Ciprofloxacin

Ciprofloxacin is a fluoroquinolone antibiotic reserved for the treatment of bacterial infections that have not responded to first-line antibiotics or for which fluoroquinolones are the most appropriate option. It is effective against a wide range of Gram-negative and some Gram-positive organisms and is commonly prescribed for complicated urinary tract infections, prostatitis, certain gastrointestinal infections, and bone and joint infections.

Due to the risk of serious side effects affecting tendons, nerves, and muscles, European and UK regulatory authorities recommend that ciprofloxacin be used only when other antibiotics are unsuitable. This cautious approach reflects a careful balancing of its powerful antibacterial properties against its potential for harm.

How to Take Ciprofloxacin

Take ciprofloxacin tablets with a full glass of water, at evenly spaced intervals throughout the day. It can be taken with or without food, though taking it with a meal may reduce stomach upset. Avoid consuming dairy products, calcium-fortified juices, or antacids within two hours of a dose, as these can significantly reduce absorption.

Stay well hydrated throughout the course of treatment to reduce the risk of crystalluria (crystal formation in the urine). Avoid excessive sun exposure, as ciprofloxacin increases photosensitivity.

The dose depends on the type and severity of infection. For uncomplicated urinary tract infections, the typical dose is 250 mg to 500 mg twice daily for three to seven days. For more serious infections, 500 mg to 750 mg twice daily may be prescribed for seven to fourteen days or longer. Dose adjustments are necessary for patients with impaired kidney function. Your prescriber will determine the appropriate dose and duration.

Common Side Effects

Common side effects include:

• Nausea and diarrhoea
• Headache
• Dizziness
• Abdominal discomfort

Serious Side Effects

Serious side effects, though uncommon, include tendon inflammation and rupture (particularly of the Achilles tendon), peripheral neuropathy (tingling, numbness, or pain in the extremities), and effects on the central nervous system including confusion and, rarely, seizures. Stop the medication and seek medical advice immediately if you experience tendon pain, muscle weakness, or unusual neurological symptoms.

Ciprofloxacin should be discontinued immediately if signs of tendinitis develop. The risk of tendon rupture is increased in patients over 60, those taking corticosteroids, and organ transplant recipients. Avoid strenuous physical activity during treatment if you experience any musculoskeletal discomfort.

This medication may prolong the QT interval on an electrocardiogram and should be used with caution in patients with a history of cardiac arrhythmias or those taking other QT-prolonging drugs. Ciprofloxacin also enhances the effect of caffeine, so reducing caffeine intake during treatment is advisable.

Ciprofloxacin is contraindicated in patients with a known allergy to fluoroquinolone antibiotics. It should not be used concurrently with tizanidine due to the risk of severe hypotension and sedation. It is generally avoided in children and adolescents (except for specific indications under specialist guidance) due to the risk of joint and cartilage damage, and should not be used during pregnancy or breastfeeding.