Cipro XR

Generic name: Ciprofloxacin hydrochloride, Cipro- - ciprofloxacin hydrochloride
Cipro HC - ciprofloxacin hydrochloride with hydrocortisone
Brand names: Cipro XR, Cipro HC Otic, Cipro, Cipro HC

Why are Cipro and Cipro HC prescribed?

Ciprofloxacin is an antibiotic used to treat infections of the lower respiratory tract, the abdomen, the skin, the bones and joints, and the urinary tract, including cystitis (bladder inflammation) in women. It is also prescribed for severe sinus or bronchial infections, infectious diarrhea, typhoid fever, inhalational anthrax, infections of the prostate gland, and some sexually transmitted diseases such as gonorrhea. Additionally, some doctors prescribe Cipro for certain serious ear infections, tuberculosis, and some of the infections common in people with AIDS.

Hydrocortisone is an anti-inflammatory

Ciprofloxacin may also be prescribed for children with a urinary tract infection or kidney infection when other antibiotics are not effective.

Because Ciprofloxacin is effective only for certain types of bacterial infections, before beginning treatment your doctor may perform tests to identify the specific organisms causing your infection.

Cipro is available as a tablet and an oral suspension (liquid). Cipro HC Otic is a suspension (ear drops) that also contains the anti-inflammatory drug hydrocortisone; it's used externally to treat ear infections.

Cipro XR, an extended-release form of the drug, is used to treat cystitis, urinary tract infection, and kidney infection.

Most important facts about Cipro and Cipro HC

Ciprofloxacin kills a variety of bacteria, and is frequently used to treat infections in many parts of the body. However, be sure to stop taking Cipro and notify your doctor immediately at the first sign of a skin rash or any other allergic reaction. Although quite rare, serious and occasionally fatal allergic reactions--some following the first dose--have been reported in people receiving this type of antibacterial drug. Some reactions have been accompanied by collapse of the circulatory system, loss of consciousness, swelling of the face and throat, shortness of breath, tingling, itching, and hives. Fever and jaundice (yellowing of the skin and eyes) are other potential symptoms that should send you to the doctor immediately.

How should you use Cipro and Cipro HC?

Cipro tablets can be taken with food or on an empty stomach. Cipro should not be taken with dairy products (such as milk or yogurt) or calcium-fortified juices alone; however, Cipro may be taken with a meal that contains these products. Drink plenty of fluids while taking Cipro to prevent crystals from forming in your urine.

Like other antibiotics, Cipro works best when there is a constant amount in the blood and urine. To help keep the level constant, try not to miss any dose, and take them at approximately the same time every day.

Your doctor will only prescribe Cipro to treat a bacterial infection; it will not cure a viral infection, such as the common cold. It's important to take the full dosage schedule of Cipro, even if you're feeling better in a few days. Not completing the full dosage schedule may decrease the drug's effectiveness and increase the chances that the bacteria may become resistant to Cipro and similar antibiotics.

If you are taking the oral suspension, be sure to shake the bottle vigorously for 15 seconds before each dose. Swallow without chewing the microcapsules in the suspension. Reclose the bottle completely, following the instructions on the cap.

Do not use Cipro HC Otic suspension in your eyes, and avoid contaminating the dropper by letting it touch your ears, fingers, or other surfaces. To administer the Cipro HC ear drops:
1. Warm the Cipro HC otic suspension by holding the bottle in your hand for a minute or two; putting a cold Cipro HC suspension into the ear can cause dizziness.
2. Have the person lie down with the affected ear up.
3. Shake the bottle, then position the filled dropper above the entrance to the ear canal.
4. Squeeze 3 drops of Cipro HC into the ear. The person should not get up for 30 to 60 seconds after the drops have been given.
5. Throw away any Cipro HC suspension that remains after treatment is finished.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Cipro tablets should be stored at room temperature. Cipro suspension may be stored at room temperature or in the refrigerator. The suspension is good for 14 days. Protect Cipro HC Otic suspension from light and avoid freezing.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Cipro.

• More common side effects may include:
  Abdominal pain/discomfort, diarrhea, headache, nausea, rash, restlessness, vomiting

Why should Cipro or Cipro HC not be prescribed?

If you are sensitive to or have ever had an allergic reaction to Cipro or certain other antibiotics of this type such as Floxin, Noroxin and Trovan, you should not take ciprofloxacin. Make sure that your doctor is aware of any drug reactions that you have experienced.

Cipro HC Otic suspension should not be used on anyone whose eardrum is perforated or who has a viral infection of the ear.

Special warnings about Cipro and Cipro HC

Cipro may cause you to become dizzy or light-headed; therefore, you should not drive a car, operate dangerous machinery, or participate in any hazardous activity that requires full mental alertness until you know how the drug affects you.

Continued or prolonged use of ciprofloxacin may result in a growth of bacteria that do not respond to Cipro and can cause a secondary infection. Therefore, it is important that your doctor monitor your condition on a regular basis.

Cipro can cause increased pressure within the brain. Convulsions have been reported in people receiving the drug. If you experience a seizure or convulsion, notify your doctor immediately.

ciprofloxacin may stimulate the central nervous system, which may lead to tremors, restlessness, light-headedness, confusion, depression, and hallucinations. If these reactions occur, consult your doctor at once. Other central nervous system reactions include nervousness, agitation, insomnia, anxiety, nightmares, and paranoia.

If you have a known or suspected central nervous system disorder such as epilepsy or hardening of the arteries in the brain, make sure your doctor knows about it when prescribing Cipro.

