Instructions for use CIPROFLOXACIN
Severe infections and mixed infections caused by gram-positive bacteria and anaerobic pathogens
. Ciprofloxacin monotherapy is not intended for the treatment of severe infections and infections that may be caused by gram-positive bacteria or anaerobic microorganisms. In the case of such infections, appropriate antibacterial agents should be used simultaneously with ciprofloxacin.
Streptococcal infections
(including Streptococcus pneumoniae). Ciprofloxacin is not recommended for the treatment of streptococcal infections due to lack of effectiveness.
Genital tract infections.
Epididymitis orchioepididymitis and pelvic inflammatory disease can be caused by fluoroquinolone-resistant Neisseria gonorrhoeae. Ciprofloxacin should be used in conjunction with other appropriate antibacterial agents unless resistance to Neisseria gonorrhoeae can be excluded. If clinical improvement does not occur after 3 days of treatment, treatment should be reconsidered.
Intra-abdominal infections.
Data on the effectiveness of ciprofloxacin in the treatment of postoperative intra-abdominal infections are limited.
Travelers' diarrhea.
When prescribing ciprofloxacin, information on the resistance of relevant pathogens to it in the countries visited by the patient should be taken into account.
Bone and joint infections.
Ciprofloxacin should be used in combination with other antimicrobial agents, depending on the results of microbiological analysis.
Aerosol contact with anthrax pathogen.
The use of a drug in humans is based on in vitro susceptibility data, data from experimental animal models and a small amount of data for humans. The physician should familiarize himself with national and/or internationally recognized documentation on the treatment of anthrax.
Complicated urinary tract infections and pyelonephritis.
For the treatment of urinary tract infections, ciprofloxacin is used when it is impossible to resort to other types of treatment, and its use should be based on the results of a microbiological analysis.
Other specific severe infections.
For the treatment of other serious infections, ciprofloxacin is used according to official guidelines or after a careful benefit/risk assessment if other therapies are not possible, or after failure of conventional treatment and if microbiological data justify the use of ciprofloxacin.
Increased sensitivity.
After a single dose of ciprofloxacin, allergic reactions may occur, including anaphylactic and anaphylactoid reactions, which can be life-threatening. If such reactions occur, the use of ciprofloxacin should be discontinued and, if necessary, appropriate medical attention should be provided.
Musculoskeletal system.
In general, ciprofloxacin should not be used in patients with a history of tendon disease/damage associated with quinolone treatment. However, in some cases, after microbiological identification of the causative agent and a benefit-risk assessment, ciprofloxacin may be prescribed to such patients for the treatment of certain severe infections, particularly in cases of failure of standard therapy or bacterial resistance, where microbiological data may justify the use of ciprofloxacin. Tendinitis and tendon rupture (especially Achilles), sometimes bilateral, can occur within the first 48 hours after using ciprofloxacin. The risk of tendinopathy may increase in elderly patients or in the case of concomitant use of corticosteroids. If any signs of tendonitis (eg, painful swelling, inflammation) occur, ciprofloxacin should be discontinued. Ciprofloxacin should be used with caution in patients with myasthenia gravis.
Photosensitivity.
Ciprofloxacin has been shown to cause photosensitive reactions. Patients using ciprofloxacin should be advised to avoid direct exposure to excessive sunlight or ultraviolet radiation during treatment.
CNS.
Quinolones are known to induce convulsions or reduce the threshold for their occurrence. Ciprofloxacin should be used with caution in patients with central nervous system disorders who may be susceptible to seizures. If seizures occur, use of ciprofloxacin should be discontinued. Mental reactions may appear after the first use. In rare cases, depression or psychosis can progress to the point where the patient's behavior becomes threatening. In such cases, ciprofloxacin should be discontinued.
Cases of polyneuropathy (defined by neurological symptoms such as pain, burning sensation, sensory disturbances or muscle weakness, alone or in combination) have been reported with the use of ciprofloxacin.
Ciprofloxacin has an effect on prolonging the QT interval. Elderly patients have increased sensitivity to the effects of drugs that cause QT interval prolongation. Therefore, ciprofloxacin should be used with caution in combination with drugs that prolong the QT interval (eg, class IA and III antiarrhythmic drugs) or in patients at increased risk of developing AF (eg, with known QT prolongation, uncorrected hypokalemia).
