ciprofloxacin (oral)

What is the most important information I should know about ciprofloxacin?

Ciprofloxacin can cause serious side effects, including tendon problems, nerve damage, serious mood or behavior changes, or low blood sugar.

What is ciprofloxacin?

Ciprofloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic, it 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. Ciprofloxacin extended-release is only approved for use in adults.

Fluoroquinolone antibiotics can cause serious or disabling side effects that may not be reversible. Ciprofloxacin should be used only for infections that cannot be treated with a safer antibiotic.

Ciprofloxacin may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking ciprofloxacin?

• you also take tizanidine; or
• you are allergic to other fluoroquinolones (levofloxacin, moxifloxacin, norfloxacin, ofloxacin).

Tell your doctor if you have ever had:

• arthritis or problems with your tendons, bones or joints (especially in children);
• diabetes, low blood sugar;
• nerve problems;
• an aneurysm or blood circulation problems;
• heart problems, or a heart attack;
• muscle weakness, myasthenia gravis;
• liver or kidney disease;
• a seizure, head injury, or brain tumor;
• trouble swallowing pills;
• long QT syndrome (in you or a family member); or
• low levels of potassium in your blood (hypokalemia).

Do not give this medicine to a child without medical advice.

How should I take ciprofloxacin?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Take ciprofloxacin at the same time each day, with or without food.

Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Ciprofloxacin will not treat a viral infection such as the flu or a common cold.

What happens if I miss a dose?

If you take regular tablets or oral suspension: Take the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 6 hours.

If you take extended-release tablets: Take the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 8 hours.

Do not take two doses at one time.

What happens if I overdose?

What should I avoid while taking ciprofloxacin?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor before using anti-diarrhea medicine.

What are the possible side effects of ciprofloxacin?

Ciprofloxacin can cause serious side effects, including tendon problems, damage to your nerves (which may be permanent), serious mood or behavior changes (after just one dose), or low blood sugar (which can lead to coma).

• low blood sugar --headache, hunger, irritability, dizziness, nausea, fast heart rate, or feeling shaky;
• nerve damage symptoms --numbness, tingling, burning pain in your hands, arms, legs, or feet:
• serious mood or behavior changes --nervousness, confusion, agitation, paranoia, hallucinations, memory problems, trouble concentrating, thoughts of suicide; or
• 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).

• severe stomach pain, diarrhea that is watery or bloody;
• fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out);
• any skin rash, no matter how mild;
• muscle weakness, breathing problems;
• little or no urination;
• jaundice (yellowing of the skin or eyes); or
• increased pressure inside the skull --severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes.

Common side effects may include:

• nausea, vomiting, diarrhea, stomach pain;
• headache; or
• abnormal 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. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect ciprofloxacin?

• the ulcer medicine sucralfate, or antacids that contain calcium, magnesium, or aluminum (such as Maalox, Milk of Magnesia, Mylanta, Pepcid Complete, Rolaids, Tums, and others);
• didanosine (Videx) powder or chewable tablets;
• vitamin or mineral supplements that contain calcium, iron, magnesium, or zinc.

Tell your doctor about all your other medicines, especially:

• clozapine, cyclosporine, methotrexate, phenytoin, probenecid, ropinirole, sildenafil, or theophylline;
• a blood thinner (warfarin, Coumadin, Jantoven);
• heart medication or a diuretic or "water pill";
• oral diabetes medicine;
• products that contain caffeine;
• medicine to treat depression or mental illness;
• steroid medicine (such as prednisone); o
• NSAIDs (nonsteroidal anti-inflammatory drugs) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;

This list is not complete. Other drugs may affect ciprofloxacin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about ciprofloxacin.