Ciprofloxacin is an antibiotic used to treat a number of bacterial infections. This includes bone and joint infections, intra abdominal infections, certain type of infectious diarrhea, respiratory tract infections, skin infections, typhoid fever, and urinary tract infections, among others.
For some infections it is used in addition to other antibiotics. It can be taken by mouth, in eye drops, or intravenously.
Common side effects include nausea, vomiting, diarrhea and rash. Ciprofloxacin increases the risk of tendon rupture. In people with myasthenia gravis, there is worsening muscle weakness.
Rates of side effects appear to be higher than some groups of antibiotics such as cephalosporins but lower than others such as clindamycin. Studies in other animals raise concerns regarding use in pregnancy.
No problems were identified, however, in the children of a small number of
women who took the medication. It appears to be safe during breastfeeding. It is a second-generation fluoroquinolone with a broad spectrum of activity that usually results in the death of the bacteria.
Ciprofloxacin was introduced in 1987. It is on the World Health Organization’s List of Essential Medicines, the most effective and safe medicines needed in a health system. It is available as a generic medication and is not very expensive. The wholesale cost in the developing world is between US$0.03 and US$0.13 a dose. In the United States it is sold for about US$0.40 per dose.
Mechanism of action
Ciprofloxacin is a broad-spectrum antibiotic of the fluoroquinolone class. It is active against both Gram-positive and Gram-negative bacteria.
It functions by inhibiting DNA gyrase, and a type II topoisomerase, topoisomerase IV, necessary to separate bacterial DNA, thereby inhibiting cell division.
This medication is used to treat a variety of bacterial infections. Ciprofloxacin belongs to a class
of drugs called quinolone antibiotics. It works by stopping the growth of bacteria.
This antibiotic treats only bacterial infections. It will not work for virus infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections
Oral and intravenous ciprofloxacin are approved by the FDA for use in children for only two indications due to the risk of permanent injury to the musculoskeletal system: 1) Inhalational anthrax (postexposure) 2) Complicated urinary tract infections and pyelonephritis due to Escherichia coli, but never as first-line agents.
Current recommendations by the American Academy of Pediatrics note the systemic use of ciprofloxacin in children should be restricted to infections caused by multidrug-resistant pathogens or when no safe or effective alternatives are available.
Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking ciprofloxacin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
This medication may be taken with or without food as directed by your doctor, usually twice a day (every 12 hours) in the morning and evening.
Shake the container well for 15 seconds before pouring each dose.
Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Do not chew the contents of the suspension.
Do not use the suspension with feeding tubes because the suspension may clog the tube. The dosage and length of treatment is based on your medical condition and response to treatment. Drink plenty of fluids while taking this medication unless your doctor tells you
Take this medication at least 2 hours before or 6 hours after taking other products that may bind to it, decreasing its effectiveness.
Ask your pharmacist about the other products you take. Some examples include: quinapril, sevelamer, sucralfate, vitamins/minerals (including iron and zinc supplements), and products containing magnesium, aluminum, or calcium (such as antacids, didanosine solution, calcium supplements).
Calcium-rich foods, including dairy products (such as milk, yogurt) or calcium-enriched juice, can also decrease the effect of this medication. Take this medication at least 2 hours before or 6 hours after eating calcium-rich foods, unless you are eating these foods as part of a larger meal that contains other (non-calcium-rich) foods. These other foods decrease the calcium binding effect.
Ask your doctor or pharmacist about safely using nutritional supplements/replacements with this
medication.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.
Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.
Tell your doctor if your condition persists or worsens.
- Taking tizanidine at the same timeUse by those who are hypersensitive to any member of the quinolone class of antimicrobial agents
- Ciprofloxacin is also considered to be contraindicated in children (except for the indications outlined above), in pregnancy, to nursing mothers, and in people with epilepsy or other seizure disorders.
Nausea, diarrhea, dizziness, lightheadedness, headache, or trouble sleeping may occur. If any of these effects persist or w orsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: unusual bruising/bleeding, signs of a new infection (such as new/persistent fever, persistent sore throat), signs of kidney problems (such as change in the amount of urine, red/pink urine), signs of liver problems (such as unusual tiredness, stomach/abdominal pain, persistent nausea/vomiting, yellowing eyes/skin, dark urine).
Get medical help right away if you have any very serious side effects, including:
severe dizziness, fainting, fast/irregular heartbeat. This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a type of resistant bacteria.
This condition may occur during treatment or weeks to months after treatment has stopped.
Tell your doctor right away if you develop: persistent diarrhea, abdominal or stomach pain/cramping, blood/mucus in your stool.
Do not use anti-diarrhea or opioid medications if you have any of these symptoms because these products may make them worse.
Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Before taking ciprofloxacin, tell your doctor or pharmacist if you are allergic to it; or to other quinolone antibiotics such as norfloxacin, gemifloxacin, levofloxacin, moxifloxacin, or ofloxacin; or if you have any other allergies.
This product may contain inactive ingredients, which can cause allergic reactions or other problems.
Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of:
diabetes, heart problems (such as recent heart attack), joint/tendon problems (such as tendonitis, bursitis), kidney disease, liver disease, mental/mood disorders (such as depression), myasthenia gravis, nerve problems (such as peripheral neuropathy), seizures, conditions that increase your risk of seizures (such as brain/head injury, brain tumors, cerebral atherosclerosis).
Ciprofloxacin may cause a condition that affects the heart rhythm (QT
prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.
The risk of QT prolongation may be increased if you have certain medical
conditions or are taking other drugs that may cause QT prolongation.
Before using ciprofloxacin, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).
Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using ciprofloxacin safely.
This medication may rarely cause serious changes in blood sugar, especially if you have diabetes. Check your blood sugar regularly as directed and share the results with your doctor.
Watch for symptoms of high blood sugar such as increased thirst/urination. Ciprofloxacin may increase the blood-sugar-lowering effects of the medication glyburide.
Also watch for symptoms of low blood sugar such as sudden
sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar.
If you don’t have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or by drinking fruit juice or non- diet soda. Tell your doctor right away about the reaction and the use of this product.
To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Your doctor may need to switch you to another antibiotic or adjust your diabetes medications if any reaction occurs.
This drug may make you dizzy. Alcohol or marijuana can make you more dizzy.
Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.