Ciprofloxacin (sip-roe-FLOX-a-sin)

Treats infections and plague (including pneumonic and septicemic plague). It is also given to people who have been exposed to anthrax. This medicine is a quinolone antibiotic.

Brand Name(s):

Cipro

When This Medicine Should Not Be Used:

How to Use This Medicine:

Liquid, Tablet, Long Acting Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed. Take this medicine at the same time each day.
• You may take this medicine with or without food. Do not take this medicine with only a source of calcium, including milk, yogurt, or juice that contains added calcium. You may have foods or drinks that contain calcium as part of a larger meal.
• Swallow the extended-release tablet whole. Do not crush, break, or chew it.
• Oral liquid: Shake for at least 15 seconds just before each use. The liquid has small beads floating in it. Do not chew the beads when you drink the liquid. Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• Tablet: You may swallow the tablet whole or break it in half at the score line. Do not crush or chew it. Tell your doctor if you have trouble swallowing the tablet.
• Drink extra fluids so you will urinate more often and help prevent kidney problems.
• Take all of the medicine in your prescription to clear up your infection, even if you feel better after the first few doses.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: If you miss a dose of the oral liquid or tablet and it is 6 hours or more until your next regular dose, take the missed dose as soon as possible, and then go back to your regular schedule. If you miss a dose and it is less than 6 hours until your next regular dose, skip the missed dose and take your next dose at the regular time.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Throw away any leftover liquid medicine after 14 days.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with tizanidine.
• Some foods and medicines can affect how ciprofloxacin works. Tell your doctor if you are using any of the following:
  • Clozapine, cyclosporine, duloxetine, lidocaine, methotrexate, olanzapine, pentoxifylline, phenytoin, probenecid, ropinirole, sildenafil, theophylline, zolpidem
  • Antibiotic (including azithromycin, clarithromycin, erythromycin)
  • Blood thinner (including warfarin)
  • Insulin or oral diabetes medicine (including glimepiride, glyburide)
  • Medicine for depression or mental illness
  • Medicine for heart rhythm problems (including amiodarone, procainamide, quinidine, sotalol)
  • NSAID pain medicine (including aspirin, celecoxib, diclofenac, ibuprofen, naproxen)
  • Steroid medicine (including hydrocortisone, methylprednisolone, prednisone)
• Take ciprofloxacin at least 2 hours before or 6 hours after you take didanosine buffered tablets for oral suspension or the pediatric powder for oral suspension, sucralfate, or antacids, multivitamins, or other products containing aluminum, magnesium, lanthanum, sevelamer, iron, or zinc.
• This medicine slows the digestion of caffeine, so it might affect you for longer than normal.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or planning to become pregnant, or if you have kidney disease, liver disease, diabetes, heart disease, myasthenia gravis, aortic aneurysm (bulge in the wall of the largest artery), or a history of heart rhythm problems (including prolonged QT interval), electrolyte imbalance, nerve problems, seizures, brain problems, stroke, or mental illness. Tell your doctor if you have ever had tendon or joint problems, including rheumatoid arthritis, or if you have received a transplant.
• Your doctor may tell you to stop breastfeeding, and pump and discard your breast milk during treatment and for at least 2 days after your final dose.
• This medicine may cause the following problems:
  • Tendinitis and tendon rupture (which may happen after treatment ends)
  • Nerve damage in the arms or legs, which may become permanent
  • Changes in mood or behavior, seizures, or increased pressure in the head
  • Serious skin reactions
  • Kidney problems
  • Liver problems
  • Increased risk of aortic aneurysm
  • Heart rhythm changes
  • Changes in blood sugar levels
• This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• This medicine can cause diarrhea. Call your doctor if the diarrhea becomes severe, does not stop, or is bloody. Do not take any medicine to stop diarrhea until you have talked to your doctor. Diarrhea can occur 2 months or more after you stop taking this medicine.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• Call your doctor if your symptoms do not improve or if they get worse.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Change in how much or how often you urinate, cloudy or bloody urine
• Dark urine, pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Diarrhea which may contain blood
• Fainting, dizziness, or lightheadedness
• Fast, slow, or uneven heartbeat
• Numbness, tingling, weakness, or burning pain in your hands, arms, legs, or feet
• Pain, stiffness, swelling, or bruises around your ankle, leg, shoulder, or other joints
• Seizures, severe headache, unusual thoughts or behaviors, trouble sleeping, feeling anxious, confused, or depressed, seeing, hearing, or feeling things that are not there
• Sensitivity of the skin to sunlight, redness or other discoloration of the skin, severe sunburn
• Sudden chest, stomach, or back pain, trouble breathing, cough
• Unusual bleeding, bruising, or weakness

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088