Cipro

Uses

What is Cipro® (ciprofloxacin) used for?

Cipro® is commonly used for treating a variety of bacterial infections. Ciprofloxacin belongs to a class of drugs called quinolone antibiotics. It works by stopping the growth of bacteria.

Cipro® is also used to treat people who have been exposed to anthrax or certain types of plague.

How should I take Cipro® (ciprofloxacin)?

Cipro® is a fluoroquinolone antibiotic that fights bacteria in the body but cause serious or disabling side effects. Cipro® should be used only for infections that cannot be treated with a safer antibiotic.

Cipro® may cause swelling or tearing of a tendon, especially if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant.

Take this medication by mouth with or without food as directed by your doctor, usually twice a day (every 12 hour) in the morning and evening. Take this medicine with water, and drink extra fluids to keep your kidneys working properly.

The tablet is recommended to swallow whole because it may have a bitter taste if you split, chew, or crush it before taking it.

Take this medication at least 2 hours before or 6 hours after taking other products that may bind to it, decreasing its effectiveness.

How do I store Cipro® (ciprofloxacin)?

Cipro® is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Cipro® in the bathroom or the freezer. There may be different brands of Cipro® that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Cipro® down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Cipro® (ciprofloxacin)?

Before using this drug, tell your doctor if:

• You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
• You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
• You have allergy with any of active or inactive ingredients of Cipro® or other medications.
• You have any other illnesses, disorders, or medical conditions.

Cipro® may cause swelling or tearing of a tendon, especially if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant.

You may not be able to use Cipro® if you have a muscle disorder. Tell your doctor if you have a history of myasthenia gravis.

You should not use Cipro® if you are also taking tizanidine.

Stop taking Cipro® and call your doctor at once if you have sudden pain, swelling, bruising, tenderness, stiffness, or movement problems in any of your joints. Rest the joint until you receive medical care or instructions.

Do not take Cipro® with dairy products such as milk or yogurt, or with calcium-fortified juice. You may eat or drink these products as part of a regular meal, but do not use them alone when taking Cipro®. They could make the medication less effective.

Avoid taking the following medicines within 6 hours before or 2 hours after you take Cipro®. These other medicines can make ciprofloxacin much less effective when taken at the same time:

• Antacids that contain magnesium or aluminum (such as Maalox, Mylanta, or Rolaids), or the ulcer medicine sucralfate (Carafate)
• Didanosine (Videx) powder or chewable tablets
• A phosphate binder such as lanthanum carbonate (Fosrenol) or sevelamer (Renagel)
• Vitamin or mineral supplements that contain calcium, iron, or zinc

Avoid caffeine while you are taking Cipro®, because the medication can make the effects of caffeine stronger.

Cipro® may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Avoid exposure to sunlight or tanning beds. Cipro® can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Call your doctor if you have severe burning, redness, itching, rash, or swelling after being in the sun.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

• A=No risk
• B=No risk in some studies
• C=There may be some risk
• D=Positive evidence of risk
• X=Contraindicated
• N=Unknown

Side effects

What side effects can occur from Cipro® (ciprofloxacin)?

Common side effects may include:

• Nausea, vomiting, diarrhea
• Lightheadedness, headache
• Trouble sleeping
• Rash
• Abnormal liver function tests

Stop using Cipro® and call your doctor immediately if you have:

• Severe stomach pain, diarrhea that is watery or bloody
• Headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats
• Muscle pain or weakness
• A seizure
• Signs of tendon rupture: sudden pain, swelling, bruising, tenderness, stiffness, movement problems, or a snapping or popping sound in any of your joints
• Nerve symptoms: numbness, weakness, tingling, burning, pain, or being more sensitive to temperature, light touch, or the sense of your body position
• Changes in mood or behavior: depression, confusion, hallucinations, paranoia, tremors, feeling restless or anxious, unusual thoughts or behavior, insomnia, nightmares
• Liver problems: upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice
• Increased pressure inside the skull: severe headaches, ringing in your ears, vision problems, pain behind your eyes
• Severe skin reaction: skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Get emergency medical help if you have signs of an allergic reaction to Cipro®: hives, or the first sign of a skin rash; fast heartbeat, difficult breathing; swelling of your face, lips, tongue, or throat.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Cipro® (ciprofloxacin)?