Compound
Ciprofloxacin ear and eye drops contain ciprofloxacin hydrochloride at a concentration of 3 mg/ml (in terms of pure substance), Trilon B, benzalkonium chloride, sodium chloride, purified water.
The active substance is also contained in the eye ointment at a concentration of 3 mg/ml.
Ciprofloxacin tablets: 250, 500 or 750 mg of ciprofloxacin, MCC, potato starch, corn starch, hypromellose, croscarmellose sodium, talc, magnesium stearate, colloidal anhydrous silicon dioxide, macrogol 6000, additive E171 (titanium dioxide), polysorbate 80.
The solution for infusion contains the active substance at a concentration of 2 mg/ml. Excipients: sodium chloride, disodium edetate, lactic acid, diluted hydrochloric acid , water for injection.
Ciprofloxacin analogs
Level 4 ATC code matches:
Norfloxacin
Synonyms: Ciprofloxacin-Teva , Basijen , Ciprofloxacin-FPO , Ificipro , Ciprofloxacin-Promed , Procipro , Ciprofloxacin-AKOS , Tsiprinol , Ciprodox , Cifran , Ecotsifol , Tseprova .
Analogues of Ciprofloxacin with a similar mechanism of action: Abaktal , Gatispan , Zanotsin , Ivacin , Levotek , Levofloxacin , Moximac , Nolitsin , Ofloxacin , Oflocid , Pefloxacin , Eleflox .
How much does Ciprofloxacin cost?
The average price of Ciprofloxacin in tablets of 500 mg in Ukraine is 22 UAH (package No. 10), the cost of an antibiotic in tablets of 250 mg (package No. 10) is 9-10 UAH. The price of Ciprofloxacin in the form of a solution for infusion therapy is on average 22.5 UAH. The price of an ampoule with eye/ear drops in Kharkov or Kyiv is 17-19 UAH.
In Russian pharmacies the cost of 500 mg tablets is from 33 rubles, 250 mg tablets are from 18 rubles. The solution can be purchased for an average of 35 rubles. The price of Ciprofloxacin eye drops is from 17 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Ciprofloxacin tablets p.p.o.
500 mg 10 pcs. Ozon LLC 39 rub. order - Ciprofloxacin tablets p.p.o. 500 mg 10 pcs. Rapharma JSC
74 RUR order
- Ciprofloxacin solution for inf. 0.2% fl. 100 ml No. 120 (for hospitals) Limited Liability Partnership “Kelun-Kazpharm” (“
RUR 3,521 order
- Ciprofloxacin eye drops 0.3% tube dropper 10 ml RenewalAO Update PFK
41 rub. order
- Ciprofloxacin-AKOS eye drops 0.3% 5ml NOT DEFINED
24 RUR order
Pharmacy Dialogue
- Ciprofloxacin-AKOS (drops 0.3% 5ml) Sintez (Kurgan) OJSC
20 rub. order
- Ciprofloxacin (tab.p.p./vol. 500 mg No. 10) Sintez (Kurgan) OJSC
49 RUR order
- Ciprofloxacin (tab.p.pl/vol. 500 mg No. 10) Ozone LLC
39 RUR order
- Ciprofloxacin bottle 2 mg/ml 100 ml Elfa NPC CJSC/Elfa Laboratories
32 RUR order
- Ciprofloxacin tablets 500 mg No. 10Teva Pharmaceutical
114 RUR order
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Pharmacy24
- Ciprofloxacin 0.2% 100 ml solution
30 UAH. order - Ciprofloxacin 0.25 No. 10 tablets PrAT "Technolog", Uman, Cherkasy region, Ukraine
15 UAH order
- Ciprofloxacin 200 mg 100 ml No. 1 solution
36 UAH order
- Ciprofloxacin 0.2% 100 ml solution
18 UAH order
- Ciprofloxacin 500 mg No. 10 tablets PrAT "Technolog", Uman, Cherkasy region, Ukraine
30 UAH order
PaniPharmacy
- Ciprofloxacin infusion Ciprofloxacin infusion solution 0.2% 100ml Ukraine, Novofarm-Biosintez LLC
18 UAH order
- Ciprofloxacin infusion Ciprofloxacin infusion solution 0.2% 100ml Ukraine, Yuria-Pharm LLC
37 UAH order
- Ciprofloxacin tablets Ciprofloxacin film-coated tablets 0.25g No. 10 Ukraine, OZ GNTsLS LLC
13 UAH order
- Ciprofloxacin tablets Ciprofloxacin film-coated tablets 0.25g No. 10 Ukraine, Tekhnolog ChAO
17 UAH order
- Ciprofloxacin liquid Ciprofloxacin h/o 0.3% 5ml Ukraine, OZ GNTsLS LLC
31 UAH order
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Interaction
Use in combination with Theophylline helps to increase plasma concentration and increase T1/2 of the latter.
