What Is Ciprofloxacin (Cipro)?

Ciprofloxacin is the generic form of the brand-name antibiotic Cipro.

Doctors prescribe ciprofloxacin to treat or prevent infections caused by various bacteria that are sensitive to ciprofloxacin.The drug works by preventing bacteria from reproducing. Ciprofloxacin belongs to a family of antibiotics called fluoroquinolones.The Food and Drug Administration (FDA) approved ciprofloxacin in 1987 for Bayer Healthcare under the brand name Cipro.

In 2004, the FDA approved generic ciprofloxacin for several drug manufacturers.Today, companies also sell ciprofloxacin under the brand names Cipro XR Extended-Release Tablets and Proquin XR Extended-Release Tablets.

Doctors prescribe ciprofloxacin to treat infections caused by many different species of bacteria, including:
1.Enterococcus
2.Staphylococcus
3.Streptococcus
4.Proteus
5.Pseudomonas
6.Salmonella
7.Shigella
8.Klebsiella
9.Anthrax

Common infections treated with ciprofloxacin include:
Skin infections
Sinusitis
Urinary tract infections (UTI)
Prostatitis
Pneumonia
Bone and joint infections
Diarrhea caused by bacteria
Gonorrhea
Typhoid fever

Ciprofloxacin won’t work against infections caused by viruses (such as colds and the flu), so your doctor will prescribe ciprofloxacin only if it’s very likely that you have a bacterial infection.That’s because using antibiotics like ciprofloxacin against viruses or other illnesses they can't treat increases the chance that in time they will no longer work against bacterial infections either.

Known as drug resistance, this growing worldwide threat develops because bacteria can adapt, making antibiotics less effective or not effective at all. These multi-drug-resistant bacteria, or "superbugs," can spread through direct contact, or indirectly in food or water.In April 2014, the Centers for Disease Control and Prevention (CDC) reported that a surge in gonorrhea rates in 17 American cities between 1991 and 2006 might have been due to ciprofloxacin resistance.

The CDC noted that roughly 820,000 gonorrhea cases develop in the United States each year and that antibiotic-resistant bacteria could affect treatment and control efforts for this sexually transmitted infection.

Ciprofloxacin Warnings
Ciprofloxacin may increase the risk for swelling and tearing of tendons, such as those that attach muscles to bones in the hands, shoulders, and ankles.The likelihood of tendon damage is greater if you also take a steroid medication or if you're older than 60. If you experience pain, swelling, or stiffness while taking ciprofloxacin, let your doctor know.

In some people, ciprofloxacin may cause changes in brain activity. This affects people with a history of seizures.Possible symptoms of these changes include dizziness, hallucinations, tremors, seizures, confusion, depression, and suicidal thoughts.If you have any of these symptoms while on ciprofloxacin, let your doctor know right away.

Ciprofloxacin may cause a severe reaction called anaphylaxis if you are allergic to it. This reaction, which can be life-threatening, may include hives, swelling of the throat, and difficulty breathing.It's important to know that once you start a course of ciprofloxacin, you should finish the whole course. Do not stop taking ciprofloxacin, even if you feel better, until all of the medication is gone.

If you don’t take an antibiotic long enough, your infection can come back stronger. And stopping ciprofloxacin too soon can lead to bacteria becoming resistant to it.You may not be able to take ciprofloxacin if you have a condition called myasthenia gravis. Ciprofloxacin may increase muscle weakness caused by this condition.

You should also take ciprofloxacin with caution if you have certain conditions. Tell your doctor if you have:
Heartburn or reflux
Depression
Seizures
Asthma
Tendon injury
Heart condition
Liver disease
Kidney disease

Ciprofloxacin and Pregnancy
Before taking ciprofloxacin, women should let their doctors know if they are or may be pregnant or if they're breastfeeding.It’s unknown whether ciprofloxacin is safe to take during pregnancy. Experts do know that ciprofloxacin passes through breast milk, so it is not safe to take if you are breastfeeding.Except for children with a few specific and serious infections, no one younger than 18 should take ciprofloxacin.

Ciprofloxacin Side Effects
The most common side effects of ciprofloxacin are nausea, diarrhea, vomiting, and rash. Let your doctor know if you have any side effects.

