Ciprofloxacin - Oral

Ciprofloxacin is an antibiotic. It is used to treat certain bacterial infections of the lungs, skin, genitals, kidneys and bladder.

This medicine may be used to treat other bacterial infections as decided by your doctor.

Take Ciprofloxacin exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

You may take this medicine with or without food. Try to take it at the same time each day.

Ciprofloxacin is available as a conventional or extended-release tablet and granules for oral suspension.

If you are taking the conventional tablet, swallow it whole with a glass of water.

If you are taking the extended-release type of tablet (usually labelled as "ER"), swallow it whole. Do not divide, chew, or crush the tablet.

If you are taking the oral suspension, shake the bottle well before you take the medicine to ensure that the liquid is evenly mixed. Use the measuring spoon or cup provided to measure your dose.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type and severity of your infection.

Take Ciprofloxacin at regular intervals. Do not skip any doses. You must complete the entire course of this medicine. If you don't, the infection will not be properly controlled.

If you miss a dose and you are taking the conventional tablet or oral suspension, you may take it anytime but not later than 6 hours prior the next scheduled dose. If it is less than 6 hours before the next dose is due, skip the missed dose and return to your normal dosing schedule.

If you miss a dose and you are taking the extended-release tablet, you may take it anytime but not later than 8 hours prior the next scheduled dose. If it is less than 8 hours before the next dose is due, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Do not take Ciprofloxacin if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or similar antibiotics such as ofloxacin, levofloxacin, and norfloxacin.

Do not take Ciprofloxacin with tizanidine (muscle relaxant).

Inform your doctor if you have the following conditions:

• family history of heart problems
• heart diseases e.g. heart failure (weakness and inability of the heart to pump blood), myocardial infarction (heart attack), slow heartbeat
• high blood pressure
• rheumatoid arthritis (inflammation in the joints of fingers, wrist, feet, and ankles)
• infective endocarditis (infection in the lining of the heart and heart valves)
• uncorrected imbalance of essential minerals in the body e.g. low potassium or magnesium levels in the blood
• diabetes
• G6PD deficiency (an inherited blood disorder where the body lacks a certain enzyme necessary for the proper functioning of red blood cells)
• myasthenia gravis (muscle weakness disorder)
• kidney disease

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Ciprofloxacin to a child or the elderly. Children and elderly people may be more sensitive to the side effects.

If you are going to have certain laboratory tests (e.g. drug test), inform your doctor that you are taking this medicine.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. complete blood count, liver and kidney function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Regular monitoring of signs or symptoms of allergic reactions, tendon problems, nerve damage, and mental status may also be needed.

Ciprofloxacin may make you feel less alert. If affected, do not drive or take part in any activity in which you need to be alert.

This medicine may also make your skin more sensitive to sunlight. Apply sunscreen when going outdoors and avoid prolonged exposure to sunlight and UV lamps.

Other side effects include any of the following: headache, dizziness, nausea, vomiting, decreased appetite, abdominal cramps, stomach wind, indigestion, joint pain, back pain, fever, and difficulty sleeping.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• rashes, breathlessness, swelling of the face, eyes or mouth
• severe diarrhoea or diarrhoea with severe stomach cramps or bloody stools
• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• pain, numbness or tingling sensation in the hands and feet
• swelling or discomfort in the tendons, difficulty controlling or moving a joint
• fits or seizures
• unusual changes in mood or behaviour (being too depressed, agitated, or having compulsive and impulsive behaviour) or having thoughts of self-harm
• fast or irregular heartbeat, chest pain or pressure
• unusual hunger or thirst, feeling sleepy, passing urine more often, fruity-smelling breath

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Ciprofloxacin with tizanidine (muscle relaxant).

Inform your doctor and pharmacist if you are taking or using any of these medicines:

• corticosteroids (anti-inflammatory medicines)
• other antibiotics e.g. clarithromycin, erythromycin
• medicines for irregular heartbeat e.g. amiodarone, sotalol, quinidine
• medicines for mood disorders e.g. olanzapine
• medicines for depression e.g. amitriptyline, clomipramine
• medicines for diabetes e.g. glibenclamide, insulin
• blood-thinning medicines e.g. warfarin
• NSAIDs (medicines for pain and inflammation)
• theophylline (asthma medicine)
• probenecid (medicine for gout [high uric acid level in the blood])
• phenytoin (medicine for fits or seizures)

This list does not include all medicines that may interact with Ciprofloxacin.

This medicine should not be taken with aluminium-, calcium-, or magnesium-containing antacids (medicines that neutralise stomach acids), supplements with iron or zinc, didanosine (medicine for HIV infection), or sucralfate (medicine used to treat ulcer in the small intestine) as they could reduce the effectiveness of Ciprofloxacin. If you must take them, take Ciprofloxacin at least 2 hours before or 6 hours after you have taken these medicines.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in a cool, dry place away from the reach of children.

The oral suspension can be stored between 2-8°C after you have mixed the powder with water. Do not freeze it otherwise, it will become less effective. Throw away unused portions after 14 days.

Medicines must not be used past the expiry date.