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

Treats infections that are caused by bacteria. Also used to treat anthrax infection after possible exposure. This medicine is a fluoroquinolone 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 of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• The extended-release tablet (Cipro® XR, Proquin® XR) is NOT the same as the regular-release tablet (Cipro®) or liquid (Cipro®). Use the exact medicine that your doctor prescribed. Do not use a different medicine, even if the names look alike.
• You may take this medicine with or without food. Do not take this medicine with milk, yogurt, or other dairy products. Do not drink any juice with calcium added when you take this medicine. You may have dairy products or juice as part of a larger meal and then take this medicine with that meal.
• Proquin® XR tablets should be taken with a main meal, preferably the evening meal.
• Swallow the extended-release tablet whole. Do not crush, break, or chew it.
• Shake the oral liquid for at least 15 seconds just before each use. The oral liquid has small microcapsules floating in it. These microcapsules may look like bubbles or small beads. Do not chew the microcapsules when you drink the oral liquid. Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems.
• Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose. Do not take more than one extended-release tablet (Cipro® XR, Proquin® XR) each day.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. You may store the oral liquid at room temperature or in the refrigerator. Do not freeze. Do not keep the oral liquid for more than 14 days. Throw away any unused liquid after 14 days.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

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

• Make sure your doctor knows if you are using a steroid medicine (such as dexamethasone, prednisolone, prednisone, or Medrol®). Using a steroid together with this medicine may increase your chance of having tendon problems.
• Make sure your doctor knows if you are also using cyclosporine (Gengraf®, Neoral®, Sandimmune®), metoclopramide (Reglan®, Reglan ODT®), methotrexate (Folex®, Rheumatrex®, Trexall®), omeprazole (Prilosec®), phenytoin (Dilantin®), probenecid (Benemid®, Col-probenecid®), or theophylline (Elixophyllin®, Theochron®, Theolair®, Theo-Dur®, Theo-24®, Uniphyl®). Tell your doctor if you are using a blood thinner (such as warfarin, Coumadin®, Jantoven®), diabetes medicine (such as glyburide, Diabeta®, Glucovance®, Glynase®, or Micronase®), heart rhythm medicine (such as amiodarone, disopyramide, dofetilide, quinidine, procainamide, sotalol, Betapace®, Cardioquin®, Cordarone®, Norpace®, Procanbid® , Quinaglute®, or Tikosyn®), or pain or arthritis medicine (such as ibuprofen, naproxen, Advil®, Aleve®, or Celebrex®).
• Make sure your doctor knows if you are also using medicine for depression (such as amitriptyline, fluoxetine, nortriptyline, Elavil®, Pamelor®, Prozac®, Sarafem®, or Vivactil®) or medicine to treat mental illness (such as haloperidol, mesoridazine, pimozide, prochlorperazine, quetiapine, thioridazine, ziprasidone, Compazine®, Geodon®, Haldol®, Mellaril®, Orap®, Serentil®, or Seroquel®).
• Some medicines, including antacids and mineral supplements, can change with the way ciprofloxacin works in your body. Tell your doctor if you are using any antacids that contain magnesium or aluminum (such as Maalox®, Mylanta®), or any kind of vitamin or mineral supplement that contains calcium, zinc, or iron. Also talk with your doctor if you use sucralfate (Carafate®) or didanosine (Videx®, Videx® EC) powder or chewable buffered tablets. If you use any of these medicines, take them at least 2 hours before or 6 hours after you take ciprofloxacin.
• Avoid caffeine (coffee, soda, chocolate) while you are using this medicine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, diabetes, heart rhythm problems (such as QT prolongation), hypokalemia (low blood potassium), nerve problems, rheumatoid arthritis or joint problems, or a history of seizures, epilepsy, head injury, or stroke.
• This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you or your child have a rash; itching; hives; hoarseness; shortness of breath; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after you take this medicine.
• Serious side effects can occur during treatment with this medicine. Sometimes serious side effects can occur without warning. However, possible warning signs are including black, tarry stools; blistering, peeling, or loosening of the skin; bloody or cloudy urine; chills; decreased urination; diarrhea; fever; joint or muscle pain; red skin lesions, often with a purple center; sores, ulcers, or white spots in the mouth or on the lips; severe stomach pain; skin rash; swelling of the face, fingers, feet, or lower legs; unusual bleeding or bruising; unusual weight gain; or yellow skin or eyes. Stop taking this medicine and check with your doctor immediately if you or your child notice any of these warning signs.
• This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.
• This medicine may rarely cause inflammation or tearing of a tendon (the cord that attaches muscles to bones). This can occur while you are taking the medicine or after you finish taking it. The risk of having tendon problems may be increased if you are over 60 years of age, are using steroid medicines (such as dexamethasone, prednisolone, prednisone, or Medrol®), have severe kidney problems, have a history of tendon problems (such as rheumatoid arthritis), or if you have received an organ transplant (such as heart, kidney, or lung). Stop using this medicine and check with your doctor right away if you have sudden pain or swelling in a tendon after exercise (such as ankle, back of the knee or leg, shoulder, elbow, or wrist), bruise more easily after an injury, or are unable to bear weight or move the affected area. Refrain from exercise until your doctor says otherwise.
• If you have severe diarrhea, ask your doctor before taking any medicine to stop the diarrhea. It may occur 2 months or more after you stop taking this medicine.
• Stop using this medicine and check with your doctor right away if you or your child starts having numbness, tingling, or burning pain in your hands, arms, legs, or feet. These may be symptoms of a condition called peripheral neuropathy.
• This medicine may make you dizzy, drowsy, and lightheaded. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• If your symptoms do not improve or if they get worse, call your doctor.
• Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.
• Use this medicine only to treat the infection your doctor has prescribed it for. Do not use this medicine for any infection that has not been checked by a doctor.

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, or red skin rash.
• Blood in the urine, lower back pain, side pain, or sharp back pain just below the ribs.
• Change in how much or how often you urinate.
• Chest pain, shortness of breath, or coughing up blood.
• Confusion, unusual thoughts or behavior.
• Diarrhea that may contain blood.
• Fast, slow, pounding, or uneven heartbeat.
• Fever, chills, cough, runny or stuffy nose, sore throat, and body aches.
• Increased hunger or thirst.
• Lightheadedness, dizziness, or fainting.
• Nausea, vomiting, loss of appetite, or pain in your upper stomach.
• Numbness, tingling, weakness, or burning pain in your hands, arms, legs, or feet.
• Pain or swelling in your knee, ankle, shoulder, elbow, hand, or wrist.
• Red or dark brown urine or stool.
• Seeing, hearing, or feeling things that are not there.
• Seizures or tremors.
• Unusual bleeding, bruising, or weakness.
• Worsening muscle weakness or breathing problems.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Blurred vision, feeling more sensitive to light or colors.
• Feeling nervous, restless, anxious, or agitated.
• Headache, migraine, bad dreams, or trouble sleeping.
• Mild muscle or joint pain, decreased joint movement.
• Mild nausea, vomiting, diarrhea, or stomach pain.
• Mild skin rash or itching.
• Sores or white patches in your mouth or throat.
• Vaginal itching or discharge.

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