Ciprofloxacin
Drug class: Fluoroquinolone; Quinolone antibiotic, is a second-generation fluoroquinolone.
Ciprofloxacin (CIPROXIN)（中文：環丙沙星）
Common Strengths[edit]
- Tablet: 250 mg, 500 mg
- Infusion: 200 mg/100 mL
- Eye/ear-drop 0.3% and eye-ointment 0.3%
Drug Trade Names[edit]
CIPROXIN
Drug Usage[edit]
Ciprofloxacin is a broad-spectrum antibiotic used to treat various bacterial infections, including:
- Urinary tract infections (UTIs)
- Respiratory tract infections (e.g., bronchitis, pneumonia)
- Skin and soft tissue infections
- Cystitis in women
- Prostatitis
- Gonorrhoea
- Anthrax (treatment and post-exposure)
- Surgical prophylaxis
- Crohn’s disease
- Prevention of secondary case of meningococcal meningitis
Mechanism of Action[edit]
Ciprofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, enzymes crucial for DNA replication and transcription. This action prevents bacterial cell division and growth.
Route of Administration[edit]
Ciprofloxacin can be administered via:
- Oral (tablets or liquid)
- Intravenous (IV)
- Topical (ear drops, eye drops)
Dosages[edit]
Typical dosages for adults are as follows:
- General Adult Dosage: 250 mg to 750 mg every 12 hours, depending on the infection type.
Renal dosing adjustments based on estimated Glomerular Filtration Rate (eGFR):
- eGFR >50 mL/min: Standard dosing
- eGFR 30-50 mL/min: Reduce dose by 50%
- eGFR <30 mL/min: Use with caution; consult healthcare provider.
Side Effects[edit]
| Frequency | Adverse reactions |
|---|---|
| Common Side Effects | Nausea |
| Diarrhea | |
| Headache | |
| Dizziness | |
| Serious Side Effects | Tendon rupture or swelling |
| Peripheral neuropathy | |
| Severe mood changes |
Pharmacokinetics[edit]
- Half-life: About 4 hours
- Onset of Action: Typically within 1-2 hours after oral administration
- Duration: Effects last approximately 12 hours per dose
Drug Precautions[edit]
Pregnancy
Ciprofloxacin is generally not recommended during pregnancy due to potential risk to the fetus.
Breastfeeding
Caution is advised as ciprofloxacin can pass into breast milk.
Children and Elderly
Use with caution; increased risk of tendon damage in these populations.
Drug Monitoring Items
Monitor renal function, liver function tests, and signs of adverse reactions.
- Symptoms of Tendinitis: Patients should be monitored for signs of tendinitis or tendon rupture, particularly in the Achilles tendon, as ciprofloxacin is associated with an increased risk of these conditions.
- Altered Mental Status: Monitoring for neuropsychiatric effects such as agitation, confusion, and seizures is crucial.
Drug Interactions
Avoid concurrent use with:
- Antacids containing aluminum or magnesium
- Iron supplements
- Warfarin: Ciprofloxacin can enhance the anticoagulant effect of warfarin, increasing the risk of bleeding.
- Tizanidine: This muscle relaxant should not be combined with ciprofloxacin, as it can significantly increase tizanidine levels, leading to severe hypotension and sedation.
- Duloxetine (Cymbalta): The combination may lead to elevated levels of duloxetine, increasing the risk of serotonin syndrome.
FAQ[edit]
How should I take the tablet?
Swallow whole with plenty of water; do not crush or chew.
What should I avoid while taking?
Ciprofloxacin should be taken at least 2 hours before or 6 hours after consuming dairy products. This is necessary because the calcium in dairy can bind to ciprofloxacin, reducing its absorption and effectiveness.
Similar to dairy, ciprofloxacin should not be taken with antacids that contain calcium, magnesium, or aluminum. It is recommended to separate the doses by at least 2 hours before or 6 hours after taking these antacids.
What happens if I miss a dose?
Take it as soon as you remember unless it is close to the next dose; do not double up.
