Generic Name: ciprofloxacin (SIP-roe-FLOX-a-sin)
Brand Name: Cipro I.V.
Ciprofloxacin is associated with an increased risk of tendon problems. These include pain, swelling, inflammation, and possible breakage of tendons. The risk of tendon problems is greater in patients who older than 60 years old, patients who take corticosteroids (eg, prednisone), and in those who have received kidney, heart, or lung transplants. The Achilles tendon in the back of the foot/ankle is most often affected. However, problems may also occur in other tendons (eg, in the shoulder, arm, hand). Problems may occur while you use ciprofloxacin or up to several months after you stop using it.
Signs of tendon problems may include pain, soreness, redness, or swelling of a tendon or joint; bruising right after an injury in a tendon area; hearing or feeling a snap or pop in a joint or tendon area; or inability to move or bear weight on a joint or tendon area. Tell your doctor right away if you experience any of these symptoms while you use ciprofloxacin or within several months after you stop using it.
Ciprofloxacin may worsen muscle weakness and breathing problems in patients with myasthenia gravis. Do not take ciprofloxacin if you have a history of myasthenia gravis.
Ciprofloxacin is used for:
Treating bacterial infections. It may also be used to prevent or slow anthrax after exposure.
Ciprofloxacin is a fluoroquinolone antibiotic. It works by killing sensitive bacteria.
Do NOT use ciprofloxacin if:
- you are allergic to any ingredient in ciprofloxacin or to any other fluoroquinolone (eg, levofloxacin)
- you have a history of myasthenia gravis
- you have a certain type of irregular heartbeat (prolonged QT interval), low blood potassium or magnesium levels, or certain heart problems (eg, heart failure, heart attack, slow heartbeat)
- you are taking certain antiarrhythmic medicines (eg, amiodarone, procainamide, quinidine, sotalol), macrolide antibiotics (eg, clarithromycin), tizanidine, or tricyclic antidepressants (eg, amitriptyline)
- you are taking any medicines that can cause a certain type of irregular heartbeat (prolonged QT interval). There are many medicines that can do this. Ask your doctor or pharmacist if you are not sure
Contact your doctor or health care provider right away if any of these apply to you.
Before using ciprofloxacin:
Some medical conditions may interact with ciprofloxacin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a stomach infection, liver problems, brain or nervous system problems, increased pressure in the brain, Alzheimer disease, brain blood vessel problems, muscle problems (eg, myasthenia gravis), or a history of seizures
- if you have a history of stroke, severe or persistent diarrhea, skin sensitivity to the sun, low blood potassium or magnesium levels, heart problems, or irregular heartbeat (eg, QT prolongation), or if you have a family member with a history of irregular heartbeat
- if you have a history of joint or tendon problems; rheumatoid arthritis; kidney problems or decreased kidney function; or a heart, kidney, or lung transplant
- if you take corticosteroids (eg, prednisone) or you participate in strenuous physical work or exercise
Some MEDICINES MAY INTERACT with ciprofloxacin. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Theophylline because the risk of serious and sometimes fatal side effects may be increased
- Antiarrhythmics (eg, amiodarone, quinidine), macrolide antibiotics (eg, clarithromycin), or tricyclic antidepressants (eg, amitriptyline) because the risk of serious side effects, including irregular heartbeat, may be increased
- Corticosteroids (eg, prednisone) because they may increase the risk of tendon problems
- Diuretics (eg, furosemide, hydrochlorothiazide), metoclopramide, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), or probenecid because they may increase the risk of ciprofloxacin's side effects
- Anticoagulants (eg, warfarin), antipsychotics (eg, clozapine, olanzapine), cyclosporine, duloxetine, methotrexate, oral medicine for diabetes (eg, glimepiride, glyburide), ropinirole, sildenafil, tizanidine, or xanthines (eg, pentoxifylline) because the risk of their side effects may be increased by ciprofloxacin
- Phenytoin because its effectiveness may be decreased by ciprofloxacin
This may not be a complete list of all interactions that may occur. Ask your health care provider if ciprofloxacin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use ciprofloxacin:
Use ciprofloxacin as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Ciprofloxacin comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get ciprofloxacin refilled.
- Ciprofloxacin is given as an injection at your doctor's office, hospital, or clinic. Contact your health care provider if you have any questions.
- To clear up your infection completely, use ciprofloxacin for the full course of treatment. Keep using it even if you feel better in a few days.
