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Pronounced: SIP-roh
Generic name: Ciprofloxacin hydrochloride

Why is this drug prescribed: Cipro is used to treat infections of the lower respiratory tract, the abdomen, the skin, the bones and joints, and the urinary tract, including cystitis (bladder inflammation) in women. It is also prescribed for severe sinus or bronchial infections, infectious diarrhea, typhoid fever, inhalational anthrax, infections of the prostate gland, and some sexually transmitted diseases such as gonorrhea. Additionally, some doctors prescribe Cipro for certain serious ear infections, tuberculosis, and some of the infections common in people with AIDS. Because Cipro is effective only for certain types of bacterial infections, before beginning treatment your doctor may perform tests to identify the specific organisms causing your infection. Cipro is available as a tablet and an oral suspension and as a suspension to be used externally in the ear.

Most important fact about this drug: Cipro kills a variety of bacteria, and is frequently used to treat infections in many parts of the body. However, be sure to stop taking Cipro and notify your doctor immediately at the first sign of a skin rash or any other allergic reaction. Although quite rare, serious and occasionally fatal allergic reactions--some following the first dose--have been reported in people receiving this type of antibacterial drug. Some reactions have been accompanied by collapse of the circulatory system, loss of consciousness, swelling of the face and throat, shortness of breath, tingling, itching, and hives. Fever and jaundice (yellowing of the skin and eyes) are other potential symptoms that should send you to the doctor immediately.

How should you take this medication: Cipro may be taken with or without meals but is best tolerated when taken 2 hours after a meal. Drink plenty of fluids while taking this medication to prevent crystals from forming in your urine. Cipro, like other antibiotics, works best when there is a constant amount in the blood and urine. To help keep the level constant, try not to miss any doses, and take them at evenly spaced intervals around the clock. If you are taking the suspension, be sure to shake the bottle vigorously for 15 seconds before each dose. Swallow without chewing the microcapsules in the suspension. Reclose the bottle completely, following the instructions on the cap. Do not use Cipro HC Otic suspension in your eyes, and avoid contaminating the dropper by letting it touch your ears, fingers, or other surfaces. Warm the otic suspension by holding the bottle in your hand for a minute or two; putting a cold suspension into the ear can make you dizzy. Lie down with the affected ear up, and do not get up for 30 to 60 seconds after the drops are instilled. Throw away any suspension that remains after treatment is finished. --If you miss a dose... Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time. --Storage instructions... Cipro tablets should be stored at room temperature. Cipro suspension may be stored at room temperature or in the refrigerator. The suspension is good for 14 days. Protect Cipro HC Otic suspension from light and avoid freezing.

What side effects may occur: Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Cipro. Most common side effect: Nausea Less common side effects may include: Abdominal pain/discomfort, diarrhea, headache, rash, restlessness, vomiting Rare side effects may include: Abnormal dread or fear, achiness, bleeding in the stomach and/or intestines, blood clots in the lungs, blurred vision, breast pain, change in color perception, chills, confusion, constipation, convulsions, coughing up blood, decreased vision, depression, difficulty in swallowing, dizziness, double vision, drowsiness, eye pain, fainting, fever, flushing, foot pain, gas, gout flare up, hallucinations, hearing loss, heart attack, hiccups, high blood pressure, hives, inability to fall or stay asleep, inability to urinate, indigestion, intestinal inflammation, involuntary eye movement, irregular heartbeat, irritability, itching, joint or back pain, joint stiffness, kidney failure, labored breathing, lack of muscle coordination, lack or loss of appetite, large volumes of urine, light-headedness, loss of sense of identity, loss of sense of smell, mouth sores, neck pain, nightmares, nosebleed, pounding heartbeat, ringing in the ears, seizures, sensitivity to light, severe allergic reaction, skin peeling, redness, sluggishness, speech difficulties, swelling of the face, neck, lips, eyes, or hands, swelling of the throat, swollen lymph nodes, tender, red bumps on skin, tingling sensation, tremors, unpleasant taste, unusual darkening of the skin, vaginal inflammation, vague feeling of illness, weakness, yellowed eyes and skin

Why should this drug not be prescribed: If you are sensitive to or have ever had an allergic reaction to Cipro or certain other antibiotics of this type such as Floxin, Noroxin and Trovan, you should not take this medication. Make sure that your doctor is aware of any drug reactions that you have experienced. Cipro HC Otic suspension should not be used on anyone whose eardrum is perforated or who has a viral infection of the ear.

