Fluoroquinolones, including ciprofloxacin, are associated with disabling and potentially irreversible serious adverse reactions that have occurred together, including tendinitis and tendon rupture, peripheral neuropathy, and CNS effects. Discontinue ciprofloxacin and avoid use of fluoroquinolones in patients with these serious adverse reactions. Reserve use of ciprofloxacin for patients with no alternative treatment options for an acute exacerbation of chronic bronchitis or acute sinusitis. Fluoroquinolones, including ciprofloxacin, may exacerbate muscle weakness in persons with myasthenia gravis. Avoid in patients with known history of myasthenia gravis .
Medically reviewed on September 3, 2018
Commonly used brand name(s)
In the U.S.
- Cipro IV
- Cipro Iv Minibags
Available Dosage Forms:
Therapeutic Class: Antibiotic
Chemical Class: Fluoroquinolone
Uses For ciprofloxacin
Ciprofloxacin injection is used to treat bacterial infections in many different parts of the body. It is also used to treat anthrax infection after inhalational exposure. Ciprofloxacin is also used to treat and prevent plague (including pneumonic and septicemic plague).
Ciprofloxacin belongs to the class of drugs known as quinolone antibiotics. It works by killing bacteria or preventing their growth. However, ciprofloxacin will not work for colds, flu, or other virus infections.
Ciprofloxacin is to be given only by or under the direct supervision of your doctor.
Before Using ciprofloxacin
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ciprofloxacin, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to ciprofloxacin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of ciprofloxacin injection in children. However, because of ciprofloxacin's toxicity, it should be used with caution, after other alternatives have been considered and/or found ineffective. Ciprofloxacin injection may be used in children to prevent anthrax infection after possible exposure, and to treat serious kidney infections.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ciprofloxacin injection in the elderly. However, elderly patients are more likely to have age-related heart or kidney problems, or develop severe tendon problems (including tendon rupture), which may require caution in patients receiving ciprofloxacin injection.
|All Trimesters||C||Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.|
Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.Ciprofloxacin Lactate
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving ciprofloxacin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using ciprofloxacin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using ciprofloxacin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Cholera Vaccine, Live
- Doxorubicin Hydrochloride Liposome
- Inotuzumab Ozogamicin
- Insulin Aspart, Recombinant
- Insulin Bovine
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Lispro, Recombinant
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
Using ciprofloxacin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aminolevulinic Acid
- Lanthanum Carbonate
- Mycophenolate Mofetil
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using ciprofloxacin with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use ciprofloxacin, or give you special instructions about the use of food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of ciprofloxacin. Make sure you tell your doctor if you have any other medical problems, especially:
- Bradycardia (slow heartbeat) or
- Diabetes or
- Diarrhea or
- Heart attack, history of or
- Heart disease (eg, heart failure) or
- Heart rhythm problems (eg, prolonged QT interval), or family history of or
- Hypokalemia (low potassium in the blood), uncorrected or
- Hypomagnesemia (low magnesium in the blood), uncorrected or
- Liver disease or
- Seizures (epilepsy), history of or
- Stroke, history of—Use with caution. May make these conditions worse.
- Brain disease (eg hardening of the arteries) or
- Kidney disease, severe or
- Organ transplant (eg, heart, kidney, or lung), history of or
- Tendon disorder (eg, rheumatoid arthritis), history of—Use with caution. May cause side effects to become worse.
- Myasthenia gravis (severe muscle weakness), or history of—Should not be used in patients with this condition.
Proper Use of ciprofloxacin
A nurse or other trained health professional will give you or your child ciprofloxacin. Ciprofloxacin is given through a needle placed in one of your veins. Ciprofloxacin is given slowly, so the needle will remain in place for about an hour.
Ciprofloxacin comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.
Drink extra fluids so you will pass more urine while you are using ciprofloxacin. This will keep your kidneys working well and help prevent kidney problems.
Your doctor will give you or your child a few doses of ciprofloxacin until your condition improves, and then you may be switched to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.
Precautions While Using ciprofloxacin
It is very important that your doctor check your or your child's progress while you are receiving ciprofloxacin. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it. Blood and urine tests may be needed to check for unwanted effects.
Do not take tizanidine (Zanaflex®) while you are receiving ciprofloxacin. Tell your doctor if you or your child are also using theophylline (Theo-Dur®) or other products that contain caffeine (eg, coffee, soda, chocolate). Using these medicines together may increase risks for more serious side effects.
