What is the most important information I should know about ciprofloxacin?
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.
What is ciprofloxacin?
Ciprofloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic that fights bacteria in the body. Ciprofloxacin is used to treat different types of bacterial infections. Ciprofloxacin 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.
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 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).
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.
To make sure ciprofloxacin is safe for you, tell your doctor if you have ever had:
- tendon problems, arthritis or other joint problems (especially in children);
- a muscle or nerve disorder;
- liver disease;
- kidney disease;
- seizures or epilepsy;
- a head injury or brain tumor;
- a personal or family history of Long QT syndrome;
- diabetes (especially if you take oral diabetes medication); or
- low levels of potassium in your blood (hypokalemia).
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 ciprofloxacin. 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?
Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Take ciprofloxacin 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 ciprofloxacin oral suspension through a feeding tube.
Do not crush, chew, or break an extended-release tablet. Swallow it whole.
Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Ciprofloxacin will not treat a viral infection such as the flu or a common cold.
Do not share this medicine with another person, even if they have the same symptoms you have.
Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze. Throw away any unused liquid after 14 days.
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 happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
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 ciprofloxacin. 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); or
- vitamin or mineral supplements that contain calcium, iron, or zinc.
Avoid caffeine while you are taking ciprofloxacin, because the medication can make the effects of caffeine stronger.
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. Do not use anti-diarrhea medicine unless your doctor tells you to.
Avoid exposure to sunlight or tanning beds. Ciprofloxacin can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Call your doctor if you have severe burning, redness, itching, rash, or swelling after being in the sun.
Ciprofloxacin may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
What are the possible side effects of ciprofloxacin?
Get emergency medical help if you have signs of an allergic reaction: hives, or the first sign of a skin rash; fast heartbeat, difficult breathing; swelling of your face, lips, tongue, or throat.
Ciprofloxacin may cause swelling or tearing of (rupture) a tendon. Ciprofloxacin 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); or
-
nerve symptoms --numbness, tingling, burning pain, or being more sensitive to temperature, light touch, or the sense of your body position.
Also, stop using ciprofloxacin 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 side effects may include:
- nausea, vomiting, diarrhea;
- rash; 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?
Tell your doctor about all your current medicines and any you start or stop using, especially:
- cyclosporine, methotrexate, phenytoin, probenecid, ropinirole, sildenafil, theophylline, or zolpidem;
- a blood thinner (warfarin, Coumadin, Jantoven);
- a diuretic or "water pill";
- heart rhythm medication;
- medicine to treat depression or mental illness;
-
NSAIDs (nonsteroidal anti-inflammatory drugs) --ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others; or
-
steroid medicine --prednisone, methylprednisolone, and others.
This list is not complete. Other drugs may interact with ciprofloxacin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Where can I get more information?
Your pharmacist can provide more information about ciprofloxacin.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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