Effect of selected meals and dosing conditions on the absorption and bioavailability of ciprofloxacin

Abstract

This study evaluated the effects of different dietary patterns and feeding schedules on the pharmacokinetics and tolerability of an orally administered drug. Five dosing conditions were compared: fasted state, high-fat diet, ketogenic diet, carbohydrate-rich diet, and 6 PM time-restricted feeding. The fasted condition produced the highest Cmax (p < 0.001) and the fastest Tmax (p < 0.001), but was associated with a significantly higher incidence of gastrointestinal (GI) side effects (p = 0.002) compared to fed states. High-fat feeding significantly delayed Tmax (p = 0.004) and reduced Cmax (p = 0.006), while markedly decreasing GI side effects (p = 0.01). The ketogenic diet demonstrated slightly improved bioavailability (p = 0.03) relative to other diets but was linked to mild tolerability issues such as dry mouth and dizziness (p = 0.02). In contrast, the carbohydrate-rich diet exhibited intermediate Cmax and Tmax values, with a more favorable tolerability profile (p > 0.05 vs. high-fat and ketogenic groups). The 6 PM time-restricted feeding pattern mirrored the fasted group in terms of adverse events (p = 0.07) but displayed moderate pharmacokinetic outcomes between fasted and fed conditions. These results emphasize the substantial influence of dietary and feeding conditions on drug absorption and tolerability, suggesting the need for tailored dosing recommendations. Future research should explore individualized nutrition-drug strategies to optimize therapeutic outcomes.