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Ciprofloxacin
Generic Name: ciprofloxacin (sip row FLOX a sin)
Brand Names: Cipro, Cipro XR

What is the most important information I should know about ciprofloxacin?
Do not take ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified juice. You may eat or drink dairy products or calcium-fortified juice with a regular meal, but do not use them alone when taking ciprofloxacin. They could make the medication less effective. Take all of the ciprofloxacin that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated. Drink several extra glasses of fluid every day while taking ciprofloxacin. If you drink dairy products (milk, yogurt) or calcium-fortified juice, drink them with a meal and not when you are taking your ciprofloxacin dose. Certain medicines should be taken at least 2 hours after or 6 hours before you take ciprofloxacin. This includes didanosine (Videx) chewable/buffered tablets or powder; sucralfate (Carafate); antacids that contain calcium, magnesium or aluminum (such as Tums or Rolaids); or vitamin or mineral supplements that contain calcium, iron, or zinc.

Taking ciprofloxacin can make your skin more sensitive to sunlight. Avoid exposure to sunlight, sun lamps, or tanning beds.

What is ciprofloxacin?
Ciprofloxacin is an antibiotic in a group of drugs called fluoroquinolones. Ciprofloxacin fights bacteria in the body.

Ciprofloxacin is used to treat different types of bacterial infections.

Ciprofloxacin may also be used for purposes other than those listed here.

What should I discuss with my healthcare provider before taking ciprofloxacin?
Before taking ciprofloxacin, tell your doctor if you have:

a history of allergic reaction to an antibiotic;
joint problems;
kidney disease; or
epilepsy or seizures.

If you have any of these conditions, you may not be able to use ciprofloxacin or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C: This medication may be harmful to an unborn baby. Do not use ciprofloxacin without telling your doctor if you are pregnant. Tell your doctor if you become pregnant during treatment. Ciprofloxacin passes into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take ciprofloxacin?
Take ciprofloxacin exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor.

Take each dose with a full glass of water (8 ounces). Drink several extra glasses of fluid each day while you are taking ciprofloxacin. Shake the oral suspension (liquid) for at least 15 seconds just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

When taking the oral liquid, swallow it without chewing the medicine beads you may notice in the liquid.

Do not crush, chew or break the extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

Ciprofloxacin may be taken with or without food, but take it at the same time each day. 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. Take this medication for as many days as it has been prescribed for you even if you begin to feel better. Your symptoms may get better before the infection is completely treated. Ciprofloxacin will not treat a viral infection such as the common cold or flu. Store ciprofloxacin at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.

What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine.
Symptoms of a ciprofloxacin overdose may include seizures, urination problems, weakness, or blue lips with pale skin.

What should I avoid while taking ciprofloxacin?
Avoid caffeine while you are taking ciprofloxacin, because the medication can make the effects of caffeine stronger.

Avoid prolonged exposure to sunlight, sunlamps, or tanning beds. Ciprofloxacin make your skin more sensitive to sunlight, and a sunburn may result. Wear protective clothing and use a sunscreen if you must be out in the sun. Call your doctor if you have severe burning, redness, itching, rash, or swelling after being in the sun.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Ciprofloxacin can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What other drugs will affect ciprofloxacin?
Do not use ciprofloxacin if you are also taking tizanidine (Zanaflex). Certain medicines should be taken at least 2 hours after or 6 hours before you take ciprofloxacin. This includes didanosine (Videx) chewable/buffered tablets or powder; sucralfate (Carafate); antacids that contain calcium, magnesium or aluminum (such as Tums or Rolaids); or vitamin or mineral supplements that contain calcium, iron, or zinc.
Before taking ciprofloxacin, tell your doctor if you are taking any of the following drugs:

didanosine (Videx, ddI);

theophylline (Theo-Dur, Theolair, Slo-Phyllin, Slo-Bid, Elixophyllin);

warfarin (Coumadin);

probenecid (Benemid);

insulin or an oral diabetes medication such as glipizide (Glucotrol), glyburide (Micronase, Diabeta, Glynase), and others;

a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin, others), naproxen (Aleve, Naprosyn, Anaprox), ketoprofen (Orudis KT, Orudis, Oruvail), and others;

phenytoin (Dilantin); or

cyclosporine (Neoral, Sandimmune).

There may be other drugs not listed that can affect ciprofloxacin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Stop using ciprofloxacin and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using ciprofloxacin and call your doctor at once if you have any of these serious side effects:
   seizure (black-out or convulsions);

   confusion, hallucinations, depression, or thoughts of hurting yourself or others;

   sudden pain or swelling near your joints (especially in your arm or ankle);

   nausea, stomach pain, low fever, lost appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

   diarrhea that is watery or bloody;

   urinating more or less than usual;

   numbness, tingling, or unusual pain anywhere in your body; or

   chest pain, pounding or fast heartbeats.

Other less serious side effects are more likely to occur, such as:

   nausea, vomiting;

   dizziness or drowsiness;

   blurred vision;

   sleep problems (insomnia);

   joint stiffness or muscle pain; or

   increased sensitivity of the skin to sunlight.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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Ciprofloxacin is available with a prescription under the brand name Cipro. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Cipro 250 mg - round, yellowish, film-coated tablets

• Cipro 500 mg - capsule-shaped, yellowish, film-coated tablets

• Cipro 750 mg - capsule-shaped, yellowish, film-coated tablets

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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