Special warnings about this medication: Cipro may cause you to become dizzy or light-headed; therefore, you should not drive a car, operate dangerous machinery, or participate in any hazardous activity that requires full mental alertness until you know how the drug affects you. Continued or prolonged use of this drug may result in a growth of bacteria that do not respond to this medication and can cause a secondary infection. Therefore, it is important that your doctor monitor your condition on a regular basis. Cipro can cause increased pressure within the brain. Convulsions have been reported in people receiving the drug. If you experience a seizure or convulsion, notify your doctor immediately. This medication may stimulate the central nervous system, which may lead to tremors, restlessness, light-headedness, confusion, depression, and hallucinations. If these reactions occur, consult your doctor at once. Other central nervous system reactions include nervousness, agitation, insomnia, anxiety, nightmares, and paranoia. If you have a known or suspected central nervous system disorder such as epilepsy or hardening of the arteries in the brain, make sure your doctor knows about it when prescribing Cipro. Remember to stop taking Cipro and see your doctor at the first hint of an allergic reaction (see "Most important fact about this drug"). Also call your doctor if you develop diarrhea. Antibiotics such as Cipro occasionally trigger a form of diarrhea that needs a doctor's attention. You may become more sensitive to light while taking this drug. Try to stay out of the sun as much as possible. People taking Cipro have been known to suffer torn tendons. If you feel any pain or inflammation in a tendon area, stop taking the drug and call your doctor; you should rest and avoid exercise. You may need surgery to repair the tendon. If you must take Cipro for an extended period of time, your doctor will probably order blood tests and tests for urine, kidney, and liver function. If you are taking Cipro to treat gonorrhea, the doctor should test you for syphilis after 3 months.

Possible food and drug interactions when taking this medication: Serious and fatal reactions have occurred when Cipro was taken in combination with theophylline (Theo-Dur). These reactions have included cardiac arrest, seizures, status epilepticus (continuous attacks of epilepsy with no periods of consciousness), and respiratory failure. The following can interfere with the absorption of Cipro and should be taken no less than 6 hours before or 2 hours after a dose: Antacids containing magnesium and aluminum Carafate Supplements and other products containing calcium, iron, or zinc Videx chewable tablets and pediatric powder You should also avoid taking Cipro with milk or yogurt alone, though calcium taken as part of a full meal has no significant effect on the drug. Cipro may increase the effects of caffeine. If Cipro is taken with certain other drugs, the effects of either could be increased, decreased, or altered. These drugs include: Cyclophosphamide (Cytoxan) Cyclosporine (Sandimmune, Neoral) Glyburide (DiaBeta, Glynase, Micronase) Metoprolol (Lopressor) Phenytoin (Dilantin) Probenecid Warfarin (Coumadin)

Special information if you are pregnant or breastfeeding: Although there's reason to believe that Cipro poses little danger during pregnancy, its effects have not been adequately studied. If you are pregnant or plan to become pregnant, notify your doctor immediately. Cipro does appear in breast milk when it's taken internally, and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding your baby until your treatment is finished.

Recommended dosage: ADULTS: Urinary Tract Infections The usual adult dosage is 250 milligrams taken every 12 hours. Complicated infections, as determined by your doctor, may require 500 milligrams taken every 12 hours. Treatment usually lasts 7 to 14 days. For cystitis in women, the dosage is either 100 milligrams or 250 milligrams every 12 hours. Treatment usually lasts 3 days. Lower Respiratory Tract, Skin, Bone, and Joint Infections The usual recommended dosage is 500 milligrams taken every 12 hours. Complicated infections, as determined by your doctor, may require a dosage of 750 milligrams taken every 12 hours. Treatment usually lasts 7 to 14 days, except for bone and joint infections, which require 4 to 6 weeks. Infectious Diarrhea; Typhoid Fever; Sinus, Prostate, and Abdominal Infections The recommended dosage is 500 milligrams taken every 12 hours. Treatment lasts 5 to 7 days for diarrhea, 10 days for typhoid fever and sinus infections, 7 to 14 days for abdominal infections, and 28 days for prostate infections. Inhalational Anthrax For adults, the recommended dosage is 500 milligrams taken every 12 hours. Children's doses are calculated at a rate of 15 milligrams per 2.2 pounds of body weight up to a maximum of 500 milligrams per dose. Treatment continues for 60 days. Gonorrhea in the Urethra or Cervix For these sexually transmitted diseases, a single 250-milligram dose is the usual treatment. Ear Infection Instill 3 drops of suspension into the ear twice a day for 7 days. CHILDREN: Except for treatment of inhalational anthrax, safety and effectiveness of Cipro oral tablets and suspension have not been established in children and adolescents under 18 years of age. The dosage of Cipro HC Otic suspension for children aged 1 and up is the same as for adults. If you are using the oral suspension, 1 teaspoonful of 5% suspension equals 250 milligrams and 1 teaspoonful of 10% suspension equals 500 milligrams. If you have kidney problems, your doctor will decrease your dose of Cipro accordingly. Treatment should usually be continued for 2 days after the signs and symptoms of the infection have disappeared.

Overdosage: Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

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