Ciprofloxacin

For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule.

Read the Medication Guide provided by your pharmacist before you start using ciprofloxacin and each time you get a refill. If you have any questions, consult your doctor or pharmacist. This medication is given by injection into a vein, usually 2 to 3 times a day or as directed by your doctor. It should be injected slowly over 1 hour. The dosage is based on your medical condition and response to treatment. If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely. Drink plenty of fluids while using this medication unless your doctor tells you otherwise. Antibiotics work best when the amount of medicine in your body is kept at a constant level. Therefore, use this drug at evenly spaced intervals (e.g., every 12 hours, every 8 hours). Continue to use this medication for the full time prescribed, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a return of the infection. Tell your doctor if your condition persists or worsens.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: clozapine, corticosteroids (e.g., prednisone, hydrocortisone), cyclosporine, duloxetine, glyburide, methotrexate, nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, naproxen), phenytoin, probenecid, ropinirole, theophylline, tizanidine, live bacterial vaccines, warfarin. Many drugs besides ciprofloxacin may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide, quinidine, procainamide, sotalol, certain macrolide antibiotics (e.g., erythromycin, clarithromycin), and certain antipsychotic medications (e.g., pimozide, thioridazine, ziprasidone), among others. Therefore, before using ciprofloxacin, report all medications you are currently using to your doctor or pharmacist. Also report the use of drugs which might increase seizure risk when combined with ciprofloxacin such as isoniazid (INH), phenothiazines (e.g., thioridazine), theophylline, or tricyclic antidepressants (e.g., amitriptyline), among others. Consult your doctor or pharmacist for details. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas), eating large amounts of chocolate, or taking medications that contain caffeine such as over-the-counter stimulants. This drug may increase and prolong the effects of caffeine.

With prolonged use, laboratory and/or medical tests (e.g., kidney and liver function tests, complete blood count) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: an unusual change in the amount of urine.

Before using ciprofloxacin, tell your doctor or pharmacist if you are allergic to it; or to other quinolone antibiotics (e.g., gatifloxacin, levofloxacin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: seizure disorder, conditions that increase your risk of seizures (e.g., brain/head injury, brain tumors), nervous system disorders (e.g., peripheral neuropathy), kidney disease, liver disease, joint/tendon problems (e.g., tendonitis, bursitis), heart problems (e.g., slow/fast/irregular heartbeat, recent heart attack). Ciprofloxacin may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can infrequently result in serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that require immediate medical attention. The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may affect the heart rhythm (see also Drug Interactions section). Before using ciprofloxacin, tell your doctor or pharmacist if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death). Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using ciprofloxacin safely. If you have diabetes, you may experience changes in blood glucose levels due to infection or use of ciprofloxacin. Symptoms of high blood sugar include increased thirst and urination. Ciprofloxacin may increase the blood sugar-lowering effects of the medication glyburide. Watch for symptoms of low blood sugar such as nervousness, shaking, sweating, fast heartbeat, or hunger. Follow your doctor's instructions to treat your low blood sugar level (e.g., take glucose tablets or gel; eat a quick source of sugar such as table sugar, honey, or candy; drink a glass of orange juice or non-diet soda). Tell your doctor immediately if you experience symptoms of high or low blood sugar while using this medication. Monitor your blood glucose levels as directed by your doctor. This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors. Caution is advised when using this medication in children younger than 18 years of age because they may be at greater risk for joint/tendon problems. Discuss the risks and benefits with the doctor. Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, older adults may be at greater risk for tendon problems while using this drug, especially if they are also taking corticosteroids (e.g., prednisone, hydrocortisone). Older adults may also be more sensitive to the side effect of this medication on the heart rhythm (QT prolongation). Discuss the risks and benefits with your doctor. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. This medication passes into breast milk. Consult your doctor before breast-feeding.

Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

See also Warning section. Diarrhea, nausea, dizziness, or lightheadedness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if you have any serious side effects, including: sunburn-like skin reaction (sun sensitivity), shaking (tremors), mental/mood changes (such as anxiety, confusion, hallucinations, depression, rare thoughts of suicide), redness/swelling/pain at the injection site, seizures, severe/persistent headache, vision changes, unusual change in the amount of urine, easy or unusual bruising/bleeding, signs of a new infection (e.g., new/persistent fever, persistent sore throat). Get medical help right away if any of these rare but very serious side effects occur: severe dizziness, fainting, fast/irregular heartbeat. Ciprofloxacin may rarely cause serious nerve problems that may be reversible if identified and treated early. Get medical help right away if you develop any of the following symptoms: pain/numbness/burning/tingling/weakness in any part of the body, changes in how you sense touch/pain/temperature/vibration/body position. This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a type of resistant bacteria. This condition may occur during treatment or weeks to months after treatment has stopped. Do not use anti-diarrhea products or narcotic pain medications if you have any of the following symptoms because these products may make them worse. Tell your doctor immediately if you develop: persistent diarrhea, abdominal or stomach pain/cramping, blood/mucus in your stool. Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms. A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing, chest pain, fainting, signs of liver problems (e.g., unusual tiredness, stomach/abdominal pain, persistent nausea/vomiting, yellowing eyes/skin, dark urine). This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

This medication may rarely cause tendon damage (e.g., tendinitis, tendon rupture) during or after treatment. Your risk for tendon problems is greater if you are over 60 years of age, if you are taking corticosteroids (such as prednisone), or if you have had a kidney, heart or lung transplant. Stop exercising, rest, and seek immediate medical attention if you develop joint/muscle/tendon pain or swelling.