Ciprofloxacin may rarely cause inflammation (tendinitis) or tearing of a tendon (the cord that attaches muscles to bones). This can occur while you are using the medicine or after you finish using it. The risk of having tendon problems may be increased if you are over 60 years of age, are using steroid medicines (eg, dexamethasone, prednisolone, prednisone, Medrol®), have severe kidney problems, have a history of tendon problems (eg, rheumatoid arthritis), or if you have received an organ transplant (eg, heart, kidney, or lung). Check with your doctor right away if you have sudden pain or swelling in a tendon after exercise (eg, ankle, back of the knee or leg, shoulder, elbow, or wrist), bruise more easily after an injury, or are unable to bear weight or move the affected area. Refrain from exercise until your doctor says otherwise.
Tell your doctor right away if you or your child have any of the following symptoms while using ciprofloxacin: convulsions, feeling anxious, confused, or depressed, seeing, hearing, or feeling things that are not there, severe headache, trouble sleeping, or unusual thoughts or behaviors.
Ciprofloxacin may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you or your child have a rash, itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you receive ciprofloxacin.
Serious skin reactions can occur with ciprofloxacin. Check with your doctor right away if you or your child have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using ciprofloxacin.
Check with your doctor right away if you or your child have dark urine, clay-colored stools, abdominal or stomach pain, or yellow eyes or skin. These maybe symptoms of a serious liver problem.
Ciprofloxacin injection may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop using ciprofloxacin. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.
Tell your doctor right away if you or your child start having numbness, tingling, or burning pain in your hands, arms, legs, or feet. These may be symptoms of a condition called peripheral neuropathy.
Some people who receive ciprofloxacin injection may become more sensitive to sunlight than they are normally. Exposure to sunlight, even for brief periods of time, may cause severe sunburn, or skin rash, redness, itching, or discoloration. When you or your child begin receiving ciprofloxacin:
- Stay out of direct sunlight, especially between the hours of 10:00 AM and 3:00 PM, if possible.
- Wear protective clothing, including a hat and sunglasses.
- Apply a sun block product that has a sun protection factor (SPF) of at least 15. Some people may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor.
- Do not use a sunlamp or tanning bed or booth.
If you have a severe reaction from the sun, check with your doctor.
Ciprofloxacin injection may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to ciprofloxacin before you drive, use machines, or do anything else that can be dangerous if you are dizzy or not alert. If these reactions are especially bothersome, check with your doctor.
If you are a diabetic patient taking diabetes medicine by mouth: Ciprofloxacin may cause hypoglycemia (low blood sugar) in some patients. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. If you or your child experience symptoms of low blood sugar, stop using ciprofloxacin and check with your doctor right away:
- Symptoms of low blood sugar can include: Anxious feeling, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty with concentrating, drowsiness, excessive hunger, headache, nausea, nervousness, rapid heartbeat, shakiness, or unusual tiredness or weakness.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Ciprofloxacin Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
- Black, tarry stools
- bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
- chest pain
- painful or difficult urination
- sores, ulcers, or white spots on the lips or in the mouth
- suicidal thoughts
- unusual bleeding or bruising
- unusual tiredness or weakness
- Abdominal or stomach cramps or pain
- ankle, knee, or great toe joint pain
- arm, back, or jaw pain
- back or side pain
- blistering, peeling, or loosening of the skin
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- change in walking and balance
- changes in skin color, pain, tenderness, or swelling of the foot or leg
- changes in urination
- chest tightness or heaviness
- cold, clammy, or pale skin
- cough or hoarseness
- darkening of the skin
- diarrhea, watery and severe, which may also be bloody
- difficulty with breathing, chewing, swallowing, or talking
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- fast, slow, irregular, pounding, or racing heartbeat or pulse
- flushing or redness of the skin, especially on the face and neck
- headache, severe and throbbing
- increased sensitivity of the skin to sunlight
- irregular heartbeats
- itching skin
- joint or muscle pain
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- light-colored stools
- loss of ability to use or understand speech or language
- mood or mental changes
- muscle spasm or jerking of all extremities
- nausea and vomiting
- numbness of the hands
- pain in the ankles or knees
- pain or discomfort in the arms, jaw, back, or neck
- pounding in the ears
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- red skin lesions, often with a purple center
- red, irritated eyes
- severe constipation
- severe sunburn
- severe vomiting
- shakiness in the legs, arms, hands, or feet
- small red or purple spots on the skin
- sudden shortness of breath or troubled breathing
- trouble concentrating
- trouble sleeping
- unsteadiness, trembling, or other problems with muscle control or coordination
- vomiting of blood
- yellow eyes and skin
Incidence not known
- Bone pain
- burning, numbness, tingling, or painful sensations
- confusion as to time, place, or person
- excessive muscle tone
- increased sensitivity to pain or touch
- inflammation of the joints
- rhythmic movement of muscles
- seeing, hearing, or feeling things that are not there
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Acid or sour stomach
- runny nose
- Continuing ringing or buzzing or other unexplained noise in the ears
- eye pain
- hearing loss
- loss of sense of smell
- swelling of the breasts or breast soreness in both females and males
- white patches in the mouth or on the tongue
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
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