Ancipro
Generic Name
Ciprofloxacin
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ancipro 250 mg tablet | ৳ 8.50 | ৳ 85.00 |
Description
Overview of the medicine
Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic used to treat various bacterial infections.
Uses & Indications
Dosage
Adults
Dosage varies depending on the type and severity of infection. Common doses are 250 mg to 750 mg orally twice daily. For uncomplicated UTIs: 250 mg twice daily for 3 days. For more severe infections: 500-750 mg twice daily for 7-14 days or longer.
Elderly
No specific dose adjustment is required solely based on age; however, dose should be adjusted based on renal function.
Renal_impairment
For creatinine clearance 30-60 mL/min, administer 250-500 mg every 12 hours. For creatinine clearance <30 mL/min, administer 250-500 mg every 18-24 hours. For patients on hemodialysis or peritoneal dialysis, administer after dialysis session.
How to Take
Take orally with a glass of water, with or without food. Do not take with dairy products or calcium-fortified juices. Swallow the tablet whole; do not crush, chew, or break it. Take at least 2 hours before or 6 hours after antacids containing magnesium, aluminum, or calcium, or products containing iron or zinc.
Mechanism of Action
Ciprofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, essential enzymes for bacterial DNA replication, transcription, repair, and recombination, leading to bacterial cell death.
Pharmacokinetics
Onset
Within 1-2 hours of oral administration.
Excretion
Primarily excreted unchanged by the kidneys (50-70%) via both glomerular filtration and tubular secretion. Approximately 15% is excreted via the fecal route.
Half life
Approximately 3-5 hours in adults with normal renal function.
Absorption
Rapidly and well absorbed from the gastrointestinal tract. Absolute bioavailability is approximately 70-80%. Peak plasma concentrations are achieved 1-2 hours after oral administration.
Metabolism
Undergoes limited hepatic metabolism (approximately 10-15%) via CYP1A2 pathway to four active metabolites, which have less activity than the parent compound.
Side Effects
Contraindications
- Hypersensitivity to ciprofloxacin or other fluoroquinolones.
- Concomitant administration with tizanidine.
Drug Interactions
NSAIDs
Increased risk of CNS stimulation and convulsions.
Warfarin
Potentiation of anticoagulant effect, increased risk of bleeding.
Tizanidine
Increased risk of hypotension and sedation.
Cyclosporine
Increased cyclosporine serum concentrations.
Methotrexate
Increased methotrexate plasma levels, potentially leading to toxicity.
Theophylline
Increased theophylline levels and toxicity.
Antacids (containing Mg, Al, Ca), Iron, Zinc supplements
Reduced ciprofloxacin absorption. Separate administration by at least 2 hours before or 6 hours after.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
In the event of an acute overdose, reversible renal toxicity has been reported. Management should include emptying the stomach by induced vomiting or gastric lavage. The patient should be carefully observed and given supportive treatment. Adequate hydration should be maintained. Hemodialysis or peritoneal dialysis remove only a small amount of ciprofloxacin (<10%).
Pregnancy & Lactation
Pregnancy Category C. Ciprofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk; due to the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Side Effects
Contraindications
- Hypersensitivity to ciprofloxacin or other fluoroquinolones.
- Concomitant administration with tizanidine.
Drug Interactions
NSAIDs
Increased risk of CNS stimulation and convulsions.
Warfarin
Potentiation of anticoagulant effect, increased risk of bleeding.
Tizanidine
Increased risk of hypotension and sedation.
Cyclosporine
Increased cyclosporine serum concentrations.
Methotrexate
Increased methotrexate plasma levels, potentially leading to toxicity.
Theophylline
Increased theophylline levels and toxicity.
Antacids (containing Mg, Al, Ca), Iron, Zinc supplements
Reduced ciprofloxacin absorption. Separate administration by at least 2 hours before or 6 hours after.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
In the event of an acute overdose, reversible renal toxicity has been reported. Management should include emptying the stomach by induced vomiting or gastric lavage. The patient should be carefully observed and given supportive treatment. Adequate hydration should be maintained. Hemodialysis or peritoneal dialysis remove only a small amount of ciprofloxacin (<10%).
Pregnancy & Lactation
Pregnancy Category C. Ciprofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk; due to the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture.
Availability
Available in pharmacies and hospitals
Approval Status
Widely approved globally
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Ciprofloxacin has undergone extensive clinical trials for its efficacy and safety in treating a wide range of bacterial infections. Ongoing post-marketing surveillance continues to monitor its long-term effects.
Lab Monitoring
- Renal function tests (Creatinine, BUN) - especially in elderly or renally impaired patients.
- Liver function tests (ALT, AST) - periodically.
- Complete blood count (CBC) - periodically, especially with prolonged use.
- Prothrombin time/INR - if co-administered with warfarin.
Doctor Notes
- Consider resistance patterns in the local area when prescribing.
- Adjust dose for renal impairment.
- Educate patients on black box warnings, especially tendon rupture and peripheral neuropathy, and advise immediate discontinuation if symptoms occur.
Patient Guidelines
- Complete the entire course of medication as prescribed, even if symptoms improve.
- Drink plenty of fluids to prevent crystalluria.
- Avoid excessive exposure to sunlight or artificial UV light, as ciprofloxacin can increase photosensitivity. Use sunscreen and wear protective clothing.
- Report any tendon pain, swelling, or rupture immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Ciprofloxacin may cause dizziness or lightheadedness, which could impair your ability to drive or operate machinery. Exercise caution until you know how the medication affects you.
Lifestyle Advice
- Maintain good hydration throughout the treatment.
- Avoid strenuous exercise if experiencing any tendon pain or discomfort.
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