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What is the most important information I should know about ciprofloxacin?

You should not use this medication if you are taking tizanidine (Zanaflex), or if you are allergic to ciprofloxacin or similar antibiotics such as levofloxacin (Levaquin), moxifloxacin (Avelox), ofloxacin (Floxin), norfloxacin (Noroxin), lomefloxacin (Maxaquin), and others.

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.

Before taking ciprofloxacin, tell your doctor if you have kidney or liver disease, myasthenia gravis, joint problems, diabetes, a history of seizures, low levels of potassium in your blood (hypokalemia), or a personal or family history of "Long QT syndrome.”

Avoid taking antacids, vitamin or mineral supplements, sucralfate (Carafate), or didanosine (Videx) powder or chewable tablets within 6 hours before or 2 hours after you take ciprofloxacin. These other medicines can make ciprofloxacin much less effective when taken at the same time.

Ciprofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles’ tendon of the heel. These effects may be more likely to occur if you are over 60, if you take an oral steroid medication, or if you have had a kidney, heart, or lung transplant. Stop taking ciprofloxacin and call your doctor at once if you have sudden pain, swelling, tenderness, stiffness, or movement problems in any of your joints. Rest the joint until you receive medical care or instructions.

Warning

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.

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What is ciprofloxacin?

Ciprofloxacin is an antibiotic in a group of drugs called fluoroquinolones (flor-o-KWIN-o-lones). Ciprofloxacin fights bacteria in the body.

Ciprofloxacin is used to treat different types of bacterial infections.

Ciprofloxacin may also be used for other purposes not listed in this medication guide.

Precautions

You should not use ciprofloxacin if you are also taking tizanidine (Zanaflex), or if you are allergic to ciprofloxacin or similar medications such as levofloxacin (Levaquin), lomefloxacin (Maxaquin), moxifloxacin (Avelox), ofloxacin (Floxin), norfloxacin (Noroxin), and others.

Before taking ciprofloxacin, tell your doctor if you have a heart rhythm disorder, especially if you are being treated with one of these medications: quinidine (Cardioquin, Quinidex, Quinaglute), disopyramide (Norpace), bretylium (Bretylol), procainamide (Pronestyl, Procan SR), amiodarone (Cordarone, Pacerone), or sotalol (Betapace).

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you take ciprofloxacin, tell your doctor if you have:

  • a history of allergic reaction to an antibiotic;
  • joint problems;
  • myasthenia gravis;
  • kidney or liver disease;
  • epilepsy or seizures;
  • diabetes;
  • low levels of potassium in your blood (hypokalemia); or
  • a personal or family history of "Long QT syndrome."

FDA pregnancy category C. It is not known whether ciprofloxacin is 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.

Ciprofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles’ tendon of the heel. These effects may be more likely to occur if you are over 60, if you take an oral steroid medication, or if you have had a kidney, heart, or lung transplant. Stop taking ciprofloxacin and call your doctor at once if you have sudden pain, swelling, tenderness, stiffness, or movement problems in any of your joints. Rest the joint until you receive medical care or instructions.

Do not share this medication with another person (especially a child), even if they have the same symptoms you have.

You may be taking certain other medicines that should not be taken at the same time as ciprofloxacin. Avoid taking the following medicines within 6 hours before or 2 hours after you take ciprofloxacin. These other medicines can make ciprofloxacin much less effective when taken at the same time:

  • antacids that contain calcium, magnesium or aluminum (such as Tums, Mylanta, or Rolaids);
  • the ulcer medicine sucralfate (Carafate);
  • didanosine (Videx) powder or chewable tablets; or
  • vitamin or mineral supplements that contain calcium, iron, or zinc.

Avoid caffeine while you are taking ciprofloxacin, because the medication can make the effects of caffeine stronger.

Avoid exposure to sunlight, sunlamps, or tanning beds. Ciprofloxacin can make your skin more sensitive to sunlight, and a sunburn may result. Wear protective clothing and use a sunscreen (SPF-15 or higher) 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.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include seizures, urination problems, weakness, or blue lips with pale skin.

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.

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Side Effects

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:

  • dizziness, fainting, fast or pounding heartbeat;
  • sudden pain or swelling near your joints (especially in your arm or ankle);
  • diarrhea that is watery or bloody;
  • confusion, hallucinations, depression, unusual thoughts or behavior;
  • seizure (convulsions);
  • pale or yellowed skin, dark colored urine, fever, weakness;
  • urinating less than usual or not at all;
  • easy bruising or bleeding;
  • numbness, tingling, or unusual pain anywhere in your body;
  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or
  • the first sign of any skin rash, no matter how mild.

Less serious side effects may include:

  • nausea, vomiting;
  • dizziness or drowsiness;
  • blurred vision;
  • feeling nervous, anxious, or agitated;
  • sleep problems (insomnia or nightmares); or
  • increased sensitivity of the skin to sunlight.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may report side effects to FDA at 1-800-FDA-1088.

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Interactions

Do not take ciprofloxacin together with tizanidine (Zanaflex).

Before taking ciprofloxacin, tell your doctor if you are taking any of the following drugs:

  • a blood thinner such as warfarin (Coumadin);
  • clozapine (Clozaril, FazaClo);
  • cyclosporine (Neoral, Sandimmune);
  • insulin or diabetes medication you take by mouth, such as glyburide (Micronase, Diabeta, Glynase);
  • methotrexate (Rheumatrex, Trexall);
  • metoclopramide (Reglan);
  • phenytoin (Dilantin);
  • probenecid (Benemid);
  • ropinirole (Requip);
  • tacrine (Cognex);
  • theophylline (Theo-Dur, Theolair, Slo-Phyllin, Slo-Bid, Elixophyllin);
  • a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin, others), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), naproxen (Aleve, Naprosyn, Anaprox), and others; or
  • an oral steroid medication such as prednisone and others.

This list is not complete and there may be other drugs that can interact with 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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Disclaimer

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.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04