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Ciprofloxacin

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IMPORTANT WARNING
Taking ciprofloxacin increases the risk that you will develop tendinitis (swelling of a fibrous tissue that connects a bone to a muscle) or have a tendon rupture (tearing of a fibrous tissue that connects a bone to a muscle) during your treatment or for up to several months afterward. These problems may affect tendons in your shoulder, your hand, the back of your ankle, or in other parts of your body. Tendinitis or tendon rupture may happen to people of any age, but the risk is highest in people over 60 years of age. Tell your doctor if you have or have ever had a kidney, heart, or lung transplant; kidney disease; a joint or tendon disorder such as rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function); or if you participate in regular physical activity. Tell your doctor and pharmacist if you are taking oral or injectable steroids such as dexamethasone (Decadron, Dexpak), methylprednisolone (Medrol), or prednisone (Sterapred). If you experience any of the following symptoms of tendinitis, stop taking ciprofloxacin, rest, and call your doctor immediately: pain, swelling, tenderness, stiffness, or difficulty in moving a muscle. If you experience any of the following symptoms of tendon rupture, stop taking ciprofloxacin and get emergency medical treatment: hearing or feeling a snap or pop in a tendon area, bruising after an injury to a tendon area, or inability to move or to bear weight on an affected area. [More...]
Why is this medication prescribed?
Ciprofloxacin is used to treat or prevent certain infections caused by bacteria. Ciprofloxacin is also used to treat or prevent anthrax (a serious infection that may be spread on purpose as part of a bioterror attack) in people who may have been exposed to anthrax germs in the air. Ciprofloxacin extended-release (long-acting) tablets are used only to treat certain types of urinary tract infections. Ciprofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections. Antibiotics will not work for colds, flu, or other viral infections.

How should this medicine be used?
Ciprofloxacin comes as a tablet, a suspension (liquid), and an extended-release tablet to take by mouth. The tablet and suspension are usually taken twice a day, in the morning and evening, with or without food. The extended-release tablets are usually taken once a day. Cipro XR brand extended-release tablets may be taken with or without food. Proquin XR brand extended-release tablets should be taken with a main meal of the day, preferably the evening meal. Take ciprofloxacin at around the same time(s) every day. The length of your treatment depends on the type of infection you have. Your doctor will tell you how long to take ciprofloxacin. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ciprofloxacin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

One brand or type of ciprofloxacin cannot be substituted for another. Be sure that you receive only the brand or type of ciprofloxacin that was prescribed by your doctor. Ask your pharmacist if you have any questions about the type of ciprofloxacin you were given.

Do not take ciprofloxacin with dairy products or calcium-fortified juices alone. However, you may take ciprofloxacin with a meal that includes these foods or drinks.

Swallow the tablets whole; do not split, crush, or chew them. If you cannot swallow tablets whole, tell your doctor.

If you are taking the suspension, shake the bottle very well for 15 seconds before each use to mix the medication evenly. Swallow the correct dose without chewing the granules in the suspension. Close the bottle completely after each use. Do not give the suspension to a patient through a feeding tube.

You should begin feeling better during the first few days of your treatment with ciprofloxacin. If your symptoms do not improve or if they get worse, call your doctor. If you are being treated for a urinary tract infection, call your doctor if you develop fever or back pain during or after your treatment. These symptoms may be signs that your infection is worsening.

Take ciprofloxacin until you finish the prescription, even if you feel better. Do not stop taking ciprofloxacin without talking to your doctor unless you experience certain serious side effects listed in the IMPORTANT WARNING and SIDE EFFECTS sections If you stop taking ciprofloxacin too soon or if you skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

Other uses for this medicine
In the event of biological warfare, ciprofloxacin may be used to treat and prevent dangerous illnesses that are deliberately spread such as plague, tularemia, and anthrax of the skin or mouth. Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?
Before taking ciprofloxacin,
What special dietary instructions should I follow?
Do not drink or eat a lot of caffeine-containing products such as coffee, tea, energy drinks, cola, or chocolate. Ciprofloxacin may increase nervousness, sleeplessness, heart pounding, and anxiety caused by caffeine.

Make sure you drink plenty of water or other fluids every day while you are taking ciprofloxacin.

What should I do if I forget a dose?
If you miss a dose of ciprofloxacin, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.Do not take more than two doses of the tablets or suspension or more than one dose of the extended-release tablets in one day.

What side effects can this medication cause?
Ciprofloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately, but do not stop taking ciprofloxacin without talking to your doctor: If you experience any of the following symptoms, or the symptoms of tendinitis or tendon rupture described in the IMPORTANT WARNING section, stop taking ciprofloxacin and call your doctor immediately or get emergency medical help: Ciprofloxacin may cause problems with bones, joints, and tissues around joints in children. Ciprofloxacin should not normally be given to children younger than 18 years of age unless they have certain serious infections that cannot be treated with other antibiotics or they have been exposed to anthrax in the air. If your doctor prescribes ciprofloxacin for your child, be sure to tell the doctor if your child has or has ever had joint-related problems. Call your doctor if your child develops joint problems such as pain or swelling while taking ciprofloxacin or after treatment with ciprofloxacin.

Ciprofloxacin may cause nerve damage that may not go away even after you stop taking ciprofloxacin. This damage may occur soon after you begin taking ciprofloxacin. If you experience any of the following symptoms, call your doctor immediately: numbness, tingling, pain, or burning in the arms or legs; or a change in your ability to feel light touch, pain, heat, or cold. If you experience these symptoms, do not take any more ciprofloxacin until you talk to your doctor. Your doctor may prescribe a different antibiotic for you to take instead of ciprofloxacin.

Talk to your doctor about the risks of taking ciprofloxacin or giving ciprofloxacin to your child.

Ciprofloxacin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets and extended-release tablets at room temperature and away from excess heat and moisture (not in the bathroom). Store the suspension in the refrigerator or at room temperature, closed tightly, for up to 14 days. Do not freeze ciprofloxacin suspension. Throw away any suspension that is left over after 14 days and any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to ciprofloxacin.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish taking ciprofloxacin, call your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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Last Revised - 12/15/2013
© 2014. The American Society of Health-System Pharmacists, Inc.
ASHP
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