Cipro® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products that may interact with this drug are:

• Cyclosporine, methotrexate, metoclopramide, omeprazole, pentoxifylline, phenytoin, probenecid, ropinirole, sildenafil, theophylline
• A diuretic or “water pill’
• Heart rhythm medication – amiodarone, disopyramide, dofetilide, dronedarone, procainamide, quinidine, sotalol, and others
• Medicine to treat depression or mental illness – amitriptylline, clomipramine, clozapine, desipramine, duloxetine, iloperidone, imipramine, nortriptyline, and others
• NSAIDs (nonsteroidal anti-inflammatory drugs) – aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others

Does food or alcohol interact with Cipro® (ciprofloxacin)?

Cipro® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

Using caffeine together with ciprofloxacin may increase the effects of caffeine.

Ciprofloxacin and multivitamin with minerals should not be taken orally at the same time. Products that contain magnesium, aluminum, calcium, iron, and/or other minerals may interfere with the absorption of ciprofloxacin and reduce its effectiveness.

Do not take ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified foods (for example, cereal, juice). You may eat or drink dairy products or calcium-fortified foods with a regular meal, but do not use them alone when taking ciprofloxacin.

What health conditions may interact with Cipro® (ciprofloxacin)?

Cipro® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Health conditions that may interact with this drug are:

• CNS Disorders
• Myasthenia Gravis
• QT Interval Prolongation
• Tendonitis
• Colitis
• Crystalluria
• Diabetes
• Hemodialysis
• Renal Dysfunction

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this medication.

What is the dose of Cipro® (ciprofloxacin) for an adult?

Skin and Skin Structure: The recommended dose is 500–750 mg / every 12 hours / 7 to 14 days.

Bone and Joint: The recommended dose is 500–750 mg / every 12 hours / 4 to 8 weeks.

Complicated Intra-Abdominal: The recommended dose is 500 mg / every 12 hours / 7 to 14 days.

Infectious Diarrhea: The recommended dose is .500 mg / every 12 hours / 5 to 7 days

Typhoid Fever: The recommended dose is 500 mg / every 12 hours / 10 days.

Uncomplicated Urethral and Cervical Gonococcal Infections: The recommended dose is 250 mg /single dose / single dose.

Inhalational anthrax (post-exposure): The recommended dose is 500 mg / every 12 hours / 60 days /4 to 8 weeks.

Plague 3: The recommended dose is 500–750 mg / every 12 hours / 14 days.

Chronic Bacterial Prostatitis: The recommended dose is 500 mg / every 12 hours / 28 days.

Lower Respiratory Tract Infections: The recommended dose is 500–750 mg / every 12 hours / 7 to 14 days.

Urinary Tract Infections: The recommended dose is 250–500 mg / every 12 hours / 7 to 14 days.

Acute Uncomplicated Cystitis: The recommended dose is 250 mg / every 12 hours / 3 days.

Acute Sinusitis: The recommended dose is 500 mg / every 12 hours / 10 days.

What is the dose of Cipro® (ciprofloxacin) for a child?

Complicated Urinary Tract or Pyelonephritis (patients from 1 to 17 years of age): 10 mg/kg to 20 mg/kg (maximum 750 mg per dose; not to be exceeded even in patients weighing more than 51 kg) / Every 12 hours / 10–21 days.

Inhalational Anthrax (Post-Exposure)²: The recommended dose is 15 mg/kg (maximum 500 mg per dose) / Every 12 hours / 60 days.

Plague: The recommended dose is 15 mg/kg (maximum 500 mg per dose) / Every 8 to 12 hours / 10–21 days.

How is Cipro® (ciprofloxacin) available?

Cipro® is available in the following dosage forms and strengths:

• Tablets, oral suspension: ciprofloxacin hydrochloride 250mg
• Tablet, film coated: ciprofloxacin hydrochloride 250mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Cipro®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.