Proquin XR

Generic Name: ciprofloxacin (oral) (SIP roe FLOX a sin)
Brand Name: Cipro, Cipro XR, Proquin XR

What is Proquin XR?

Proquin XR (ciprofloxacin) is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic that fights bacteria in the body.

Proquin XR is used to treat different types of bacterial infections.

Proquin XR is also used to treat people who have been exposed to anthrax or certain types of plague.

Fluoroquinolone antibiotics can cause serious or disabling side effects. Proquin XR should be used only for infections that cannot be treated with a safer antibiotic.

Important information

Proquin XR may cause swelling or tearing of a tendon, especially if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant.

You may not be able to use Proquin XR if you have a muscle disorder. Tell your doctor if you have a history of myasthenia gravis.

You should not use this medication if you are also taking tizanidine.

Stop taking Proquin XR and call your doctor at once if you have sudden pain, swelling, bruising, tenderness, stiffness, or movement problems in any of your joints. Rest the joint until you receive medical care or instructions.

Before taking this medicine

You should not use Proquin XR if you are allergic to a fluoroquinolone antibiotic, or if you are also taking tizanidine (Zanaflex).

To make sure Proquin XR is safe for you, tell your doctor if you have:

• tendon problems, arthritis or other joint problems (especially in children);

• a history of myasthenia gravis or other nerve-muscle disorder;

• a heart rhythm disorder (especially if you take medication to treat it) or history of long QT syndrome;

• trouble swallowing pills;

• liver or kidney disease;

• a history of seizures;

• diabetes (especially if you take oral diabetes medication);

• low levels of potassium in your blood (hypokalemia); or

• if you use a blood thinner (warfarin, Coumadin, Jantoven) and have "INR" or prothrombin time tests.

Ciprofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles' tendon of the heel. This can happen during treatment or up to several months after you stop taking Proquin XR. Tendon problems may be more likely to occur if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant.

Do not give this medicine to a child without medical advice. Tendon and joint problems may be more likely in a child taking Proquin XR.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Ciprofloxacin can pass into breast milk and may harm a nursing baby. You should not breast-feed while using Proquin XR.

How should I take Proquin XR?

Proquin XR is usually taken every 12 hours. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take Proquin XR with water, and drink extra fluids to keep your kidneys working properly.

Proquin XR may be taken with or without food, but take it at the same time each day.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Proquin XR will not treat a viral infection such as the flu or a common cold.

Do not share this medicine with another person, even if they have the same symptoms you have.

Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze. Throw away any unused liquid after 14 days.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Proquin XR?

Do not take Proquin XR with dairy products such as milk or yogurt, or with calcium-fortified juice. You may eat or drink these products as part of a regular meal, but do not use them alone when taking Proquin XR. They could make the medication less effective.

Avoid taking the following medicines within 6 hours before or 2 hours after you take Proquin XR. These other medicines can make Proquin XR much less effective when taken at the same time:

• antacids that contain magnesium or aluminum (such as Maalox, Mylanta, or Rolaids), or the ulcer medicine sucralfate (Carafate);

• didanosine (Videx) powder or chewable tablets;

• a phosphate binder such as lanthanum carbonate (Fosrenol) or sevelamer (Renagel); or

• vitamin or mineral supplements that contain calcium, iron, or zinc.

Avoid caffeine while you are taking Proquin XR, because the medication can make the effects of caffeine stronger.

Proquin XR may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Avoid exposure to sunlight or tanning beds. Proquin XR can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Call your doctor if you have severe burning, redness, itching, rash, or swelling after being in the sun.

Proquin XR side effects

Get emergency medical help if you have signs of an allergic reaction to Proquin XR: hives, or the first sign of a skin rash; fast heartbeat, difficult breathing; swelling of your face, lips, tongue, or throat.

Ciprofloxacin may cause swelling or tearing of (rupture) a tendon. Ciprofloxacin can also have serious effects on your nerves, and may cause permanent nerve damage.

Stop using Proquin XR and call your doctor at once if you have:

• severe stomach pain, diarrhea that is watery or bloody;

• headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

• muscle pain or weakness;

• a seizure (convulsions);

• signs of tendon rupture - sudden pain, swelling, bruising, tenderness, stiffness, movement problems, or a snapping or popping sound in any of your joints (rest the joint until you receive medical care or instructions);

• nerve symptoms - numbness, weakness, tingling, burning, pain, or being more sensitive to temperature, light touch, or the sense of your body position;

• changes in mood or behavior - depression, confusion, hallucinations, paranoia, tremors, feeling restless or anxious, unusual thoughts or behavior, insomnia, nightmares;

• liver problems - upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• increased pressure inside the skull - severe headaches, ringing in your ears, vision problems, pain behind your eyes; or

• severe skin reaction - skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common Proquin XR side effects may include:

• nausea, vomiting, diarrhea;

• rash; or

• abnormal liver function tests.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Proquin XR?

Tell your doctor about all your current medicines and any you start or stop using while using Proquin XR, especially:

• cyclosporine, methotrexate, metoclopramide, omeprazole, pentoxifylline, phenytoin, probenecid, ropinirole, sildenafil, theophylline;

• a diuretic or "water pill";

• heart rhythm medication - amiodarone, disopyramide, dofetilide, dronedarone, procainamide, quinidine, sotalol, and others;

• medicine to treat depression or mental illness - amitriptylline, clomipramine, clozapine, desipramine, duloxetine, iloperidone, imipramine, nortriptyline, and others; or

• NSAIDs (nonsteroidal anti-inflammatory drugs) - aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with ciprofloxacin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

• Your pharmacist can provide more information about Proquin XR.

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• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Proquin XR only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2016 Cerner Multum, Inc. Version: 18.01. Revision Date: 2016-06-30, 11:15:55 AM.