Ciprofloxacin

💊 What is Ciprofloxacin used for?

• •Skin and skin structure infections
• •Bone and joint infections
• •Complicated intra-abdominal infections (used together with metronidazole)
• •Infectious diarrhea
• •Typhoid fever (enteric fever)
• •Uncomplicated cervical and urethral gonorrhea
• •Inhalational anthrax after exposure (adults and children)
• •Plague (adults and children)
• •Chronic bacterial prostatitis
• •Lower respiratory tract infections, including acute exacerbation of chronic bronchitis
• •Urinary tract infections, including acute uncomplicated cystitis and complicated UTI and kidney infection (pyelonephritis) in children
• •Acute sinusitis

How it works

The label describes ciprofloxacin as a synthetic antibacterial medicine. It is used to treat infections caused by germs (bacteria) that the medicine can act against. The label text provided does not explain the mechanism in more detail.

How it is usually taken

• •The label says ciprofloxacin is taken by mouth. Doses are given on a schedule that depends on the infection, and the label describes these schedules in its dosage tables. The label says the dose and length of treatment depend on how severe the infection is, which germ is causing it, and the person's kidney and liver function. The label also says treatment should usually continue for at least 2 days after symptoms are gone, except for inhalational anthrax after exposure. Follow the instructions from your prescriber or pharmacist.

Comes as

• •250 mg tablets (white to off-white, round, film-coated, with a score line on one side)
• •500 mg tablets (white to off-white, capsule-shaped, film-coated, with a score line on one side)
• •750 mg tablets (white to off-white, capsule-shaped, film-coated)

⚠️ Ciprofloxacin side effects

🛑 Who should not take Ciprofloxacin, and who should be careful

The label says not to take it if

• 🚨You have a known allergy or hypersensitivity to ciprofloxacin, any quinolone antibacterial, or any ingredient in the product. The label lists this as a contraindication.
• 🚨You take tizanidine. The label says using it together with ciprofloxacin is contraindicated.
• 🚨You have a known history of myasthenia gravis. The label says to avoid ciprofloxacin in this case.
• 🚨You have a history of tendon disorders or have had tendinitis or tendon rupture. The label says to avoid fluoroquinolones in this case.
• 🚨You have had a serious reaction to a fluoroquinolone in the past. The label says to avoid fluoroquinolones in people who have experienced these serious reactions.
• 🚨You have a known QT interval prolongation. The label says to avoid use in patients with known prolongation.

Tell your doctor before taking it if

• •Tell your provider if you have ever had a reaction to ciprofloxacin or to any other quinolone antibacterial medicine.
• •Tell your provider if you have a history of seizures. The label says CNS side effects can happen after the first dose.
• •Tell your provider if you have myasthenia gravis.
• •Tell your provider if you have had a tendon disorder, including tendinitis or tendon rupture, or a condition such as rheumatoid arthritis that affects tendons.
• •Tell your provider if you are over 60, take corticosteroid drugs, or have had a kidney, heart, or lung transplant. The label says these factors increase the risk of tendon problems.
• •Tell your provider about kidney failure or heart problems, including a known QT interval prolongation or low potassium (hypokalemia), since the label says to avoid use in these cases.
• •Tell your provider about all other medicines you take, including those listed in the interactions section.
• •The label says ciprofloxacin should be used only for infections proven or strongly suspected to be caused by bacteria.

🔀 Ciprofloxacin with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Tizanidine: using it with ciprofloxacin is contraindicated because the label says it can increase the blood-pressure-lowering and sleep-causing effects of tizanidine.
• •Theophylline: the label says to avoid use, because theophylline levels may rise and cause brain or other side effects. If use cannot be avoided, levels may need to be monitored.
• •Drugs that prolong the QT interval, such as certain antiarrhythmics, tricyclic antidepressants, macrolide antibiotics, and antipsychotics: the label says to avoid use together.
• •Oral antidiabetic drugs, mainly sulfonylureas such as glyburide and glimepiride: the label says low blood sugar, sometimes severe, has been reported, and that fatalities have occurred. Blood glucose should be monitored.
• •Phenytoin: the label says phenytoin levels can go up or down, so phenytoin therapy should be monitored.
• •Cyclosporine: the label says kidney function, especially serum creatinine, should be monitored.
• •Antacids containing magnesium, aluminum, or calcium: the label says these can reduce how well ciprofloxacin is absorbed.
• •The label says ciprofloxacin inhibits the CYP1A2 enzyme, which can raise levels of other drugs that the body breaks down through this enzyme.

Alcohol and food

The label does not say.

🤰 Ciprofloxacin in pregnancy and breastfeeding

Pregnancy

The label says that long-term experience in pregnant women, based on published case reports and observational studies, has not identified a drug-associated risk of major birth defects, miscarriage, or other adverse outcomes. Animal studies at certain doses did not cause birth defects. The label also says that available studies have limitations and cannot fully rule out risk. Talk with your provider about pregnancy.

Breastfeeding

The label does not say.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store ciprofloxacin tablets at 20 to 25 degrees C (68 to 77 degrees F), with brief excursions allowed between 15 and 30 degrees C (59 to 86 degrees F). It also says not to use the tablets if the blister is torn or broken.

If a dose is missed

The label does not say.

If too much is taken

The label says that in an acute overdose, reversible kidney toxicity has been reported in some cases. Treatment described in the label includes emptying the stomach by inducing vomiting or by gastric lavage, close observation, and supportive treatment, including monitoring of kidney function. The label says adequate hydration must be maintained. It also says that only a small amount of ciprofloxacin (less than 10%) is removed by hemodialysis or peritoneal dialysis.

🗒️ Questions to ask about Ciprofloxacin

• Is ciprofloxacin the right choice for my infection, or are there other treatment options?
• Given my medical history, such as myasthenia gravis, seizures, or tendon problems, is this medicine appropriate for me?
• What tendon, nerve, or mood symptoms should I watch for, and when should I call you?
• How long will I need to take this medicine, and what should I do if I feel better early?
• Should I avoid any of my other medicines, including antacids, blood sugar medicines, or tizanidine, while I take this?
• Is it safe for me to drink alcohol or take this medicine with food?
• What should I do if I miss a dose?

❓ Ciprofloxacin: frequently asked questions