Antibiotic Ciprofloxacin

Ciprofloxacin is a prescription antibiotic used to treat bacterial infections. Among other things, it is prescribed for severe urinary tract infections, such as cystitis or inflammation of the kidney pelvis. Typical side effects of ciprofloxacin include diarrhea, nausea, and skin rashes. However, it can also cause much more serious side effects, which is why it should only be prescribed under certain conditions. Find out here what side effects can occur and all the things you should be aware of when taking the antibiotic.

Prescription antibiotic

Bacteria, viruses, and fungi are constantly trying to invade our bodies. If the immune system is intact, the pathogens are usually quickly rendered harmless. However, if the immune system is weakened, they can multiply in the body and cause an infection. If the pathogens are bacteria, they can be fought with an antibiotic. Ciprofloxacin is a prescription antibiotic from the group of fluoroquinolones – also called gyrase inhibitors. This name is derived from the way the substance works: ciprofloxacin blocks the protein gyrase in the body, which bacteria need to multiply. If the bacteria can no longer multiply further, the inflammation heals.

Ciprofloxacin as a reserve antibiotic.

Because of some significant side effects, ciprofloxacin now serves as a so-called reserve antibiotic. Such antibiotics are used only for infections for which no other antibiotic has worked. In such cases, it is then a case of infection with resistant pathogens. In the therapy of a simple infection, reserve antibiotics are usually avoided in order to prevent the development of resistance. Often, reserve antibiotics-as in the case of ciprofloxacin-are associated with serious side effects.

When is ciprofloxacin used?

Ciprofloxacin may be used to treat the following bacterial infections:

  • Of the respiratory tract
  • In the ear, nose and throat area
  • Of the eyes
  • Of the sexual organs
  • Of the gastrointestinal tract
  • Of the bile
  • Of the kidney and urinary tract
  • Of the skin
  • Of bones and joints

In addition, ciprofloxacin is also used for blood poisoning, cystic fibrosis and anthrax.

Side effects of ciprofloxacin.

The most common side effects of ciprofloxacin include gastrointestinal symptoms such as diarrhea, indigestion, nausea and vomiting, and skin rashes. Occasionally, the following side effects may also occur:

  • Headache
  • Dizziness
  • Fatigue
  • Insomnia
  • Drowsiness
  • Confusion
  • Nerve damage such as olfactory and gustatory disturbances.
  • Blood count changes
  • Eye burning
  • Pain, swelling, or tearing in the tendons, muscles, or joints
  • Low blood pressure
  • Increase in liver enzymes

Rare and very rare side effects

In rare cases, taking ciprofloxacin may cause the side effects listed below:

  • Allergic reactions
  • Sensory disturbances
  • Seizures
  • Anxiety
  • Hallucinations
  • Depression
  • Ringing in the ears
  • Hearing loss
  • Restrictions on kidney function
  • Shortness of breath
  • Very rarely, side effects include anemia, liver failure, tendonitis, skin bleeding, psychotic reactions, and increased intracranial pressure.

    Other side effects

    If ciprofloxacin is applied externally to the ear, itching often occurs there. In contrast, severe side effects such as tinnitus or skin inflammation are rare. Itching can also occur during the treatment of eye inflammations. In addition, possible side effects of ciprofloxacin include swelling of the eyelids, a foreign body sensation in the eye, sensitivity to light, red eyes, lid margin crusting, corneal changes, and worsening of vision.

    Dosage of ciprofloxacin.

    The amount of ciprofloxacin dosage depends on the particular infection as well as its severity. Unless otherwise prescribed by your doctor, adults may take between 500 and 700 milligrams twice daily.A lower dose is sufficient for mild urinary tract infections. The antibiotic is usually taken orally in the form of tablets, but it is also available as a suspension, in the form of solutions for intravenous administration, and in the form of eye and ear drops for topical use.

    Duration of use

    Treatment usually lasts between five and 21 days. However, in the case of particularly severe infections, the antibiotic may be used for a longer period. If there is only an uncomplicated infection, such as a mild urinary tract infection, it may be sufficient to take ciprofloxacin for a period of one to three days.

    Instructions for taking ciprofloxacin.

