Cipro (Ciprofloxacin) Antibiotic Tablets
Cipro is a prescription oral fluoroquinolone antibiotic containing ciprofloxacin. It is used in adults for complicated urinary tract infections, prostatitis, gastrointestinal infections, anthrax exposure and selected respiratory and skin infections.
- Active ingredients
- Ciprofloxacin
- Manufacturer
- Bayer
- Dosage forms
- tablet, extended-release tablet, oral suspension
- Available dosages
- 250mg, 500mg, 750mg
- Category
- Antibiotics
What is it?
Cipro is the original brand of ciprofloxacin, marketed by Bayer since 1987. It is supplied as oral tablets, extended-release tablets, oral suspension, parenteral solution and topical formulations for ear and eye infections. Multiple authorised generics are widely available. Several regulatory agencies have restricted fluoroquinolone use because of safety concerns.
Active ingredients
Each tablet contains ciprofloxacin (as the hydrochloride) as the sole active ingredient at 250mg, 500mg or 750mg. Ciprofloxacin is a second-generation fluoroquinolone antibiotic with broad-spectrum activity against many Gram-negative and some Gram-positive bacteria.
Forms and dosages
Cipro is administered orally twice daily for most indications, with adult doses ranging from 250mg to 750mg every 12 hours. According to the prescribing information, doses depend on the type and severity of infection and are reduced in renal impairment. Extended-release tablets allow once-daily dosing for selected urinary tract infections. The drug should be taken at least 2 hours before or 6 hours after antacids or mineral supplements.
Indications
Cipro is approved in adults for the treatment of complicated urinary tract infections, acute uncomplicated cystitis (where alternatives are not appropriate), pyelonephritis, prostatitis, infectious diarrhoea, typhoid fever, complicated intra-abdominal infections, bone and joint infections, and inhalational anthrax exposure. According to recent regulatory communications, fluoroquinolones should be reserved for situations where other antibiotics are not appropriate because of the risk of disabling adverse effects.
How it works
Ciprofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, enzymes essential for DNA replication, transcription, repair and recombination. The result is bactericidal activity against many Gram-negative organisms including Pseudomonas aeruginosa and many Enterobacteriaceae, with more variable activity against Gram-positive bacteria. Resistance has increased over time and limits empirical use in some settings.
Frequently asked questions
Why have fluoroquinolones been restricted? ▾
Several regulatory agencies including the European Medicines Agency and the United States Food and Drug Administration have issued warnings about disabling and potentially permanent adverse effects of fluoroquinolones, including tendon rupture, peripheral neuropathy, central nervous system effects and aortic dissection or aneurysm. According to these communications, fluoroquinolones such as ciprofloxacin should be reserved for situations where other antibiotics are not appropriate, with the prescriber weighing risks against benefits.
Why should Cipro not be taken with milk or antacids? ▾
Multivalent cations such as calcium, magnesium, aluminium, iron and zinc form chelates with ciprofloxacin in the gastrointestinal tract, substantially reducing its absorption. This includes dairy products, antacids, mineral supplements and some fortified foods. According to the prescribing information, ciprofloxacin should be taken at least 2 hours before or 6 hours after these products to ensure adequate absorption and clinical effect.
Can Cipro cause tendon problems? ▾
Yes. Ciprofloxacin and other fluoroquinolones have been associated with tendinitis and tendon rupture, particularly of the Achilles tendon, in some patients. The risk is higher in older adults, in those taking corticosteroids and after organ transplantation. According to the prescribing information, patients should stop the medication and contact a clinician immediately if they experience tendon pain, swelling or inflammation.
Can children take Cipro? ▾
Use of ciprofloxacin in children is restricted because of concerns about cartilage and joint development based on animal studies. According to the prescribing information, paediatric use is approved only for specific indications such as complicated urinary tract infections, pyelonephritis and inhalational anthrax exposure where benefits outweigh risks. Paediatric prescribing should be discussed with a paediatrician or specialist.
What are the main contraindications for Cipro? ▾
Cipro is contraindicated in known hypersensitivity to ciprofloxacin or other fluoroquinolones, in concurrent use with tizanidine, in patients with a history of tendon disorders related to fluoroquinolone use and in myasthenia gravis. Caution is required in QT prolongation, epilepsy, glucose-6-phosphate dehydrogenase deficiency and during pregnancy and breastfeeding. According to the prescribing information, the medical history must be reviewed by a clinician before any prescription.
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The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.