Cipro, Cipro XR (ciprofloxacin) Antibiotic

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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What is Cipro, and how does it work (mechinism of action)?

Ciprofloxacin is an antibiotic that is used to treat bacterial infections. It stops the multiplication of bacteria by inhibiting the reproduction and repair of their genetic material (DNA).

Ciprofloxacin belongs to the fluoroquinolone class of antibiotics. Examples of other antibiotics in the fluoroquinolone class includes:

What is the generic name for Cipro and Cipro XR?

Ciprofloxacin is the generic name for Cipro and Cipro XR.

Can I buy this antibiotic over-the-counter?

No. You need a prescription from your doctor or other medical professional for this drug.

What types of bacterial infections does Cipro treat (uses)?

Doctors and other medical healthcare professionals prescribe Cipro and Cipro XR to treat bacterial infections, for example:

What infections should not be treated with this drug?

Because of serious side effects associate with fluoroquinolones they should not be used for treating certain infections unless there are no other alternatives, and include:

What is the dosage for Cipro? In what forms is it available?

Dosage (how to take)

  • 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.

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.

Can I take Cipro of I'm tyring to conceive, are pregnant, or breastfeeding?

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

Warning: Serious adverse reactions of this medication

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.

What are the side effects Cirpo?

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

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:

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

Possible serious side effects of Cipro, Cipro XR include:

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

What drugs, foods, or supplements interact with this antibiotic?

  • 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).

What else should I know about this drug?

How should I keep this drug stored?
  • 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.
When was it approved by the FDA?
  • The FDA approved ciprofloxacin in October 1987.

Reference: FDA Prescribing Information

Summary

Ciprofloxacin (generic name), Cipro, Cipro XR (brand names) is an antibiotic prescribed for the treatment of many skin, lung, airway, bone, and joint infections caused by susceptible bacteria. Examples include:

Cipro should not be used for treating uncomplicated UTIs, acute bacterial chronic bronchitis, or acute bacterial sinusitis because of the serious side effects it may cause.

The FDA has issued a warning for fluoroquinolenes like Cipro because they have been associated with some serious adverse reactions, for example:

Common side effects of include:

Other possible serious side effects and adverse events include:

This medicine interacts with drugs, for example:

Doctors don't know if Cipro is safe to take if you are pregnant or breastfeeding. The dosage of this drug depends upon the type of bacterial infection you have. The brand name Proquin XR has been discontinued and is no longer available in the US.

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Reviewed on 11/10/2016
References
Reference: FDA Prescribing Information

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