ciproxin tablet uses

Written by Dr Maheen Zaiba [PharmD, DOW University Of Health Sciences (DUHS)], Karachi, Pakistan)

Generic:

Ciprofloxacin

Available dosage forms:

Available as tablet form in 100mg, 250mg, 500mg, & 750mg

Injection form as 0.2g injection.

Therapeutic class:

Quinolones Antibiotics

Pharmacological class:

Inhibition of bacterial DNA gyrase and topoisomerase IV.

Mechanism of action:

Ciprofloxacin is a second generation fluoroquinolone that is active against many Gram negative and Gram positive bacteria. It produces its action through inhibition of bacterial DNA gyrase and topoisomerase IV, thereby inhibiting cell division. Bacterial DNA fragmentation will occur as a result of inhibition of the enzymes.

Manufacturer:

OBS Pharmaceuticals.

Storage:

15-30 degree Celsius

Prescription drug?

Yes

Indications and doses:

Acute Sinusitis

Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 10 days

Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for acute sinusitis

Bone & Joint Infections

Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for ≥4-6 weeks

Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for ≥4-6 weeks

Chronic Bacterial Prostatitis

Indicated for chronic bacterial prostatitis caused by Escherichia coli or Proteus mirabilis

Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 28 days

Infectious Diarrhea

Mild/moderate/severe: 500 mg PO q12hr for 5-7 days

Empirical Therapy in Febrile Neutropenic Patients

Severe: 400 mg IV q8hr for 7-14 days

Intra-abdominal Infections

Complicated: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days

Lower Respiratory Tract Infections

Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days

Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for 7-14 days

Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for acute bacterial exacerbation of chronic bronchitis

Nosocomial Pneumonia

Mild/moderate/severe: 400 mg IV q8hr for 10-14 days

Skin/Skin Structure Infections

Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days

Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for 7-14 days

Urinary Tract Infections

Acute uncomplicated: Immediate-release, 250 mg PO q12hr for 3 days; extended-release, 500 mg PO q24hr for 3 days

Mild/moderate: 250 mg PO q12hr or 200 mg IV q12hr for 7-14 days

Severe/complicated: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days

Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for uncomplicated urinary tract infections

Urethral & Cervical Gonococcal Infections

Uncomplicated: 250-500 mg PO once

Anthrax Infection

Post exposure therapy

Inhalation (prophylaxis/post exposure): 500 mg PO q12hr or 400 mg IV q12hr for 60 days

Cutaneous: 500 mg PO q12hr or 400 mg IV q12hr for 60 days

Plague

Indication for treatment and prophylaxis of plague due to Yersinia pestis

500-750 mg PO q12hr x14 days, OR

400 mg IV q8-12hr x 14 days

Bronchiectasis (non-FDA approved use)

Noncystic Fibrosis Bronchiectasis (Orphan)

Dry powder for inhalation: Orphan designation for patients with NCFB who suffer from frequent severe acute pulmonary bacterial exacerbations which lead to further inflammation, airway, and lung parenchyma damage.

Dosage Modifications

Renal impairment

·         CrCl >50 mL/min

o    Dose adjustment not necessary

·         CrCl 30-50 mL/min

o    Immediate-release: 250-500 mg PO q12hr

o    Extended-release: 1 g PO q24hr

o    Intravenous: 400 mg IV q8-12hr

·         CrCl 5-29 mL/min

o    Immediate-release: 250-500 mg PO q18hr

o    Extended-release: 500 mg PO q24hr

o    Intravenous: 200-400 mg IV q12-24hr

·         Hemodialysis or peritoneal dialysis

o    Administer after dialysis

o    Immediate-release: 250-500 mg PO q24hr

o    Extended-release: 500 mg PO q24hr

o    Intravenous: 200-400 mg IV q24hr

Side Effects:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat

• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing

• Increased pressure around the brain—severe headache, blurry vision, change in vision, nausea, vomiting

• Joint, muscle, or tendon pain, swelling, or stiffness

• Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue

• Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression

• Pain, tingling, or numbness in the hands or feet

• Redness, blistering, peeling, or loosening of the skin, including inside the mouth

• Seizures

• Severe diarrhea, fever

• Sudden or severe chest, back, or stomach pain

• Unusual vaginal discharge, itching, or odor

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Diarrhea

• Dry mouth

• Headache

• Nausea

  
  

Interactions:

Do not take this medication with any of the following:

• Cisapride

• Dronedarone

• Flibanserin

• Lomitapide

• Pimozide

• Thioridazine

• Tizanidine

  
  

This medication may also interact with the following:

• Antacids

• Birth control pills

• Caffeine

• Certain medications for diabetes, like glipizide, glyburide, or insulin

• Certain medications that treat or prevent blood clots like warfarin

• Clozapine

• Cyclosporine

• Didanosine buffered tablets or powder

• Dofetilide

• Duloxetine

• Lanthanum carbonate

• Lidocaine

• Methotrexate

• Multivitamins

• NSAIDS, medications for pain and inflammation, like ibuprofen or naproxen

• Olanzapine

• Omeprazole

• Other medications that prolong the QT interval (cause an abnormal heart rhythm)

• Phenytoin

• Probenecid

• Ropinirole

• Sevelamer

• Sildenafil

• Sucralfate

• Theophylline

• Ziprasidone

• Zolpidem

  
  

Other Interactions

·         Caffeine

·         Dairy Food

Pregnancy/lactation:

Not accepted

Precautions:

This medicine may increase your risk for aortic aneurysm (bulge in the wall of the largest artery). Check with your doctor right away if you have sudden chest, stomach, or back pain, trouble breathing, cough, or hoarseness. Some people who take ciprofloxacin may become more sensitive to sunlight than they are normally

Administration guide:

Avoid the administration of ciprofloxacin with dairy products (e.g., milk or yogurt) or calcium-fortified juices alone; however, ciprofloxacin may be taken with meals that contain calcium. Protect yourself from sunlight and avoid excessive exposure to the sun when taking ciprofloxacin. Wear sunblock when outdoors.