Amoxicillin vs. Cipro

• Amoxicillin and Cipro (ciprofloxacin) are antibiotics used to treat bacterial infections of the skin, lungs or airways, urinary tract, and to treat gonorrhea.
• Amoxicillin is also used to treat bacterial infections of the middle ear, tonsils, and throat.
• Cipro is also used to treat bacterial infections of the bones and joints. Cipro is also used to treat infectious diarrheas caused by E. coli, Campylobacter jejuni, and Shigella bacteria; anthrax patients with fever and low white blood cell counts, and intra-abdominal infections; typhoid fever; chronic bacterial prostatitis; and acute uncomplicated cystitis
• Brand names of amoxicillin include Moxatag and Amoxil.
• Amoxicillin and Cipro belong to different antibiotic drug classes. Amoxicillin is a penicillin-type antibiotic and Cipro is a fluoroquinolone antibiotic.
• Side effects of amoxicillin and Cipro that are similar include diarrhea, abdominal pain, nausea, vomiting, and rash.
• Side effects of amoxicillin that are different from Cipro include dizziness, heartburn, sleep problems (insomnia), itching, confusion, easy bruising, bleeding, and allergic reactions.
• Side effects of Cipro that are different from amoxicillin include headache and restlessness. Cipro and Cipro XR and other fluoroquinolone antibiotics have been associated with tendonitis and even tendon rupture, particularly the Achilles tendon.

Amoxicillin is a penicillin-type antibiotic, in the same class as ampicillin (Unasyn), piperacillin (Pipracil), and ticarcillin (Ticar). These antibiotics stop bacteria from multiplying by preventing bacteria from forming the walls that surround them. The walls are needed to protect bacteria from their environment and to hold the contents of a bacterial cell together. Bacteria cannot survive without a cell wall. Amoxicillin is effective against a number of different bacteria such as H. influenzae, Streptococci, Pneumococci, N. gonorrhoea, E. coli, and certain strains of Staphylococci. Amoxicillin is used to treat bacterial infections of the tonsils, throat, middle ear, larynx (laryngitis), lungs (pneumonia), bronchi (bronchitis), urinary tract, and skin. Amoxicillin also is used to treat gonorrhea.

Cipro (ciprofloxacin) is a fluoroquinolone antibiotic used to treat bacterial infections of the skin, lungs or airways, bones, joints, and urinary tract. Cipro is also used to treat infectious diarrheas caused by E. coli, Campylobacter jejuni, and Shigella bacteria; anthrax patients with fever and low white blood cell counts, and intra-abdominal infections; typhoid fever; cervical and urethral gonorrhea due to Neisseria gonorrhoeae; chronic bacterial prostatitis; and acute uncomplicated cystitis. Cipro works by stopping the multiplication of bacteria by inhibiting the reproduction and repair of their genetic material (DNA). Other fluoroquinolones include levofloxacin (Levaquin), ofloxacin (Floxin), gatifloxacin (Tequin), norfloxacin (Noroxin), moxifloxacin (Avelox), and trovafloxacin (Trovan).

Amoxicillin

Side effects due to amoxicillin include

• diarrhea,
• dizziness,
• heartburn,
• insomnia,
• nausea,
• itching,
• vomiting,
• confusion,
• abdominal pain,
• easy bruising,
• bleeding,
• rash, and
• allergic reactions.

People who are allergic to the cephalosporin class of antibiotics, which are related to the penicillins, for example, cefaclor (Ceclor), cephalexin (Keflex), and cefprozil (Cefzil), may or may not be allergic to penicillins.

Serious but rare reactions include:

• seizures,
• severe allergic reactions (anaphylaxis), and
• low platelet (thrombocytopenia) or red blood cell count.

Amoxicillin can alter the normal bacteria in the colon and encourage overgrowth of some bacteria such as Clostridium difficile which causes inflammation of the colon (pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting amoxicillin (diarrhea, fever, abdominal pain, and possibly shock) should contact their physician immediately.

Cipro

WARNING

Cipro and Cipro XR as well as other antibiotics in the fluoroquinolone class of antibiotics has been associated with tendonitis and even tendon rupture, particularly the Achilles tendon. Some doctors and other medical professionals recommend that their patients discontinue vigorous exercise while they are taking fluoroquinolone antibiotics.

