Ciprofloxacin Drug Profile

What is Ciprofloxacin?

Ciprofloxacin is a broad-spectrum antibiotic belonging to the fluoroquinolone class of medications. It is used to treat various bacterial infections by killing or stopping the growth of bacteria. This prescription medication is available in oral tablets, oral suspension, and intravenous formulations for hospital use.

Uses

Ciprofloxacin is prescribed to treat several types of bacterial infections:

• Urinary tract infections (UTIs): Including complicated and uncomplicated bladder and kidney infections
• Respiratory tract infections: Such as pneumonia, bronchitis, and sinus infections caused by susceptible bacteria
• Skin and soft tissue infections: Including wound infections and cellulitis
• Gastrointestinal infections: Certain types of infectious diarrhea and traveler’s diarrhea
• Bone and joint infections: Particularly those caused by gram-negative bacteria

How it works

Ciprofloxacin works by interfering with bacterial DNA replication and repair processes. It inhibits two essential bacterial enzymes called DNA gyrase and topoisomerase IV, which are necessary for bacteria to copy their genetic material and multiply. By blocking these enzymes, ciprofloxacin prevents bacteria from reproducing and ultimately leads to bacterial cell death.

Side effects

Common side effects include:

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• Nausea and vomiting
• Diarrhea
• Stomach pain or cramping
• Headache
• Dizziness
• Sleep problems or insomnia
• Rash or skin irritation
• Vaginal itching or discharge

Serious side effects requiring immediate medical attention:

• Tendon pain, swelling, or rupture (especially Achilles tendon)
• Severe diarrhea or signs of C. difficile infection
• Irregular heartbeat or fainting
• Severe allergic reactions with difficulty breathing
• Peripheral neuropathy (numbness, tingling in hands or feet)

Warnings and precautions

• Tendon risks: Fluoroquinolones increase the risk of tendon rupture, particularly in patients over 60, those taking corticosteroids, or individuals with kidney, heart, or lung transplants
• Pregnancy and breastfeeding: Generally avoided during pregnancy and breastfeeding unless benefits clearly outweigh risks, as it may affect developing cartilage
• Kidney function: Dosage adjustments are necessary for patients with reduced kidney function to prevent drug accumulation
• CNS effects: May cause dizziness, confusion, or seizures, especially in elderly patients or those with predisposing conditions
• Myasthenia gravis: Can worsen muscle weakness in patients with this condition and should be avoided

Interactions

• Antacids and iron supplements: Significantly reduce ciprofloxacin absorption when taken together; separate doses by 2-6 hours
• Warfarin: May increase bleeding risk by enhancing warfarin’s anticoagulant effects
• Theophylline: Ciprofloxacin can increase theophylline levels, potentially causing toxicity
• Dairy products: Calcium in milk and yogurt can reduce drug absorption; avoid taking together
• Corticosteroids: Combined use further increases tendon rupture risk
• Cyclosporine: May increase cyclosporine levels and kidney toxicity risk
• Class IA and III antiarrhythmics: Increased risk of dangerous heart rhythm abnormalities
• NSAIDs: May increase risk of central nervous system stimulation and seizures

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Dosage

Typical adult dosing varies based on the type and severity of infection:

• Uncomplicated UTI: 250-500 mg every 12 hours for 3-7 days
• Complicated UTI or kidney infection: 500-750 mg every 12 hours for 7-14 days
• Respiratory tract infections: 500-750 mg every 12 hours for 7-14 days
• Skin infections: 500-750 mg every 12 hours for 7-14 days

Dosages must be adjusted for patients with kidney impairment. Always take ciprofloxacin exactly as prescribed by your healthcare provider, and complete the full course even if symptoms improve early.

Sources: FDA DailyMed drug labels (public domain), BNF, WHO Essential Medicines List. This article is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider before starting or stopping any medication.

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