- Drinking extra fluids while you are taking ciprofloxacin is recommended. Check with your doctor for instructions.
- If you miss a dose of ciprofloxacin, call your doctor to find out what to do.
Ask your health care provider any questions you may have about how to use ciprofloxacin.
Important safety information:
- Tell your doctor or dentist that you take ciprofloxacin before you receive any medical or dental care, emergency care, or surgery.
- Ciprofloxacin may cause drowsiness, dizziness, or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use ciprofloxacin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Be sure to use ciprofloxacin for the full course of treatment. If you do not, the medicine may not clear up your infection completely. The bacteria could also become less sensitive to this or other medicines. This could make the infection harder to treat in the future.
- Long-term or repeated use of ciprofloxacin may cause a second infection. Tell your doctor if signs of a second infection occur. Your medicine may need to be changed to treat this.
- Ciprofloxacin only works against bacteria; it does not treat viral infections (eg, the common cold).
- Before using ciprofloxacin, tell your doctor if you take a medicine that contains caffeine or you consume large amounts of food or drink that contain caffeine (eg, coffee, tea, cocoa, cola, chocolate).
- Tell your doctor right away if you experience pain or swelling of a tendon or weakness or loss of use of a joint area. Rest the area and avoid exercise until further instruction from your doctor.
- Serious and sometimes fatal allergic side effects have rarely happened. Discuss any questions or concerns with your doctor.
- Nerve problems in the arms, hands, legs, or feet can happen in people taking ciprofloxacin. These nerve problems can happen soon after ciprofloxacin is started and may be permanent. Call your doctor right away if you have symptoms or nerve problems (eg, not able to handle heat or cold; decreased sensation of touch; unusual burning, numbness, tingling, pain, or weakness of the arms, hands, legs, or feet).
- Serious and sometimes fatal liver problems have happened with ciprofloxacin. Call your doctor right away if you have symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, unusual stomach pain, yellowing of the skin or eyes).
- A serious skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have symptoms like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.
- Diabetes patients - Ciprofloxacin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Ciprofloxacin may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to ciprofloxacin. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
- Mild diarrhea is common with antibiotic use. However, a more serious form of diarrhea (pseudomembranous colitis) may rarely occur. This may develop while you use the antibiotic or within several months after you stop using it. Contact your doctor right away if stomach pain or cramps, severe diarrhea, or bloody stools occur. Do not treat diarrhea without first checking with your doctor.
- Have your blood work checked if you are on ciprofloxacin for a long time. Talk with your doctor.
- Use ciprofloxacin with caution in the ELDERLY; they may be more sensitive to its effects (eg, tendon problems), especially if they take corticosteroids (eg, prednisone). They may also be more sensitive to other effects (eg, irregular heartbeat).
- Ciprofloxacin should be used with extreme caution in CHILDREN younger than 18 years old; they may be more sensitive to its effects, especially joint and tendon problems.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using ciprofloxacin while you are pregnant. Ciprofloxacin is found in breast milk. Do not breast-feed while using ciprofloxacin.
Possible side effects of ciprofloxacin:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Diarrhea; dizziness; headache; mild irritation, pain, or redness at the injection site; nausea; vomiting.
Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness in the chest or throat; swelling of the mouth, face, lips, or tongue); bloody or tarry stools; chest pain; fainting; fast or irregular heartbeat; fever, chills, or unusual cough; hallucinations; inability to move or bear weight on a joint or tendon area; mood or mental changes (eg, new or worsening anxiety, agitation, confusion, depression, nervousness, nightmares, paranoia, restlessness, sleeplessness); muscle pain or weakness; pain, soreness, redness, swelling, weakness, or bruising of a tendon or joint area; persistent sore throat; seizures; severe or persistent dizziness or headache; shortness of breath or trouble breathing; suicidal thoughts or actions; sunburn; symptoms of kidney problems (eg, not able to pass urine, change in how much urine is passed, blood in the urine, a big weight gain); tremors; unusual bruising or bleeding; unusual tiredness or weakness; vaginal yeast infection; vision changes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.Proper storage of ciprofloxacin:
Ciprofloxacin is handled and stored by a health care provider. You will not store it at home. Keep all medicines out of the reach of children and away from pets.
- If you have any questions about ciprofloxacin, please talk with your doctor, pharmacist, or other health care provider.
- Ciprofloxacin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take ciprofloxacin or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about ciprofloxacin. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to ciprofloxacin. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your health care provider for complete information about the risks and benefits of using ciprofloxacin.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.
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