Cipro (Ciprofloxacin)

1. What is Cipro?
2. Indications for Use
3. Dosage Guidelines
4. Overdose
5. How to Take Cipro?
6. Duration of treatment
7. Contraindications and warnings
8. Side Effects
9. Interactions with Other Drugs

What is Cipro?

Cipro is an antibiotic of a broad spectrum of action used to treat various infectious diseases. The remedy is considered the drug of the second generation of fluoroquinols. The preparation instructions for use can be used only after determining the type of pathogenic microflora. The active substance of the drug is ciprofloxacin hydrochloride monohydrate.

The mechanism of its action is associated with the impact on DNA gyrase (topoisomerase), which plays an important role in bacterial DNA reproduction. The substance has a rapid bactericidal activity against microorganisms in resting and reproduction stage.

The spectrum of ciprofloxacin action includes the following types of Gram positive and Gram negative microorganisms:

1. Gram-Positive Bacteria: Staphylococcus, Listeria, Sreptococcus agalactiae;
2. Gram-Negative Bacteria: E.coli, Shigella, Salmonella, Citrobacter, Klebsiella, Enterobacter, Serratia, Hafnia, Edwardsiella, Proteus, Providencia, Morganella, Yersinia, Vibrio, Aeromonas, Plesiomonas, Pasteurella, Haemophilus, Campylobacter, Pseudomonas, Legionella, Neisseria, Moraxella, Branhamella, Acinetobacter, Brucella, Chlamydia.

The antibiotic is effective against bacteria that produce beta-lactamase.

Ciprofloxacin hypersensitivity varies with the following bacteria: Gardnerella, Flavobacterium, Alcaligenes, Streptococcus faecalis, Streptococcus pyogenes, Streptococcus pneumonia, Streptococcus viridans, Mycoplasma hominis, Mycobacterium tuberculosis, Mycobacterium fortuitum. Most often resistant: Streptococcus faecium, Ureaplasma urealyticum, Nocardia asteroides.

Indications for Use

Cipro is used to treat the following conditions:

• respiratory tract infection. In-patient treatment of pneumococcal pneumonia, Ciprofloxacin is not drug of the first stage, but it is indicated for pneumonia caused by, for example, Klebsiella, enterobacteria, Pseudomonas bacteria, Hemophilus, Branhamella bacteria, Legionella, staphylococci;
• middle ear and sinuses infections, especially if they are caused by Gram-negative bacteria, including Pseudomonas bacteria or staphylococci;
• eye infections;
• kidney and urinary tract infections;
• skin and soft tissue infections;
• bones and joints infections;
• pelvic infections;
• gonorrhea;
• gastrointestinal infection;
• gallbladder and biliary tract infection;
• peritonitis;
• sepsis.

If you come across with any of mentioned above disorder you are welcome on Canadian Health&Care Mall Pharmacy to order Cipro to overcome them as quick as possible. Important: this antibiotic can be used for other purposes not described in this manual.

Dosage Guidelines

In absence of specific instructions, a doctor recommends the following Cipro doses:

• One-time / daily dose for adults – uncomplicated infections of the lower and upper urinary tract – 2×125 mg;
• Complicated urinary tract infection (depending on the severity) – 2×250-500 mg;
• Respiratory Tract Infections – 2×250-500 mg;
• Other infections – 2×250-500 mg.

Patients with impaired renal function:

When creatinine clearance is less than 20 ml/min (serum creatinine level or above 3 mg / 100ml), the drug is administered 2 times a day, half the standard dose or 1 time a day full standard dose.

Patients with impaired hepatic function:

Dose adjustment is not required.

Patients on peritoneal dialysis:

At peritonitis, ciprofloxacin is administered at a dosage of 0.5 g 4 times daily or drug is added as infusion solution at a dose of 0.05 g 4 times a day on 1 liter of dialysate intraperitoneally.

Overdose

Do not exceed the recommended dosage. With an overdose of ciprofloxacin, a patient experiences the following adverse reactions:

• Tremor in the hands and feet;
• Dizziness;
• Convulsive activity;
• Headache;
• Stomach ache;
• Vomiting;
• Diarrhea;
• Hallucinations;
• Renal or hepatic insufficiency;
• Blood in the urine

An overdose therapy requires symptomatic agents.

How to Take Cipro?

• The drug is taken orally, with water;
• Take this antibiotic exactly as directed by your doctor. To clarify the indications for use, contact your doctor or pharmacist;
• Each dose should be taken with a full glass of water (200 ml). Drink a few extra glasses of water every day to prevent the formation of crystals of Cipro in the urine;
• Do not break or chew the tablet. Swallow it. Its composition is specifically designed for slow dissolution of the drug in the body;
• Cipro can be taken with food or on an empty stomach. It is recommended to take the drug twice a day after meals;
• Do not take this drug with dairy products (such as milk or yogurt) or calcium-fortified juice. The antibiotic can be used together with products containing calcium, however, when the drug is used together with milk or calcium-fortified juice, the effect of the drug may be weakened;
• Take pills at regular intervals;
• It is necessary to complete the course of treatment with the drug. Improvement can occur before the complete eradication of the infection.

