Indications
Ciprofloxacin Hydrochloride is an antibiotic used to treat bacterial infections, including urinary tract and kidney infections, certain gut infections and infectious diarrhoea, typhoid fever, bone and joint infections, some chest infections, gonorrhoea and some skin infections. It is also used after exposure to anthrax and in some other special situations. Taste-masked forms are made for oral suspensions so that the bitter taste is easier to take. It does not work against viral infections such as colds or flu.
How It Works
Ciprofloxacin is a fluoroquinolone antibiotic. It blocks two bacterial enzymes, DNA gyrase and topoisomerase IV, which bacteria need to copy and repair their DNA. Without them the bacteria cannot multiply and they die.
Dosage and Administration
Usual adult dose: 250 mg to 750 mg by mouth every 12 hours, depending on the type and severity of infection. For example, a simple bladder infection is often treated with 250 mg to 500 mg twice a day for 3 days. Children receive a dose worked out by body weight, only when a doctor decides it is needed, as prescribed. Swallow with water, with or without food, and drink plenty of fluids. Finish the full course even if you feel better. People with kidney problems may need a lower dose.
Interactions
- Antacids, Calcium, Iron, Zinc, Magnesium, Sucralfate and milk or yoghurt taken alone reduce absorption: take Ciprofloxacin at least 2 hours before or 6 hours after them.
- Tizanidine must not be taken with Ciprofloxacin.
- Theophylline, Caffeine, Clozapine, Ropinirole and Methotrexate levels can rise.
- Warfarin effect may increase; INR should be checked.
- Medicines that prolong the QT interval (such as Amiodarone, some antipsychotics and Macrolides) increase heart rhythm risk.
- NSAIDs may increase the risk of seizures; corticosteroids increase the risk of tendon damage.
- Diabetes medicines may cause low or high blood sugar.
Contraindications
- Allergy to Ciprofloxacin or other quinolones (such as Levofloxacin or Ofloxacin).
- Use with Tizanidine.
- Previous tendon problems caused by a quinolone.
- Generally avoided in children and growing teenagers, except where a doctor decides the benefit outweighs the risk.
Side Effects
Common side effects include nausea, diarrhoea, stomach pain, headache, dizziness and rash. Less common but serious effects include tendon pain, swelling or rupture (most often the Achilles tendon), nerve damage causing tingling, burning or numbness, mood changes, confusion or seizures, sensitivity to sunlight, irregular heartbeat, low or high blood sugar, severe diarrhoea caused by C. difficile, liver problems and, rarely, tears or bulges of the aorta. It may worsen muscle weakness in myasthenia gravis.
Get urgent medical help if you have sudden pain or swelling in a tendon, severe or bloody diarrhoea, a fast or irregular heartbeat or fainting, sudden severe chest, back or stomach pain, a seizure, yellowing of the skin or eyes, or a severe allergic reaction with swelling of the face or throat, difficulty breathing or a blistering rash.
Pregnancy and Lactation
Ciprofloxacin is usually avoided during pregnancy, and is used only if a doctor decides there is no safer option. It passes into breast milk, so breastfeeding is not recommended during treatment; discuss with your doctor.
Precautions and Warnings
- Fluoroquinolones carry a risk of long-lasting, disabling side effects; they are used only when other antibiotics are not suitable.
- Stop and contact your doctor at the first sign of tendon pain, numbness or tingling.
- Tell your doctor if you have epilepsy, heart rhythm problems, low potassium, diabetes, kidney disease, myasthenia gravis or aortic aneurysm, or are over 60 years.
- Avoid strong sunlight and sunbeds.
- It may cause dizziness; take care when driving.
Overdose
Overdose may cause dizziness, confusion, seizures, heart rhythm changes, nausea, vomiting and kidney problems. Get emergency medical help. Treatment is supportive with fluids and heart monitoring.
Therapeutic Class
Antibacterial, fluoroquinolone (second-generation quinolone).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Made-up suspensions should be used within the time stated on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.