Less common side effects include:
Headache
Stomachache
Heartburn
Body aches
Itching
Skin sensitivity to sunlight
Loss of appetite

Serious side effects can also occur. If you have any of these side effects, stop taking ciprofloxacin and call your doctor right away or call 911:

Seizure
Unusual thoughts or hallucinations
Dizziness
Confusion
Depression or suicidal thoughts
Tremors
Numbness, tingling, or weakness
Swelling or pain near a joint
Chest pain
Severe or bloody diarrhea
Skin rash, hives, or blistering of the skin
Difficulty breathing or swallowing
Swelling of the face, throat, or body
Decreased ability to pass urine
Loss of consciousness
Unusual bruising or bleeding
Yellowing of skin or eyes or dark-colored urine

Ciprofloxacin Interactions
Some drugs may affect the way ciprofloxacin works, and ciprofloxacin may affect other drugs you are taking.It’s very important to let your doctor know about all drugs you take, including over-the-counter (OTC) antacids, vitamins, and supplements.Many antacids, vitamins, and supplements that contain magnesium, calcium, aluminum, iron, or zinc can interfere with ciprofloxacin.Other OTC drugs, including such pain and fever medications as Advil, Aleve, and Motrin, may also interact with ciprofloxacin.

Ciprofloxacin may increase the effects of caffeine. If you drink caffeinated drinks or take OTC medications that contain caffeine while taking ciprofloxacin, you may have some caffeine side effects such as nervousness, sleeplessness, or anxiety.You may not be able to take ciprofloxacin if you are also taking the drug theophylline to treat asthma and wheezing (brand names include Elixophyllin, Uniphyl, and Theo-24). Serious reactions, including heart attack, decreased ability to breathe, and seizures, have happened when people took these medications together.

Other medications that interact with ciprofloxacin include:
Blood thinners, such as warfarin (Coumadin, Jantoven)
Anti-seizure medication, including phenytoin (Dilantin, Phenytek)
Certain antidepressants and medications to treat mental illness, such as clozapine (Clozaril, FazaClo)
Medications that contain caffeine, including Excedrin, NoDoz, and Vivarin
The immunosuppressant cyclosporine (Gengraf, Neoral, Sandimmune)
The muscle relaxant tizanidine (Zanaflex)
Diuretics (water pills)
Certain drugs for irregular heartbeat, such as amiodarone (Cordarone), disopyramide (Norpace), and procainamide (Procanbid)
The arthritis drug methotrexate (Rheumatrex, Trexall)
A drug used to treat nausea, vomiting, heartburn, and reflux called metoclopramide (Reglan)
The type 2 diabetes drug glyburide (DiaBeta, Glucovance, Micronase)
Some nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)

Other Ciprofloxacin Interactions
Ciprofloxacin can cause drowsiness and confusion. Don’t drive or participate in any dangerous activities until you know how ciprofloxacin affects you.Ciprofloxacin can make your skin more sensitive to sun exposure.Don’t use a tanning bed, and avoid long exposure to sunlight while taking it. Protect your skin in the sun with clothing or sunscreen.

You can take ciprofloxacin with or without food.Don’t take ciprofloxacin with only dairy products or with only calcium-fortified juice because calcium can interfere with absorption of ciprofloxacin. You can, however, take ciprofloxacin with a meal that includes dairy or calcium-fortified juice.

Ciprofloxacin Dosage
Your dose of ciprofloxacin will depend on the type of bacterial infection you have.Ciprofloxacin comes in regular and extended-release tablets and as a liquid.Take regular tablets or the liquid twice a day (morning and evening) at about the same time each day, and take extended-release tablets once a day.Swallow all tablets whole. Don’t crush, split, or chew them.Regular tablets come in 250, 500, and 750 milligrams (mg).

Some typical doses for common infections using regular tablets include:
Uncomplicated gonorrhea infection: 250 mg, single dose
Uncomplicated urinary tract infection: 250 mg every 12 hours for three days
Bacterial diarrhea: 500 mg every 12 hours for five to seven days
Acute sinusitis: 500 mg every 12 hours for 10 days
Severe pneumonia: 750 mg every 12 hours for seven to 14 days
Chronic bacterial prostatitis: 500 mg every 12 hours for 28 days
Moderate bone or joint infection: 500 mg every 12 hours for four to six weeks

Ciprofloxacin Overdose
A large overdose of ciprofloxacin could cause kidney damage.In animal studies, very large doses of ciprofloxacin have caused reduced breathing, vomiting, and seizures.If an overdose occurs, call a poison control center at 1-800-222-1222. If you or someone else has any severe symptoms after an overdose, call 911.

Missed Dose of Ciprofloxacin
Take ciprofloxacin exactly as directed by your doctor.Don’t stop taking ciprofloxacin on your own. Skipping doses or stopping too soon can result in a more severe infection that is harder to treat.If you miss a dose of ciprofloxacin, take the missed dose as soon as you remember.If it’s almost time for your next regular dose, however, skip the missed dose.Don’t double your dose to make up for the missed one.