur J Drug Metab Pharmacokinet. 2013;38(4):255-259. PMID 23444035
- Polk RE, Healy DP, Sahai J, Drwal L, Racht E. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother. 1989;33(11):1841-1844. PMID 2610494
- Deppermann KM, Lode H. Fluoroquinolones: interaction profile during enteral absorption. Drugs. 1993;45 Suppl 3:65-72. PMID 7689454
Stack Score
How this pair moves the number.
Effect on the composite score
If both Ciprofloxacin and Manganese 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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