Ciprofloxacin Important info, side effects & precautions

What is ciprofloxacin?
Ciprofloxacin is a fluoroquinolone antibiotic that fights bacteria in the body.

Ciprofloxacin is used to treat different types of bacterial infections. It 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. Ciprofloxacin should be used only for infections that cannot be treated with a safer antibiotic.

Important information

You should not use ciprofloxacin if you are also taking tizanidine.

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

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 effect may be more likely to occur if you are over 60, if you use steroid medication, or if you have had a kidney, heart, or lung transplant.

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 ciprofloxacin if you are allergic to it, or if:

you are also taking tizanidine; or you are allergic to other fluoroquinolones (gemifloxacin, levofloxacin, moxifloxacin, ofloxacin, norfloxacin, and others).

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 this medicine. 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 ciprofloxacin.

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

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

How should I take ciprofloxacin?

Ciprofloxacin 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 with water, and drink extra fluids to keep your kidneys working properly.

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

Shake the oral suspension (liquid) for 15 seconds just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. Do not give the oral suspension through a feeding tube.

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

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 should I avoid while taking ciprofloxacin?

Do not take ciprofloxacin 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 ciprofloxacin. They could make the medication less effective.

Avoid taking the following medicines within 6 hours before or 2 hours after you take this medicine. These other medicines can make ciprofloxacin 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); 
  • orvitamin or mineral supplements that contain calcium, iron, or zinc.

Avoid caffeine while you are taking this medicine, as ciprofloxacin can make the effects of caffeine stronger.

Ciprofloxacin side effects

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

Ciprofloxacin may cause your tendons to swell or cause tendon rupture. It can also have serious effects on your nerves, and may cause permanent nerve damage. 

Stop using this medicine and call your doctor at once if you have:

  • 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); 
  • ornerve symptoms – numbness, tingling, burning pain, or being more sensitive to temperature, light touch, or the sense of your body position.

Also, stop using this medicine and call your doctor at once if you have:

  • severe stomach pain, diarrhea that is watery or bloody;
  • a headache with chest pain and severe dizziness and fast or pounding heartbeats;
  • the first sign of any skin rash, no matter how mild;
  • confusion, hallucinations, nightmares, paranoia, depression, thoughts about hurting yourself;
  • muscle weakness or trouble breathing;
  • ongoing headaches (sometimes with blurred vision);
  • tremors, anxiety, trouble sleeping, feeling restless or nervous;a light-headed feeling, like you might pass out;
  • increased pressure inside the skull – severe headaches, ringing in your ears, dizziness, vision problems, pain behind your eyes;
  • liver problems – nausea, vomiting, loss of appetite, upper stomach pain, itching, fever, tiredness, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); 
  • or severe skin reaction – fever, sore throat, swelling in your face or tongue, burning in your eyes, 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 ciprofloxacin side effects may include:

  • nausea, vomiting, diarrhea
  • rash
  • orabnormal 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.

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