Al/Mg containing antacids help slow down the absorption of ciprofloxacin and thereby reduce its concentration in the urine and blood. Between doses of these drugs, intervals of at least 4 hours should be maintained.
Probenecid delays the elimination of the drug.
Ciprofloxacin enhances the effect of coumarin anticoagulants .
The interaction of Ciprofloxacin for use in otology and ophthalmology with other drugs has not been studied.
Reviews of Ciprofloxacin
Reviews about Ciprofloxacin tablets can be found very different: some consider the drug to be effective, others have the opposite opinion about it. Moreover, almost every review contains references to side effects that occurred during treatment with the drug.
Eye drops are rated by patients as having no disadvantages. They “really heal and heal quickly.”
According to doctors, the advantages of Ciprofloxacin are:
- high bactericidal activity;
- a wide spectrum of antimicrobial action, including Gram (-) and Gram (+) aerobes , mycoplasma , chlamydia , mycobacteria ;
- the ability to penetrate well into the cells and tissues of the macroorganism, creating concentrations there that exceed serum levels or are close to them;
- long T1/2 and the presence of a post-antibiotic effect (thanks to this, it is enough to take the drug only 2 times a day);
- proven effectiveness in the treatment of hospital-acquired and community-acquired infections of any (practically) localization (it is used for sore throat , UTI, infections of bones , skin, etc.);
- Possibility of use for severe infections (in a hospital setting) as
- empirical antibiotic therapy;
- good tolerance.
Overdose
There are no specific symptoms for an overdose of Ciprofloxacin. The patient is advised to lavage the stomach, take emetics, create an acidic urine reaction, and administer a large volume of fluid. All activities should be carried out against the background of maintaining the function of vital systems and organs.
Peritoneal dialysis and hemodialysis help remove 10% of the dose taken.
The drug does not have a specific antidote.
Contraindications
Contraindications for systemic use:
- hypersensitivity;
- pregnancy;
- lactation;
- severe kidney/liver dysfunction ;
- indications of a history of quinolone-induced tendonitis.
Eye and ear drops are contraindicated for fungal and viral infections of the eyes/ears , intolerance to Ciprofloxacin (or other quinolones), and during pregnancy and lactation.
For children, tablets and solution for intravenous administration can be prescribed from 12 years of age, eye and ear drops - from 15 years of age.
Ciprofloxacin during pregnancy
The safety and effectiveness of the drug during pregnancy have not been established.
Animal experiments showed that the drug caused arthropathy . The use of doses exceeding 6 times the average daily dose for humans in pregnant female rats and mice did not provoke any abnormalities in fetal development.
In rabbits receiving 30 and 100 mg/kg Ciprofloxacin orally, gastrointestinal dysfunction was observed and, as a consequence, weight loss and an increase in miscarriage cases. No teratogenic effect was detected.
When the drug was administered into a vein at a dose of 20 mg/kg, there was also no teratogenic effect or toxic effect on the embryo and the mother’s body.
The use of topical Ciprofloxacin during pregnancy is possible if indicated and provided that the benefits to the mother's body outweigh the risks to the fetus.
According to the FDA classification, the drug belongs to category C.
Ciprofloxacin is excreted into milk, so nursing women must decide (taking into account the importance of the drug for the mother) to stop breastfeeding or refuse treatment with Ciprofloxacin.
Local forms are used with caution during lactation, because It is unknown whether the medicine passes into breast milk in this case.
