Cipro (ciprofloxacin) is a broad-spectrum fluoroquinolone antibiotic indicated for the treatment of serious bacterial infections. It demonstrates high bioavailability and excellent tissue penetration, making it a first-line choice for complicated urinary tract infections, pyelonephritis, and certain respiratory and gastrointestinal infections. Its bactericidal action works by inhibiting bacterial DNA gyrase and topoisomerase IV, effectively disrupting DNA replication in susceptible organisms.

Features

• Active ingredient: ciprofloxacin hydrochloride
• Available in 250 mg, 500 mg, and 750 mg oral tablets
• Also available in intravenous formulation and oral suspension
• Broad-spectrum activity against Gram-negative and some Gram-positive bacteria
• Rapid absorption with peak serum concentrations within 1-2 hours
• Excellent penetration into prostate, lung, and urinary tract tissues

Benefits

• Effective against multidrug-resistant pathogens including Pseudomonas aeruginosa
• High clinical cure rates for complicated urinary tract infections and pyelonephritis
• Convenient twice-daily dosing regimen improves patient compliance
• Rapid onset of action provides prompt symptomatic relief
• Well-established safety profile with extensive clinical experience
• Available in multiple formulations for flexible administration

Common use

Cipro is commonly prescribed for:

• Complicated urinary tract infections (including pyelonephritis)
• Chronic bacterial prostatitis
• Lower respiratory tract infections (excluding pneumonia)
• Acute exacerbations of chronic bronchitis
• Skin and skin structure infections
• Bone and joint infections
• Infectious diarrhea caused by susceptible organisms
• Typhoid fever (enteric fever)
• Complicated intra-abdominal infections (in combination with metronidazole)
• Post-exposure prophylaxis for inhalation anthrax

Dosage and direction

Adults:

• Urinary tract infections: 250-500 mg every 12 hours for 7-14 days
• Pyelonephritis: 500 mg every 12 hours for 7-14 days
• Respiratory infections: 500 mg every 12 hours for 7-14 days
• Bone and joint infections: 500-750 mg every 12 hours for 4-8 weeks
• Infectious diarrhea: 500 mg every 12 hours for 5-7 days

Dosage adjustment required for:

• Renal impairment (CrCl <30 mL/min)
• Hepatic impairment
• Elderly patients
• Patients taking concomitant medications that affect clearance

Take tablets with a full glass of water, with or without food. Maintain adequate hydration during therapy. Avoid dairy products, calcium-fortified juices, or antacids within 2 hours before or 6 hours after dosing.

Precautions

• Use with caution in patients with known or suspected central nervous system disorders
• Monitor for tendon inflammation or rupture, especially in elderly patients and those taking corticosteroids
• May cause peripheral neuropathy that may be irreversible
• Can exacerbate muscle weakness in patients with myasthenia gravis
• May prolong QT interval; use caution in patients with known QT prolongation
• Photosensitivity reactions may occur; advise sun protection measures
• Clostridium difficile-associated diarrhea reported with use
• Not recommended for uncomplicated urinary tract infections unless no alternative

Contraindications

• Known hypersensitivity to ciprofloxacin or other quinolones
• Concurrent administration with tizanidine
• History of tendon disorders related to fluoroquinolone use
• Patients with known QT prolongation or uncorrected hypokalemia
• Pregnancy and breastfeeding (unless potential benefit justifies risk)
• Pediatric patients (except for specific indications like complicated UTI or pyelonephritis)

Possible side effect

Common (≥1%):

• Nausea (5.2%)
• Diarrhea (2.3%)
• Headache (1.7%)
• Dizziness (1.3%)
• Abdominal pain/discomfort (1.1%)

Less common (0.1-1%):

• Rash
• Pruritus
• Photosensitivity
• Insomnia
• Restlessness
• Elevated liver enzymes

Rare but serious (<0.1%):

• Tendon rupture or tendinitis
• Peripheral neuropathy
• QT prolongation and torsades de pointes
• Seizures
• Psychiatric reactions (anxiety, depression, hallucinations)
• Hepatotoxicity
• Blood dyscrasias
• Severe skin reactions (Stevens-Johnson syndrome)

Drug interaction

Significant interactions:

• Antacids, sucralfate, metal cations (aluminum, magnesium, calcium, iron, zinc): Reduce absorption
• Warfarin: Enhanced anticoagulant effect
• Theophylline: Increased theophylline levels
• Probenecid: Decreased renal clearance of ciprofloxacin
• NSAIDs: Increased risk of CNS stimulation
• Cyclosporine: Increased nephrotoxicity risk
• Glyburide: Enhanced hypoglycemic effect
• Methotrexate: Increased methotrexate toxicity
• Tizanidine: Contraindicated due to potentiated effects

Missed dose

Take the missed dose as soon as remembered, unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed dose. Maintain the regular dosing schedule. If multiple doses are missed, contact healthcare provider for guidance.

Overdose

Symptoms may include nausea, vomiting, diarrhea, headache, dizziness, and seizures. Management includes gastric lavage if recent ingestion, followed by close observation and supportive care. Hemodialysis removes approximately 10% of the drug. No specific antidote exists. Monitor ECG for QT prolongation and provide symptomatic treatment.

Storage

Store at room temperature (15-30°C or 59-86°F) in original container. Protect from light and moisture. Keep out of reach of children. Do not use if tablets show signs of discoloration or deterioration. Do not flush medications down toilet or pour into drain unless instructed.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. The prescribing physician should make treatment decisions based on individual patient factors and current clinical guidelines.

Reviews

“Clinical experience with ciprofloxacin spans over three decades, demonstrating consistent efficacy against a broad range of Gram-negative pathogens. Its role in treating complicated UTIs remains particularly valuable given rising resistance patterns. However, appropriate patient selection and awareness of potential adverse effects are crucial for safe prescribing.” - Infectious Disease Specialist, 15 years experience

“While ciprofloxacin maintains an important place in our antimicrobial arsenal, we’ve become more judicious in its use due to safety concerns. For appropriate indications in carefully selected patients, it continues to provide excellent coverage with predictable pharmacokinetics.” - Clinical Pharmacist, Hospital Practice

“Patient response to ciprofloxacin is generally favorable when prescribed for appropriate indications. The twice-daily dosing is convenient, though gastrointestinal side effects can be problematic for some individuals. Monitoring and patient education regarding potential tendon issues are essential components of therapy.” - Primary Care Physician