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Ciprofloxacin

sip roe flox' a sin

Brand name(s): Cipro®; Cipro XR®

Why is this medication prescribed?

Ciprofloxacin is an antibiotic used to treat certain infections caused by bacteria. Ciprofloxacin tablets and suspension (liquid) are used to treat pneumonia (lung infection); bronchitis (infection of the tubes that lead to the lungs); some types of gonorrhea (a sexually transmitted disease); diarrhea caused by bacteria; typhoid fever (a contagious illness common in developing countries); and bone, joint, skin, prostate (a male reproductive gland), sinus, and urinary tract (bladder) infections. Ciprofloxacin is also used to prevent and/or treat anthrax in people exposed to anthrax germs in the air. Ciprofloxacin is also used with another medication to treat certain infections of the internal organs. Ciprofloxacin extended release (long-acting) tablets are used to treat urinary tract and kidney infections. Ciprofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing bacteria. Antibiotics will not work for colds, flu, or other viral infections.

How should this medicine be used?

Ciprofloxacin comes as a tablet, a suspension (liquid) and an extended release (long-acting) tablet to take by mouth with or without food. The tablet and suspension are usually taken every 12 hours (twice a day). The extended release tablets are usually taken once a day. To help you remember to take ciprofloxacin, take it 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 you need 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.

Swallow the extended release tablets whole; do not split, crush, or chew them.

If you are taking the liquid, shake the bottle for 15 seconds before each use to mix the medication evenly. Swallow the correct dose without chewing the granules in the liquid. Do not give the liquid to a patient through a feeding tube.

If you are taking the tablets or extended release tablets, swallow them with a full glass of water.

You should begin feeling better during the first few days of treatment with ciprofloxacin. If you do not, call your doctor.

Take ciprofloxacin until you finish the prescription, even if you feel better. If you stop taking ciprofloxacin too soon or skip doses, your infection may not be completely cured and bacteria may become resistant to antibiotics.

Other uses for this medicine

Ciprofloxacin is also sometimes used to treat patients with cystic fibrosis who have lung infections. Ciprofloxacin is sometimes used to treat various sexually transmitted diseases and various infections such as Legionnaire disease (a type of lung infection), cat scratch disease (an infection that may develop after a patient is bitten or scratched by a cat), and brucellosis (a type of infection that causes a rising and falling fever and other symptoms). In the event of biological warfare, ciprofloxacin may be used to treat and prevent dangerous illness that are deliberately spread such as plague, tularemia, and anthrax of the skin or mouth. Ciprofloxacin may also be used to reduce the amount of certain types of bacteria in the nose to prevent serious illness. Ciprofloxacin may be used with another medication to treat disseminated Mycobacterium avium complex (MAC) (a type of lung disease that often affects people with human immunodeficiency virus [HIV] ), and tuberculosis (TB) (a type of lung infection). Talk to your doctor about the possible risks of using this drug for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking ciprofloxacin,