Duration of treatment

Duration of Cipro treatment depends on disease’s severity, clinical course, and bacteriological examination results.

• It is recommended to continue treatment for at least 3 days after temperature normalization or clinical symptoms disappearance;
• Treatment duration for acute uncomplicated gonorrhea and cystitis lasts 1 day;
• Kidneys, urinary tract, and abdominal cavity infections – up to 7 days;
• In case of osteomyelitis, treatment can last up to two months;
• For other infections course of treatment – 7-14 days;
• In patients with reduced immunity treatment is carried out during the entire period of neutropenia.

Contraindications and warnings

Contraindications for Cipro:

• Children under 18 years of age (used in extreme cases, because the process of skeleton formation is not over, and the drug can disrupt this process);
• Pregnancy and lactation;
• Diseases of ligaments and tendons;
• Allergy to the components of the drug;
• Simultaneous reception with tizanidine;
• Epilepsy

In elderly patients, the drug should be used with caution. Patients with epilepsy, seizures attacks in anamnesis, vascular diseases and organic brain lesions due to the threat of central nervous system adverse reactions, ciprofloxacin should be used only for life indications.

Warnings:

• Avoid direct sunlight. Cipro can strengthen the photosensitivity of the skin and cause sunburn. In the event that sunlight cannot be avoided, you should wear long clothes and use a sunscreen. In case of serious sunburn, redness, itching, rash or swelling due to sun exposure, consult a doctor.
• Care must be taken when driving, operating industrial equipment or performing other hazardous work. The antibiotic may cause dizziness. If you experience dizziness, refrain from dangerous activities.
• Avoid excessive consumption of products containing caffeine. The drug can enhance the effect of caffeine.

Watch the video which reveals whether Cipro is dangerous or not:

Side Effects

Ciprofloxacin is usually well tolerated by patients. Sometimes, the treatment may cause the following, usually reversible side effects:

• Cardiovascular system: very rarely – tachycardia, hot flushes, migraine, fainting.
• Digestive tract and liver: nausea, vomiting, diarrhea, abdominal pain, flatulence, anorexia.
• Nervous and mental system: dizziness, headache, fatigue, insomnia, agitation, tremor. In very rare cases: peripheral sensory disturbance, sweating, unsteady gait, seizures, convulsions, anxiety and confusion, nightmares, depression, hallucinations, taste and smell disorder, visual disturbance (diplopia, chromatopsia), tinnitus, temporary hearing loss especially at the high-pitched sounds. In the case of these reactions, you should immediately stop drug intake and inform your doctor.
• Hematopoietic system: eosinophilia, leukopenia, thrombocytopenia, rarely – leukocytosis, thrombocytosis, haemolytic anemia.
• Allergic and immunopathological reactions: skin rash, pruritus, fever, and photosensitivity; seldom – angioedema, bronchospasm, arthralgia, very rarely – anaphylactic shock, myalgia, Stevens-Johnson syndrome, Lyell’s syndrome, interstitial nephritis, hepatitis.
• Musculoskeletal system: there are few reports that Cipro was accompanied by tendon rupture shoulder, hand and Achilles tendons. When there are complaints, treatment should be discontinued.

Interactions with Other Drugs

Do not take antacids containing calcium, magnesium or aluminum; remedy for gastric ulcer sucralfate; or vitamin or nutritional supplements containing calcium, iron or zinc at least six hours before taking Cipro and within two hours after taking the drug. Almost simultaneous administration of the drug with sucralfate or vitamin or mineral supplements can greatly reduce the effect of the antibiotic.

Before you begin treatment with the drug, tell your doctor if you are taking any of the medicines listed below:

• didanosine (Videx, ddI);
• theophylline (Theo-Dur, Theolair, Slo-Phyllin, Slo-Bid, Elixophyllin);
• warfarin (Coumadin);
• probenecid (Benemid);
• insulin or oral diabetic drugs such as glipizide (Glucotrol), glibenclamide (Micronase, Diabeta, Glynase) and others;
• non-steroidal anti-inflammatory therapy (NSAIDs) such as ibuprofen (Motrin, Advil, Nuprin, others), Naproxen (Aleve, Naprosyn, Anaprox), ketoprofen (Orudis KT, Orudis, Oruvail) and others;
• phenytoin (Dilantin);
• ciclosporin (Neoral, Sandimmune).

If you are taking any of the drugs listed above, you should not start taking this antibiotic or you need to adjust the dosage and take the medicine under the supervision of a doctor.

Cipro can interact with other drugs not mentioned in this manual. When taking other prescription drugs and over-the-counter medicines, including herbs, you should consult your doctor.