Ciprofloxacin

Why this is used

Ciprofloxacin is used to treat or prevent certain infections caused by bacteria. Ciprofloxacin is also used to treat or prevent anthrax (a serious infection that may be spread on purpose as part of a bioterror attack) in people who may have been exposed to anthrax germs in the air. Ciprofloxacin extended-release (long-acting) tablets are used only to treat certain types of urinary tract infections. Ciprofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections. Antibiotics will not work for colds, flu, or other viral infections.

How to take it

Ciprofloxacin comes as a tablet, a suspension (liquid), and an extended-release tablet to take by mouth. The tablet and suspension are usually taken twice a day, in the morning and evening, with or without food. The extended-release tablets are usually taken once a day. Cipro XR brand extended-release tablets may be taken with or without food. Proquin XR brand extended-release tablets should be taken with a main meal of the day, preferably the evening meal. Take ciprofloxacin at around the same time(s) every day. The length of your treatment depends on the type of infection you have. Your doctor will tell you how long to take ciprofloxacin. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ciprofloxacin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. One brand or type of ciprofloxacin cannot be substituted for another. Be sure that you receive only the brand or type of ciprofloxacin that was prescribed by your doctor. Ask your pharmacist if you have any questions about the type of ciprofloxacin you were given. Do not take ciprofloxacin with dairy products or calcium-fortified juices alone. However, you may take ciprofloxacin with a meal that includes these foods or drinks. Swallow the tablets whole; do not split, crush, or chew them. If you cannot swallow tablets whole, tell your doctor. If you are taking the suspension, shake the bottle very well for 15 seconds before each use to mix the medication evenly. Swallow the correct dose without chewing the granules in the suspension. Close the bottle completely after each use. Do not give the suspension to a patient through a feeding tube. You should begin feeling better during the first few days of your treatment with ciprofloxacin. If your symptoms do not improve or if they get worse, call your doctor. If you are being treated for a urinary tract infection, call your doctor if you develop fever or back pain during or after your treatment. These symptoms may be signs that your infection is worsening. Take ciprofloxacin until you finish the prescription, even if you feel better. Do not stop taking ciprofloxacin unless you experience the symptoms of tendinitis or tendon rupture described in the IMPORTANT WARNING section or the symptoms of allergic reaction described in the SIDE EFFECTS section. If you stop taking ciprofloxacin too soon or if you skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

Side effects

<p></p> <p></p> <p></p> <p>Ciprofloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

<ul>
<li>
nausea</li>
<li>
vomiting</li>
<li>
stomach pain</li>
<li>
heartburn</li>
<li>
diarrhea</li>
<li>
feeling an urgent need to urinate</li>
<li>
headache</li>
<li>
vaginal itching and/or discharge</li></ul></p> <p></p> <p>Some side effects can be serious. If you experience any of these symptoms, or those mentioned in the IMPORTANT WARNING section, stop taking ciprofloxacin and call your doctor immediately:

<ul>
<li>
severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment)</li>
<li>
rash or blisters</li>
<li>
hives</li>
<li>
itching</li>
<li>
tingling or swelling of the face, neck, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs</li>
<li>
difficulty breathing or swallowing</li>
<li>
hoarseness or throat tightness</li>
<li>
wheezing</li>
<li>
rapid, irregular, or pounding heartbeat</li>
<li>
fainting</li>
<li>
fever</li>
<li>
joint or muscle pain</li>
<li>
unusual bruising or bleeding</li>
<li>
extreme tiredness</li>
<li>
lack of energy</li>
<li>
loss of appetite</li>
<li>
pain in the upper right part of the stomach</li>
<li>
yellowing of the skin or eyes</li>
<li>
dark urine</li>
<li>
flu-like symptoms</li>
<li>
seizures</li>
<li>
dizziness</li>
<li>
confusion</li>
<li>
nervousness</li>
<li>
restlessness</li>
<li>
anxiety</li>
<li>
difficulty falling asleep or staying asleep</li>
<li>
nightmares or abnormal dreams</li>
<li>
not trusting others or feeling that others want to hurt you</li>
<li>
hallucinations (seeing things or hearing voices that do not exist)</li>
<li>
depression</li>
<li>
thoughts about dying or killing yourself</li>
<li>
uncontrollable shaking of a part of the body</li>
<li>
pain, burning, tingling, numbness, and/or weakness in a part of the body</li></ul>Ciprofloxacin may cause problems with bones, joints, and tissues around joints in children. Ciprofloxacin should not normally be given to children younger than 18 years of age unless they have certain serious infections that cannot be treated with other antibiotics or they have been exposed to anthrax in the air. If your doctor prescribes ciprofloxacin for your child, be sure to tell the doctor if your child has or has ever had joint-related problems. Call your doctor if your child develops joint problems such as pain or swelling while taking ciprofloxacin or after treatment with ciprofloxacin. Talk to your child's doctor about the risks of giving ciprofloxacin to your child.Ciprofloxacin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at <a href='http://www.fda.gov/Safety/MedWatch'>http://www.fda.gov/Safety/MedWatch</a>] or by phone [1-800-332-1088].</p>

