How does this medication work? What will it do for me?
Ciprofloxacin is an antibiotic that belongs to the family of medications known as quinolones. It is used to treat infections caused by certain bacteria. It is most commonly used to treat infections of the skin, sinuses, bone, lung, abdomen, kidney, prostate, and bladder.
It can also be used to treat some sexually transmitted infections (STIs), some forms of infectious diarrhea, and typhoid fever.
The extended release form of ciprofloxacin is used to treat bladder and kidney infections.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each white, oval, film-coated tablet, imprinted with "R" on one side and "127" on the other, contains ciprofloxacin (as the hydrochloride) 500 mg. Nonmedicinal ingredients: microcrystalline cellulose, sodium starch glycolate, corn starch, colloidal silicon dioxide, magnesium stearate, hydroxypropyl methylcellulose, titanium dioxide, and polyethylene glycol.
How should I use this medication?
The recommended adult dose of ciprofloxacin tablets ranges from 250 mg to 750 mg twice daily. Depending on the type of infection being treated, you may need to take ciprofloxacin for 3 to 14 days. For bone infections it may be necessary to take ciprofloxacin for as long as 3 months. For STIs, the dose is given once as a single dose.
Ciprofloxacin tablets may be taken with food or on an empty stomach. Drink plenty of fluids while taking ciprofloxacin. Although ciprofloxacin can be taken with meals that include milk, you should not take ciprofloxacin with dairy products alone or with calcium-fortified products. Do not take antacids; supplements with calcium, magnesium, aluminum, or iron; or multivitamins 6 hours before or 2 hours after taking ciprofloxacin.
If you are taking the suspension form of this medication, use a medication syringe to measure each dose as it gives a more accurate measurement than household teaspoons. Shake the bottle well before measuring.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
It is important that this medication be taken exactly as prescribed by your doctor. Even if you start to feel better after the start of treatment, it's important to finish the entire amount that was prescribed. This helps to prevent the infection from returning and being harder to treat. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store the tablets at room temperature and keep them out of the reach of children. Store the oral suspension at room temperature or in the refrigerator in an upright position, protect it from freezing, and keep it out of the reach of children. After 14 days, safely discard any remaining medication.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use ciprofloxacin if you:
- are allergic to ciprofloxacin or any ingredients of the medication
- are allergic to other quinolone antibiotics
- are taking tizanidine
- changed sense of smell or taste
- general feeling of being unwell
- increased skin sensitivity to the sun
- loss of appetite
- mild diarrhea
- ringing in the ears or loss of hearing
- stomach discomfort or gas
- trouble sleeping
- coordination problems (unsteady walk) or muscle weakness
- hallucinations (hearing or seeing things that aren’t there)
- irregular or fast heart rate
- joint pain
- memory loss
- 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
- 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
- artery dissection (sudden severe pain in the chest, back, or abdomen)
- bulge in the wall of any artery (e.g., chest, arm, leg, brain, heart) (symptoms include cough, coughing blood, unusual pain high in neck or back, problems swallowing, pulsing sensation in chest or abdomen)
- confusion or changes in thought patterns
- diarrhea (watery and severe; may also be bloody)
- severe abdominal or stomach cramps or pain
- 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)
- thoughts of self-harm or suicide
- acetylsalicylic acid (ASA)
- amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
- 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)
- antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- BCG vaccine
- calcium supplements and multivitamins that contain calcium (do not take these products for at least 6 hours before or for 2 hours after ciprofloxacin)
- cholera vaccine
- oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
- diabetes medications (e.g., chlorpropamide, dapagliflozin, glyburide, insulin, linagliptin, metformin, rosiglitazone)
- 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)
- 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)
- 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, oxtriphylline, theophylline)
- thyroid replacements (e.g., desiccated thyroid, levothyroxine)
- typhoid vaccine
- tyrosine kinase inhibitors (e.g., bosutinib, dasatinib, erlotinib, imatinib, nilotinib, sunitinib)
- 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.
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.
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:
Stop using the medication and seek immediate medical attention if any of the following occur:
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.
HEALTH CANADA ADVISORY
January 23, 2017
Health Canada has issued new restrictions concerning the use of ciprofloxacin. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
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.
Bacterial resistance: Misuse of an antibiotic such as ciprofloxacin may lead to the growth of resistant bacteria that will not be killed by the antibiotic. If this happens, the antibiotic may not work for you in the future. Although you may begin to feel better when you first start taking ciprofloxacin, take all the medication exactly as directed by your doctor to finish ridding your body of the infection and to prevent resistant bacteria from taking hold. Do not take ciprofloxacin or other antibiotics to treat a viral infection such as the common cold; antibiotics do not kill viruses, and using them to treat viral infections can lead to the growth of resistant bacteria.
Behaviour and nervous system: Rarely, ciprofloxacin may affect behaviour and the nervous system. These changes can include confusion, tremors, depression (including thoughts of harming yourself), hallucinations (hearing, seeing, or feeling things that are not actually there), agitation, anxiety, difficulty sleeping, or nightmares. Some people have experienced a "pins and needles" feeling or numbness that does not always go away when the medication is stopped. If you experience these or any other behaviour changes while taking this medication, contact your doctor.
Blood glucose: Ciprofloxacin may cause changes in blood sugar levels (may cause a loss of blood glucose control) and glucose tolerance may change. It can cause either high or low blood glucose. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.
If you experience symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heartbeat, weakness) or symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour), talk to your doctor.
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.
Hypersensitivity syndrome: A severe allergic reaction called hypersensitivity syndrome has occurred for some people with the use of ciprofloxacin. This reaction involves a number of organs in the body and may be fatal if not treated quickly. Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.
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 by people taking ciprofloxacin, but these reports generally involved people who had conditions that predisposed them to abnormal heartbeat, or who had 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 30. Talk to your doctor if severe sun sensitivity occurs.
Tendinitis or tendon rupture: Ciprofloxacin may increase the chance of tendon injury, which occurs more commonly for seniors, people who are taking corticosteroid medications, and people who have had a kidney, heart, or lung transplant. This injury may cause permanent damage to the affected tendons. 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.
Seniors: People over the age of 65 may have a higher risk of side effects due to age-related decreases in kidney function.
What other drugs could interact with this medication?
There may be an interaction between ciprofloxacin and any of the following:
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:
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.
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