ciprofloxacin (injection)

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Pronunciation: SIP roe FLOX a sin

Brand: Cipro I.V.

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

You should not use this medicine if you are also taking tizanidine.

You may not be able to use ciprofloxacin if you have a muscle disorder. Tell your doctor if you have a history of myasthenia gravis.

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. This effect may be more likely to occur if you are over 60, if you use steroid medication, or if you have had a kidney, heart, or lung transplant.

Call your doctor at once if you have sudden pain, swelling, bruising, tenderness, stiffness, or movement problems in any of your joints. Rest the joint until you receive medical care or instructions.

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 is also used to treat people who have been exposed to anthrax.

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

What should I discuss with my healthcare provider before using ciprofloxacin?

You should not use ciprofloxacin if you are allergic to it, or if:

  • you are also taking tizanidine; or
  • you are allergic to other fluoroquinolones (gemifloxacin, levofloxacin, moxifloxacin, ofloxacin, norfloxacin, and others).

You may not be able to use ciprofloxacin if you have a muscle disorder. Tell your doctor if you have a history of myasthenia gravis.

To make sure ciprofloxacin is safe for you, tell your doctor if you have:

  • tendon problems, arthritis or other joint problems (especially in children);
  • a muscle or nerve disorder;
  • a heart rhythm disorder, especially if you take medication to treat it;
  • a personal or family history of Long QT syndrome;
  • coronary artery disease (hardened arteries);
  • liver disease;
  • kidney disease;
  • seizures or epilepsy;
  • a history of head injury or brain tumor;
  • diabetes (especially if you take oral diabetes medication); or
  • low levels of potassium in your blood (hypokalemia).

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. This can happen during treatment or up to several months after you stop using ciprofloxacin. Tendon problems may be more likely to occur if you are over 60, if you use steroid medication, or if you have had a kidney, heart, or lung transplant.

FDA pregnancy category C. It is not known whether ciprofloxacin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

Ciprofloxacin can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Do not give this medicine to anyone under 18 years old without medical advice.

How is ciprofloxacin given?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Ciprofloxacin is injected into a vein through an IV. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Ciprofloxacin must be injected slowly, over at least 60 minutes.

Drink plenty of liquids while you are using ciprofloxacin.

Ciprofloxacin is usually given every 8 to 12 hours for up to 14 days. Some infections may need to be treated for 4 to 6 weeks. Anthrax exposure is usually treated for 60 days.

Follow your doctor's dosing instructions very carefully.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Ciprofloxacin will not treat a viral infection such as the flu or a common cold.

If you use this medicine long-term, you may need frequent medical tests at your doctor's office.

Store at room temperature away from moisture, heat, and light. Do not freeze.

Do not use ciprofloxacin if it has changed colors or has particles in it. Call your pharmacist for new medication.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using ciprofloxacin?

Avoid caffeine while you are using ciprofloxacin, because the medicine can make the effects of caffeine stronger.

Avoid exposure to sunlight or tanning beds. Ciprofloxacin can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. 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 bloody, stop using ciprofloxacin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Ciprofloxacin may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

What are the possible side effects of ciprofloxacin?

Get emergency medical help if you have any of these signs of an allergic reaction: hives, tingling; fast or slow heartbeats, weak pulse, feeling like you might pass out; difficult breathing; swelling of your face, lips, tongue, or throat.

Ciprofloxacin may cause swelling or tearing of (rupture) a tendon. Ciprofloxacin can also have serious effects on your nerves, and may cause permanent nerve damage. Stop using this medicine and call your doctor at once if you have:

  • signs of tendon rupture --sudden pain, swelling, bruising, tenderness, stiffness, movement problems, or a snapping or popping sound in any of your joints (rest the joint until you receive medical care or instructions); or
  • nerve symptoms --numbness, tingling, burning pain, or being more sensitive to temperature, light touch, or the sense of your body position.

Also, stop using ciprofloxacin and call your doctor at once if you have:

  • muscle weakness or trouble breathing;
  • headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
  • the first sign of any skin rash, no matter how mild;
  • diarrhea that is watery or bloody;
  • confusion, hallucinations, nightmares, paranoia, depression, thoughts about hurting yourself;
  • pale skin, easy bruising or bleeding (nosebleeds, bleeding gums);
  • seizure (convulsions);
  • sudden weakness or ill feeling, fever, chills, swollen glands, sore throat, mouth sores, red or swollen gums, trouble swallowing;
  • liver problems --nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • increased pressure inside the skull -- severe headaches, ringing in your ears, dizziness, vision problems, pain behind your eyes;
  • signs of a kidney problem --little or no urinating, pink or red urine, swelling, rapid weight gain, feeling drowsy or short of breath;
  • swelling of your blood vessels --fever, loss of appetite, numbness, weakness, tired feeling, weight loss; or
  • severe skin reaction --fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • nausea, vomiting, diarrhea, stomach pain;
  • dizziness, agitation, feeling anxious or nervous;
  • tremors, sleep problems (insomnia);
  • vaginal itching or discharge;
  • skin rash; or
  • abnormal liver function tests.

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.

What other drugs will affect ciprofloxacin?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with ciprofloxacin, especially:

  • glyburide, methotrexate, metoclopramide, phenytoin, probenecid, theophylline;
  • a blood thinner (warfarin, Coumadin, Jantoven);
  • a diuretic or "water pill";
  • heart rhythm medication --amiodarone, disopyramide, dofetilide, dronedarone, procainamide, quinidine, sotalol, and others;
  • medicine to treat depression or mental illness --amitriptylline, clomipramine, desipramine, iloperidone, imipramine, nortriptyline, thioridazine, ziprasidone, and others; or
  • NSAIDs (nonsteroidal anti-inflammatory drugs) --aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may interact with ciprofloxacin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about ciprofloxacin.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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