NutriStack
Levofloxacin and Manganese, timing-sensitive.
Levofloxacin can chelate with multivalent cations. PubMed-indexed in vitro work found complex formation between levofloxacin and a manganese-containing gastrointestinal diagnostic drug, while fluoroquinolone reviews and human cation studies support reduced absorption as the clinically important concern. Taking manganese at the same time may reduce levofloxacin exposure.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Levofloxacin 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. Levofloxacin can chelate with multivalent cations. PubMed-indexed in vitro work found complex formation between levofloxacin and a manganese-containing gastrointestinal diagnostic drug, while fluoroquinolone reviews and human cation studies support reduced absorption as the clinically important concern. Taking manganese at the same time may reduce levofloxacin exposure.
Mechanism. Levofloxacin has quinolone metal-binding sites that can form poorly absorbed chelate complexes with multivalent cations. Manganese-containing products have demonstrated complex formation with levofloxacin in vitro.
Recommendation. Separate manganese supplements from levofloxacin by at least 2 hours, and follow any stricter directions on your prescription label. Do not take levofloxacin with mineral blends, multivitamins, or antacids unless your pharmacist confirms the timing. Seek care if infection symptoms persist or worsen.
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
- Deppermann KM, Lode H. Fluoroquinolones: interaction profile during enteral absorption. Drugs. 1993;45 Suppl 3:65-72. PMID 7689454
- 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
Stack Score
How this pair moves the number.
Effect on the composite score
If both Levofloxacin 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.
Check your full routine
One pair was the worked example. NutriStack runs every pair in your stack at once.
Drop in your supplements and prescriptions and the public database surfaces every interaction, synergy, timing rule, and contraindication, every one linked to its primary source.