Fluoroquinolones have neuromuscular blocking activity and can worsen muscle weakness in individuals with myasthenia gravis.

The most common side effects of Cipro, Cipro XR are:

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Rash
• Headache
• Restlessness

Anaphylaxis, or shock, is a rare allergic reaction to this drug. This allergic reaction is a medical emergency and you are experiencing these symptoms seek medical immediately.

Symptoms of shock include:

• Cardiovascular collapse
• Facial or throat swelling
• Shortness of breath
• Hives
• Itching

What are the serious side effects and adverse events of Cirpo?

Possible serious side effects of Cipro, Cipro XR include:

• Peripheral neuropathy
• Central nervous system effects (CNS), for example, toxic psychosis, nervousness, agitation, insomnia, anxiety, nightmares, paranoia, dizziness, tremors, depression, and hallucinations.
• Hyperglycemia
• Clostridiumdifficile-associated diarrhea (CDAD)
• Abnormal heart beats
• Liver dysfunction
• Stroke
• Convulsions
• Toxic epidermal necrolysis
• Stevens-Johnson syndrome
• Vasculitis
• Allergic pneumonitis
• Interstitial nephritis
• Acute kidney failure
• Hepatitis
• Jaundice
• Liver failure
• Anemia
• Leukopenia

Other serious side effects and adverse events of Cipro, Cipro XR include:

• Cipro, Cipro XR should be used with caution in patients with central nervous system diseases such as seizures, because rare seizures have been reported in patients receiving Cipro, Cipro XR.
• Cipro, Cipro XR should be avoided in children and adolescents less than 18 years of age, as safe use in these patients has not been established.
• Many antibiotics, including Cipro, Cipro XR, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon, (C. difficile or pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting Cipro, Cipro XR (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.
• Cardiac arrest
• Respiratory failure

Amoxicillin

• For most infections in adults the dose of amoxicillin is 250 mg every 8 hours, 500 mg every 8 hours, 500 mg every 12 hours or 875 mg every 12 hours, depending on the type and severity of infection.
• For the treatment of adults with gonorrhea, the dose is 3 g given as one dose.
• For most infections, children older than 3 months but less than 40 kg are treated with 25 or 45 mg/kg/day in divided doses every 12 hours or 20 or 40 mg/kg/day with one-third of the daily dose given every 8 hours depending on the type and severity of the infection.
• Amoxicillin can be taken with or without food.

Cipro

• 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.

Amoxicillin

Amoxicillin is rarely associated with important drug interactions.

Cipro

• 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, Jantoven). The reason for this is unknown. Anticoagulant activity should be monitored after starting or stopping ciprofloxacin.
• Sevelamer (Renagel) may reduce the absorption of ciprofloxacin and possibly reduce the effectiveness of ciprofloxacin. Milk and orange juice also may reduce the absorption of ciprofloxacin. Ciprofloxacin, as with iron and antacids, should be given two hours before or six hours after milk or orange juice.
• Administration of ciprofloxacin with diabetic medications (for example glyburide [Micronase, Diabeta, Glynase, Prestab]) may lead to severe low blood glucose.
• Ciprofloxacin may increase blood concentrations of sildenafil (Viagra) that is used for treating erectile dysfunction. This combination should be avoided if possible.
• Patients taking Cipro, Cipro XR can develop sensitivity of the skin to direct sunlight (photosensitivity) and should avoid exposure to sunlight or use sunblock.
• Fluoroquinolones worsen low blood glucose levels when combined with sulfonylureas, for example, glyburide (Micronase, Diabeta, Glynase, Prestab).

Amoxicillin

• Penicillins are generally considered safe for use by pregnant women who are not allergic to penicillin.
• Small amounts of amoxicillin may be excreted in breast milk and may cause diarrhea or allergic responses in nursing infants. Amoxicillin is generally considered safe to use while breastfeeding. Amoxicillin is used to treat infections in the newborn.

Cipro

Doctors suggest that should not use this antibiotic if you are pregnant or breastfeeding because they do not know if it is safe.