ciprofloxacin, Cipro, Cipro XR, Proquin XR (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

Fluoroquinolones have neuromuscular blocking activity and can worsen muscle weakness in individuals with myasthenia gravis. Ciprofloxacin may worsen low blood glucose when combined with sulfonylureas (for example, glyburide).

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS:

  • Tablets: 250, 500, and 750 mg.
  • Tablets extended release (XR): 500 and 1000 mg.
  • Microcapsules for suspension: 250 mg/5 ml, 500 mg/5 ml.
  • Injection or Injection concentrate: 200 mg/100 ml, 200 mg/20 mg, 400 mg/200 ml, 400 mg/40 ml.

STORAGE: Tablets should be stored below 30 C (86 F). Extended release tablets should be stored between 15 C to 30 C (59 F to 86 F). Microcapsules should be stored below 25 C (77 F) and protected from freezing. Injections should be stored between 5 C to 30 C (41 F to 86 F) and prevented from freezing.

DOSING: For most infections the recommended oral dose for adults is 250-750 mg (immediate release tablets) every 12 hours or 500-1000 mg (extended release tablets) every 24 hours. The usual intravenous dose is 200-400 mg every 8-12 hours.

DRUG INTERACTIONS: Ciprofloxacin administered together with theophylline (Respbid, Slo-Bid, Theo-24, Theolair) can lead to elevated, toxic blood levels of theophylline. Theophylline is used to open airways in the treatment of asthma. Toxic levels of theophylline can lead to seizures, and disturbances in heart rhythm. If concurrent use of ciprofloxacin and theophylline cannot be avoided, frequent blood tests to monitor theophylline blood levels are recommended.

Ciprofloxacin increases the effect of tizanidine (Zanaflex) that is used to treat muscle spasticity. Therefore, the two drugs should not be combined.

Iron salts (for example, ferrous sulfate) may reduce the absorption of ciprofloxacin because of formation of a ciprofloxacin-iron complex that is not absorbable. Antacids also may reduce the absorption of ciprofloxacin. If patients are receiving iron salts or antacids and ciprofloxacin, the ciprofloxacin should be given two hours before or six hours after the iron salt or antacid.

Ciprofloxacin may increase the blood thinning effect of warfarin (Coumadin). The reason for this is unknown. Anticoagulant activity should be monitored after starting or stopping ciprofloxacin.

Medically Reviewed by a Doctor on 12/12/2014


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