A medicine safety letter sent in June to all healthcare professionals highlighted the risk of acute kidney injury in patients treated with fluoroquinolones concomitantly with ace-inhibitors (ACEIs) or angiotensin receptor blockers (ARBs).

In summary:

• Concomitant use of fluoroquinolones with ACEIs and/or ARBs is contraindicated in patients with moderate-to-severe renal impairment (CrCl < 30 mL/min)
• Renal function should be assessed before initiating treatment and monitored during treatment with fluoroquinolones or ACEIs/ARBs, whether used separately and/or concomitantly
• Patients currently being treated with both fluoroquinolones and ACEIs/ARBs should contact their doctor to re-evaluate their treatment

Package inserts and patient information leaflets of fluoroquinolones, ACEIs and ARBs will be amended. See the full letter here.