In this drug factsheet:
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- general feeling of being unwell
- increased skin sensitivity to the sun
- loss of appetite
- mild diarrhea
- pain at the injection site (injection form)
- rash (injection form)
- ringing in the ears
- stomach discomfort or gas
- trouble sleeping
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- coordination problems (unsteady walk)
- hallucinations (hearing or seeing things that aren’t there)
- irregular or fast heart rate
- joint pain
- muscle pain
- numbness or burning, tingling pain
- pain, inflammation, or swelling in the shoulders, hands, or calves of legs
- pain, swelling, or rupture of a tendon
- severe abdominal or stomach cramps or pain
- signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
- symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
- symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heartbeat, weakness)
- vision changes
Stop using the medication and seek immediate medical attention if any of the following occur:
- confusion or changes in thought patterns
- diarrhea (watery and severe; may also be bloody)
- signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
- signs of a severe skin reaction (e.g., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergic reactions: In rare cases, some people may develop an allergic reaction to this medication. Signs of an allergic reaction include a severe rash, swollen face, or difficulty breathing. If these occur, get immediate medical attention.
Antibiotic-related diarrhea: This medication, like other antibiotics, can cause a potentially dangerous, severe form of diarrhea called antibiotic-associated colitis or pseudomembranous colitis. Symptoms include severe, watery diarrhea that may be bloody. If you notice these symptoms, stop taking ciprofloxacin and contact your doctor as soon as possible.
Behaviour and movement changes: Rarely, this medication can cause behaviour and movement changes such as agitation, anxiety, confusion, depression, tremors, hallucinations, and other mood changes. If you experience any of the above, contact your doctor immediately.
Driving and operating heavy machinery: Ciprofloxacin may impair your ability to drive or operate machinery, especially when combined with alcohol. Do not drive or operate machinery until you know how this medication affects you.
Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects, since ciprofloxacin is removed from the body primarily by the kidneys. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Ciprofloxacin may reduce liver function and can cause liver failure. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Neuromuscular disorders: Ciprofloxacin may cause increased muscle weakness for people with myasthenia gravis (an autoimmune disorder that causes muscle weakness). If you have myasthenia gravis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Other infections: Use of ciprofloxacin for a long time may lead to yeast infections.
QT prolongation: This medication can lengthen heartbeat as shown on an electrocardiogram test, also known as QT prolongation. Very rare cases of abnormal heartbeat have been reported in people while on ciprofloxacin, but these reports generally involved people who had conditions that predisposed them to abnormal heartbeat, or who have been taking other medications that can increase the risk of developing an abnormal heartbeat. If you have heart disease and abnormal heart rhythms, or are taking certain medications (e.g., verapamil, atazanavir), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you develop heart palpitations (fast or irregular heartbeat) or experience fainting spells, stop taking ciprofloxacin and contact your doctor immediately.
Seizures: Rarely, seizures have been reported with this medication. If you have a history of epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you have a seizure while taking this medication, stop taking it and get immediate medical attention.
Sucrose intolerance: The oral suspension form of this medication contains sucrose. People who have a hereditary condition that makes them intolerant to some sugars should not take the oral suspension.
Sun sensitivity: People who take ciprofloxacin are more likely to experience sunburn. Avoid exposure to excessive sunlight, including sunlamps and tanning beds. If you must spend time in the sun use sunblock with minimum SPF 15. Talk to your doctor if severe sun sensitivity occurs.
Tendinitis: Ciprofloxacin may increase the chance of tendon injury, which occurs more commonly for seniors who are also taking corticosteroid medications. If there is any new pain in the tendons, stop taking ciprofloxacin, avoid physical exercise, and consult your doctor.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, stop taking it immediately and call your doctor.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking ciprofloxacin, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of this medication have not been established for children less than 18 years of age.
What other drugs could interact with this medication?
There may be an interaction between ciprofloxacin and any of the following:
- acetylsalicylic acid (ASA)
- antacids that contain aluminum hydroxide, calcium, and magnesium hydroxide (do not take these products for at least 6 hours before or for 2 hours after ciprofloxacin)
- antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
- antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
- BCG vaccine
- buffered antiretroviral medications (e.g., didanosine; do not take these products for at least 6 hours before or for 2 hours after ciprofloxacin)
- calcium supplements and multivitamins that contain calcium (do not take these products for at least 6 hours before or for 2 hours after ciprofloxacin)
- certain medications that control heart rhythm
- chloral hydrate
- inhaled corticosteroids (e.g., budesonide, ciclesonide, fluticasone)
- oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
- estrogens (estradiol, conjugated equine, esterified, estropipate)
- grapefruit juice
- HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
- iron supplements (e.g., ferrous fumarate, ferrous gluconate, ferrous sulfate: do not take these products for at least 6 hours before or for 2 hours after ciprofloxacin)
- macrolide antibiotics (e.g., clarithromycin, erythromycin)
- magnesium supplements (e.g., magnesium hydroxide, magnesium oxide)
- multiple vitamins and minerals with vitamins A and E
- multivitamins that contain iron (do not take these products for at least 6 hours before or for 2 hours after ciprofloxacin)
- nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, naproxen)
- other quinolone antibiotics (e.g., norfloxacin, ofloxacin)
- St. John’s wort
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
- serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
- sodium picosulfate
- sucralfate (do not take these products for at least 6 hours before or for 2 hours after ciprofloxacin)
- sulfonylureas (e.g., gliclazide, glyburide)
- theophyllines (e.g., aminophylline, oxtryphylline, theophylline)
- tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
- typhoid vaccine
- tyrosine kinase inhibitors (e.g., dasatinib, imatinib, nilotinib, sunatinib)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.