Precautions

Before taking ciprofloxacin, tell your doctor and pharmacist if you are allergic or have had a severe reaction to ciprofloxacin; any other quinolone or fluoroquinolone antibiotic such as gatifloxacin (Tequin) (not available in the U.S.), gemifloxacin (Factive), levofloxacin (Levaquin), lomefloxacin (Maxaquin) (not available in the U.S.), moxifloxacin (Avelox), nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin), and sparfloxacin (Zagam) (not available in the U.S.); or any other medications, or if you are allergic to any of the ingredients in ciprofloxacin tablets or suspension. Ask your doctor or pharmacist for a list of the ingredients. tell your doctor if you are taking tizanidine (Zanaflex). Your doctor will probably tell you not to take ciprofloxacin while you are taking this medication. tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); certain antidepressants; antipsychotics (medications to treat mental illness); caffeine or medications that contain caffeine (Excedrin, NoDoz, Vivarin, others); clozapine (Clozaril, Fazaclo); cyclosporine (Gengraf, Neoral, Sandimmune); diuretics ('water pills'); glyburide (DiaBeta, in Glucovance, Micronase, others); certain medications for irregular heartbeat such as amiodarone (Cordarone), disopyramide (Norpace), procainamide (Procanbid), quinidine, and sotalol (Betapace, Betapace AF, Sorine); methotrexate (Rheumatrex, Trexall); metoclopramide (Reglan); certain nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others); phenytoin (Dilantin, Phenytek); probenecid (in Col-Probenecid, Probalan); ropinirole (Requip); or theophylline (Elixophyllin, Theo-24, Uniphyl, others). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with ciprofloxacin, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. if you are taking antacids containing aluminum hydroxide or magnesium hydroxide (Maalox, Mylanta, Tums, others); didanosine (Videx); calcium, iron, zinc, or vitamin supplements; or sucralfate (Carafate), you will need to allow some time to pass between when you take a dose of any of these medications and when you take a dose of ciprofloxacin. Ask your doctor or pharmacist how many hours before or after you take ciprofloxacin you may take these medications. tell your doctor if you or anyone in your family has or has ever had a prolonged QT interval (a rare heart problem that may cause irregular heartbeat, fainting, or sudden death) or an irregular heartbeat, and if you have or have ever had nerve problems, a low level of potassium in your blood, cerebral arteriosclerosis (narrowing of blood vessels in or near the brain that can lead to stroke or ministroke), seizures, or liver disease. you should know that ciprofloxacin may cause confusion, dizziness, lightheadedness, and tiredness. Do not drive a car, operate machinery or participate in activities requiring alertness or coordination until you know how this medication affects you. plan to avoid unnecessary or prolonged exposure to sunlight or ultraviolet light (tanning beds and sunlamps) and to wear protective clothing, sunglasses, and sunscreen. Ciprofloxacin may make your skin sensitive to sunlight or ultraviolet light. If your skin becomes reddened, swollen, or blistered, like a bad sunburn, call your doctor.

Overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Educational reference only — talk to a pharmacist or prescriber about Ciprofloxacin.