• tell your doctor and pharmacist if you are allergic to ciprofloxacin; other quinolone and fluoroquinolone antibiotics such as cinoxacin (Cinobac), enoxacin (Penetrex), gatifloxacin (Tequin), gemifloxacin (Factive), levofloxacin (Levaquin), lomefloxacin (Maxaquin), moxifloxacin (Avelox), nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin), sparfloxacin (Zagam), trovafloxacin and alatrofloxacin combination (Trovan); or any other medications.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: acetazolamide (Diamox); anticoagulants ('blood thinners') such as warfarin (Coumadin); brinzolamide (Azopt); cancer chemotherapy medications; chloroquine (Aralen); cyclosporine (Neoral, Sandimmune), dichlorphenamide (Daranide); dorzolamide (Cosopt, Trusopt); glyburide (DiaBeta, Glycron, Glynase, Micronase); isoniazid (INH, Nydrazid); medications for depression , pain, or mental illness; medications for diarrhea, such as dicyclomine (Bentyl), diphenoxylate (Lomotil), and loperamide (Imodium); medications that contain caffeine (NoDoz, Vivarin, others); methazolamide (GlaucTabs, Nepatazane); methocarbamol (Robaxin); metoclopramide (Reglan); methotrexate (Rheumatrex, Trexall); mycophenolate mofetil (CellCept); neostigmine (Prostigmin); nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); other antibiotics; phenytoin (Dilantin, Phenytek); physostigmine (Antilirium); potassium citrate and citric acid (Cytra-K, Polycitra-K); probenecid (Benemid); pyridostigmine (Mestinon, Regonol); pyrimethamine (Daraprim); sedatives and sleeping pills; sodium bicarbonate (Soda Mint, baking soda); sodium citrate and citric acid (Bicitra, Oracit); theophylline (Theobid, Theo-Dur, Slo-bid, others); or tacrolimus (Prograf). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• if you are taking antacids (Maalox, Mylanta); didanosine (Videx) chewable tablets or solution (liquid); calcium, iron, zinc or vitamin supplements; or sucralfate (Carafate), take them 6 hours before or 2 hours after ciprofloxacin.
• tell your doctor if you have or have ever had arthritis; dementia (memory loss and personality changes); depression; mental illness; diarrhea during or after antibiotic therapy; recent head injury; seizures; stroke or mini-stroke; or kidney or liver disease.
• you should know that ciprofloxacin and other similar antibiotics have caused serious and occasionally fatal allergic reactions in some patients. If you develop hives; difficulty breathing or swallowing; rapid, irregular or pounding heartbeat; fainting; dizziness; blurred vision, or other symptoms of a severe allergic reaction, seek emergency medical care right away. If you develop a skin rash, stop taking gemifloxacin and call your doctor. Call your doctor if you experience other signs of an allergic reaction such as itching; tingling; swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs; fever; hoarseness; joint or muscle pain; unusual bruising or bleeding; extreme tiredness; lack of energy; loss of appetite; pain in the upper right part of the stomach; yellowing of the skin or eyes; flu- like symptoms; or upset stomach.
• tell your doctor if you have ever had tendonitis (swelling or tearing of the fiber that connects a bone to a muscle) and if you participate in regular athletic activity. If you experience symptoms of tendonitis, such as pain, swelling, tenderness, stiffness, or difficulty in moving a muscle, stop taking ciprofloxacin, rest, and call your doctor immediately.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking ciprofloxacin, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ciprofloxacin.
• you should know that ciprofloxacin may cause dizziness, lightheadedness, and tiredness. Do not drive a car or operate machinery until you know how this medication affects you.
• plan to avoid unnecessary or prolonged exposure to sunlight or ultraviolet light (tanning beds) and to wear protective clothing, sunglasses, and sunscreen. Ciprofloxacin may make your skin sensitive to sunlight.
• you should know that ciprofloxacin may cause diarrhea during or after your treatment. You should not treat this diarrhea with over the counter medications. Instead, call your doctor to find out what to do.

What special dietary instructions should I follow?

Do not take ciprofloxacin with dairy products (like milk or yogurt) or calcium-added juices alone. You may take ciprofloxacin with a meal that includes these foods. Drink at least eight full glasses of water or liquid every day. Do not drink or eat a lot of caffeine-containing products such as coffee, tea, cola, or chocolate. Ciprofloxacin increases nervousness, sleeplessness, heart pounding, and anxiety caused by caffeine.

What should I do if I forget a dose?

If you are taking ciprofloxacin tablets or suspension, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

If you are taking ciprofloxacin extended release tablets and forget to take your dose at the usual time, you may take the dose later in the day. However, do not take more than one ciprofloxacin extended release tablet in one day, even if you missed a dose.

What side effects can this medication cause?

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

• upset stomach
• vomiting
• stomach pain
• indigestion
• headache
• nervousness
• agitation
• anxiety
• difficulty falling asleep or staying asleep
• nightmares or abnormal dreams

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them or those mentioned in the SPECIAL PRECAUTIONS section, call your doctor immediately:

• seizures
• vaginal yeast infection
• confusion
• shaking hands that you cannot control
• believing that others want to harm you
• hallucination (seeing things or hearing voices that do not exist)
• depression
• thoughts about dying or killing yourself

You should know that ciprofloxacin has slowed the growth and damaged the joints of young laboratory animals. It is not known if ciprofloxacin has these effects on children. Therefore, ciprofloxacin should not normally be given to children younger than 18 years old. However, if a child has been exposed to anthrax in the air, the benefits of taking ciprofloxacin to prevent this serious illness may be greater than the risk of joint damage. 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.

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Store the suspension in the refrigerator or at room temperature, closed tightly, for up to 14 days. Throw away any liquid that is left over after 14 days and any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/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.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to ciprofloxacin.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the ciprofloxacin, call your doctor.

Last Revised - 07/01/2004

American Society of Health-System Pharmacists, Inc. Disclaimer

The MedMaster™ Patient Drug Information database provides information copyrighted by the American Society of Health-System Pharmacists, Inc., Bethesda, Maryland Copyright© 2004. All Rights Reserved.

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