Remember to stop taking Cipro and see your doctor at the first hint of an allergic reaction (see "Most important fact about Cipro and Cipro HC"). Also call your doctor if you develop diarrhea. Antibiotics such as Cipro occasionally trigger a form of diarrhea that needs a doctor's attention.

Rare cases of peripheral neuropathy (changes or disturbances of the nervous system) have been reported with this type of antibiotic. Contact your doctor if you experience muscle weakness, paralysis, pain or numbness, a burning sensation, or a "pins and needles" sensation.

You may become more sensitive to light while taking ciprofloxacin. Try to stay out of the sun as much as possible.

People taking Cipro have been known to suffer torn tendons. If you feel any pain or inflammation in a tendon area, stop taking the drug and call your doctor; you should rest and avoid exercise. You may need surgery to repair the tendon.

If you must take Cipro for an extended period of time, your doctor will probably order blood tests and tests for urine, kidney, and liver function. If you are taking Cipro to treat gonorrhea, the doctor should test you for syphilis after 3 months.

Possible food and drug interactions when taking Cipro and Cipro HC

Serious and fatal reactions have occurred when Cipro was taken in combination with theophylline (Theo-Dur). These reactions have included cardiac arrest, seizures, status epilepticus (continuous attacks of epilepsy with no periods of consciousness), and respiratory failure.

The following can interfere with the absorption of Cipro and should be taken no less than 6 hours before or 2 hours after a dose:

Antacids containing magnesium and aluminum
Carafate
Supplements and other products containing calcium, iron, or zinc
Videx chewable tablets and pediatric powder

You should also avoid taking Cipro with milk or yogurt alone, though calcium taken as part of a full meal has no significant effect on the drug.

Cipro may increase the effects of caffeine.

If Cipro is taken with certain other drugs, the effects of either could be increased, decreased, or altered. These drugs include:

Cyclophosphamide (Cytoxan)
Cyclosporine (Sandimmune, Neoral)
Glyburide (DiaBeta, Glynase, Micronase)
Methotrexate (Rheumatrex)
Metoclopramide (Reglan)
Metoprolol (Lopressor)
Phenytoin (Dilantin)
Probenecid
Warfarin (Coumadin)

Certain nonsteroidal anti-inflammatory drugs (NSAIDs), with the exception of aspirin, could cause convulsions when combined with high doses of this type of antibiotic.

Special information if you are pregnant or breastfeeding

Although there's reason to believe that Cipro poses little danger during pregnancy, its effects have not been adequately studied. If you are pregnant or plan to become pregnant, notify your doctor immediately. Cipro does appear in breast milk when it's taken internally, and could affect a nursing infant. If ciprofloxacin is essential to your health, your doctor may advise you to discontinue breastfeeding your baby until your treatment is finished.

Recommended dosage of Cipro and Cipro HC

If you have kidney problems, your doctor may prescribe dosages lower than the ones listed below.

Note that if you're using the oral suspension, 1 teaspoonful of 5% suspension equals 250 milligrams and 1 teaspoonful of 10% suspension equals 500 milligrams.

ADULTS

For Cipro

Urinary Tract Infections : The usual adult dosage is 250 milligrams taken every 12 hours. Complicated infections, as determined by your doctor, may require 500 milligrams taken every 12 hours. Treatment usually lasts 7 to 14 days.

Cystitis (Bladder Inflammation) in Women: The usual dosage is either 100 milligrams or 250 milligrams every 12 hours. Treatment usually lasts 3 days.

Lower Respiratory Tract, Skin, Bone, and Joint Infections: The usual recommended dosage is 500 milligrams taken every 12 hours. Complicated infections, as determined by your doctor, may require a dosage of 750 milligrams taken every 12 hours. Treatment usually lasts 7 to 14 days, except for bone and joint infections, which require 4 to 6 weeks.

Infectious Diarrhea; Typhoid Fever; Sinus, Prostate, and Abdominal Infections: The recommended dosage is 500 milligrams taken every 12 hours. Treatment lasts 5 to 7 days for diarrhea, 10 days for typhoid fever and sinus infections, 7 to 14 days for abdominal infections, and 28 days for prostate infections.

Inhalational Anthrax: For adults, the recommended dosage is 500 milligrams taken every 12 hours. Children's doses are calculated at a rate of 15 milligrams per 2.2 pounds of body weight up to a maximum of 500 milligrams per dose. Treatment continues for 60 days.

Gonorrhea in the Urethra or Cervix: For these sexually transmitted diseases, a single 250-milligram dose is the usual treatment.

For Cipro HC Otic

Ear Infection: Instill 3 drops of Cipro HC suspension into the ear twice a day for 7 days.

For Cipro XR

Cystitis (Bladder Inflammation) in Women: The usual dosage is 500 milligrams taken once daily for 3 days.

Urinary Tract and Kidney Infections: The usual dosage is 1,000 milligrams taken once daily for 7 to 14 days.

CHILDREN AGES 1 TO 17 YEARS OLD

For Cipro

Urinary Tract and Kidney Infections: The usual dosage is based on your child's weight. It should be taken every 12 hours for 10 to 21 days.

Inhalational Anthrax: The usual dosage is based on your child's weight. It should be taken every 12 hours for 60 days.

For Cipro HC Otic

The dosage of Cipro HC is the same as for adults.

Cipro XR is not recommended for anyone less than 18 years old.

Overdosage

There is no information on the symptoms of Cipro overdose. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

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