    • Taking it may impair the ability to react and, consequently, the ability to drive and operate machinery. This is particularly true in combination with alcohol.
    • Ciprofloxacin must necessarily be taken exactly as directed by the attending physician and must not be discontinued independently. Otherwise, it may happen that the disease does not heal completely or resistance to ciprofloxacin develops.
    • Taking the antibiotic may lower the white blood cell count and make the body more susceptible to infection. If you experience symptoms of infection, contact your treating physician. This is also true if you experience signs suggestive of a torn tendon or tendonitis.
    • Refrain from visiting solariums and extensive sunbathing while taking the antibiotic.
    • Make sure to drink enough fluids.

    Contraindications of ciprofloxacin.

    In certain circumstances, ciprofloxacin should not be taken or should be taken only after a careful risk-benefit assessment. Caution is advised in patients with the following conditions: impaired liver or kidney function, myasthenia gravis, impaired salt balance, and specific cardiac arrhythmias or other heart problems. The same applies to patients who have previously suffered a seizure and to children and adolescents of growing age. Ciprofloxacin should not be used:

    • In case of hypersensitivity to the active substance. If an allergic reaction occurs, the attending physician must be contacted immediately.
    • In patients who are prone to seizures.
    • With concomitant use of tizanidine.
    • In the case of a deficiency in the enzyme glucose-6-phosphate dehydrogenase, otherwise blood formation disorders may occur.

    Ciprofloxacin during pregnancy.

    During pregnancy, ciprofloxacin should not be taken, as there is insufficient evidence to date on the consequences of its use. However, in animal studies, cartilage damage was observed in newborn animals. In the case of topical use of ciprofloxacin – for example, to treat infections of the eyes or ears – a cost-benefit assessment must be made by the physician. If ciprofloxacin is used internally, the active substance passes into breast milk and can harm the infant. If the antibiotic is taken during breastfeeding, it must therefore be weaned beforehand. In the case of topical application, a cost-benefit analysis is also necessary during breastfeeding. 10 Home remedies for cystitis

    Ciprofloxacin interactions.

    If ciprofloxacin is taken at the same time as certain other agents, interactions may occur. Used internally, for example, the antibiotic inhibits the breakdown of agents such as clozapine, ropinirole, tizanidine, methotrexate, pentoxifylline, and theophylline. This increases the effect and side effects of the substances. For most medications, it is sufficient to have the dosage adjusted by a physician. Only tizanidine must not be taken at all. There are also active substances that increase the concentration of ciprofloxacin in the body. These include, for example, the gout medicine probenecid. Simultaneous use of phenytoin can both increase and decrease the concentration of ciprofloxacin in the body. Medications that decrease the effect of ciprofloxacin in the body include antacids, the active ingredients sucralfate and sevelamer, and agents containing calcium, magnesium, iron, or aluminum. If one of these agents absolutely must be taken, ciprofloxacin should be given at least two hours before or four hours after.By the way, this also applies to milk and yogurt.

    Interactions with food

    In addition to milk and yogurt, coffee, painkillers containing caffeine, and medications for colds – which also often contain caffeine – should be avoided during treatment. This is because taking ciprofloxacin inhibits the breakdown of caffeine in the body. This restriction is especially true for people who have problems with seizures or cardiac arrhythmias.

    The pill and ciprofloxacin.

    Taking antibiotics damages the intestinal flora and makes it harder for certain active ingredients to be absorbed into the body. Thus, among other things, the effectiveness of the pill may also decrease. For ciprofloxacin, however, it has not yet been proven that the protective effect of the pill is reduced. Studies seem to indicate that the effect is not impaired by the antibiotic. To be safely protected against pregnancy, you should still resort to additional contraceptives.

    Criticism of ciprofloxacin.

    Antibiotics from the group of fluoroquinolones such as ciprofloxacin have been heavily criticized for several years due to serious and consequential side effects. Sometimes permanent damage is the result of taking ciprofloxacin. For example, the drug can cause tendon damage such as inflammation or rupture of the tendons. Tears of the Achilles tendon are particularly common. The risk of this is particularly increased in older people over the age of 60. Mental disorders such as depression and anxiety and nerve damage are also among the long-lasting side effects. The possible damage to the DNA of mitochondria by ciprofloxacin is discussed as the cause of these adverse effects. Mitochondria are responsible for energy production in human cells. Due to the described severe side effects, the German Federal Institute for Drugs and Medical Devices (BfArM) also calls for a more restrictive use of fluoroquinolones such as ciprofloxacin. A red-hand letter published in 2019 therefore restricts the use of ciprofloxacin and recommends prescribing after a careful risk-benefit assessment.


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    For example, ciprofloxacin should not be prescribed for infections that are not serious or not bacterial in origin or for those infections that resolve even without treatment.