ciprofloxacin

Ciprofloxacin is an antibiotic in a group of drugs called fluoroquinolones (flor-o-KWIN-o-lones). Ciprofloxacin fights bacteria in the body.

Ciprofloxacin is used to treat different types of bacterial infections. It is also used to treat people who have been exposed to anthrax.

Important information

You should not use this medication if you are also taking tizanidine.

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

Ciprofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles" tendon of the heel. This effect may be more likely to occur if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant.

Stop taking this medicine 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.

Before taking this medicine

You should not use this medication if you are allergic to ciprofloxacin, or if:

• you are also taking tizanidine; or

• you are allergic to other fluoroquinolones (gemifloxacin, levofloxacin, moxifloxacin, ofloxacin, norfloxacin, and others).

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

To make sure ciprofloxacin is safe for you, tell your doctor if you have:

• a heart rhythm disorder, especially if you take medication to treat it;

• a personal or family history of Long QT syndrome;

• tendon problems, arthritis or other joint problems (especially in children);

• a muscle or nerve disorder;

• trouble swallowing pills;

• liver disease;

• kidney disease (or if you are on dialysis);

• seizures or epilepsy;

• a history of head injury or brain tumor;

• diabetes (especially if you take oral diabetes medication);

• low levels of potassium in your blood (hypokalemia);

• if you use a blood thinner (warfarin, Coumadin) and have "INR" or prothrombin time tests.

Ciprofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles" tendon of the heel. This can happen during treatment or up to several months after you stop taking ciprofloxacin. Tendon problems may be more likely to occur if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant.

FDA pregnancy category C. It is not known whether ciprofloxacin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

See also: Pregnancy and breastfeeding warnings (in more detail)

Ciprofloxacin can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

How should I take ciprofloxacin?

Ciprofloxacin is usually taken every 12 hours. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take this medicine with a full glass of water (8 ounces). Drink several extra glasses of fluid each day while you are taking this medicine. Ciprofloxacin may be taken with or without food, but take it at the same time each day.

Do not take ciprofloxacin 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 ciprofloxacin. They could make the medication less effective.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Shake the oral suspension (liquid) for at least 15 seconds just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. Do not give ciprofloxacin oral suspension through a feeding tube.

Swallow the liquid without chewing the medicine beads you may notice in the liquid.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Ciprofloxacin will not treat a viral infection such as the common cold or flu.

If you are being treated for gonorrhea, your doctor may also have you tested for syphilis, another sexually transmitted disease.

Do not share this medication with another person (especially a child), even if they have the same symptoms you have.

Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze. Throw away any unused liquid after 14 days.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid?

You may be taking certain other medicines that should not be taken at the same time as ciprofloxacin. Avoid taking the following medicines within 6 hours before or 2 hours after you take ciprofloxacin. 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;

• vitamin or mineral supplements that contain calcium, iron, or zinc.

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

Avoid exposure to sunlight or tanning beds. Ciprofloxacin 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.

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

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

Ciprofloxacin side effects

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

Ciprofloxacin may cause swelling or tearing of (rupture) a tendon. It can also have serious effects on your nerves, and may cause permanent nerve damage. Stop taking this medicine and call your doctor at once if you have:

• signs of tendon rupture--sudden pain, swelling, bruising, tenderness, stiffness, movement problems, or a snapping or popping sound in any of your joints (rest the joint until you receive medical care or instructions); or

• nerve symptoms--numbness, tingling, burning pain, or being more sensitive to temperature, light touch, or the sense of your body position.

Stop using ciprofloxacin and call your doctor at once if you have:

• headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

• nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• muscle weakness or trouble breathing;

• diarrhea that is watery or bloody;

• sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, easy bruising or bleeding;

• depression, confusion, hallucinations, paranoia, tremors, feeling restless or anxious, unusual thoughts or behavior, insomnia, nightmares;

• seizure (convulsions); or

• increased pressure inside the skull-- severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes.

Common ciprofloxacin side effects may include:

• stomach discomfort, vomiting, mild diarrhea;

• vaginal itching or discharge;

• mild dizziness; or

• mild headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect ciprofloxacin?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with ciprofloxacin, especially:

• 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; or

• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with ciprofloxacin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.