Cicol-D
Generic Name
Ciprofloxacin & Dexamethasone
Manufacturer
Hypothetical Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cicol d 500 mg tablet | ৳ 10.00 | N/A |
Description
Overview of the medicine
Cicol-D 500 mg Tablet is a combination medication containing Ciprofloxacin, a broad-spectrum fluoroquinolone antibiotic, and Dexamethasone, a potent synthetic corticosteroid. Ciprofloxacin treats bacterial infections by inhibiting bacterial DNA gyrase, while Dexamethasone reduces inflammation and suppresses immune responses. This combination is typically used for bacterial infections accompanied by significant inflammation, where both antibiotic and anti-inflammatory effects are desired.
Uses & Indications
Dosage
Adults
Typically, one Cicol-D 500 mg tablet twice daily for 5-7 days, or as directed by a physician. Duration may vary based on infection severity and response.
Elderly
No specific dose adjustment typically required based on age alone, but renal function should be assessed. Use with caution.
Renal_impairment
Dose adjustment for Ciprofloxacin may be required in severe renal impairment (e.g., CrCl < 30 mL/min). Consult physician.
How to Take
Take the tablet orally with a glass of water, preferably on an empty stomach or at least 2 hours after a meal. Avoid taking with dairy products or antacids containing magnesium/aluminum/calcium.
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. Dexamethasone exerts its anti-inflammatory and immunosuppressive effects by binding to cytoplasmic glucocorticoid receptors, modifying gene expression to reduce the synthesis of inflammatory mediators and inhibit immune cell function.
Pharmacokinetics
Onset
Ciprofloxacin: 0.5-2 hours (antibacterial effect). Dexamethasone: 1-2 hours (anti-inflammatory effects).
Excretion
Ciprofloxacin: Primarily renal excretion (50-70% as unchanged drug), some fecal excretion. Dexamethasone: Excreted renally as inactive metabolites.
Half life
Ciprofloxacin: 3-5 hours. Dexamethasone: Plasma half-life 3-4.5 hours; biological half-life 36-54 hours.
Absorption
Ciprofloxacin is well absorbed orally, with bioavailability of 70-80%. Dexamethasone is rapidly and extensively absorbed after oral administration.
Metabolism
Ciprofloxacin: Primarily hepatic metabolism (minor), producing less active metabolites. Dexamethasone: Extensively metabolized in the liver to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to ciprofloxacin, other fluoroquinolones, dexamethasone, or any component of the formulation.
- History of tendinitis or tendon rupture associated with quinolone use.
- Concurrent use with Tizanidine.
- Systemic fungal infections (for dexamethasone).
Drug Interactions
NSAIDs
May increase the risk of CNS stimulation and convulsive seizures with Ciprofloxacin; increased risk of gastrointestinal ulceration with Dexamethasone.
Warfarin
Potentiation of anticoagulant effects, increasing bleeding risk.
Theophylline
Increased plasma levels of Theophylline, potentially leading to toxicity.
Oral Hypoglycemics/Insulin
Dexamethasone may increase blood glucose levels, requiring dose adjustment of antidiabetic agents.
Antacids/Mineral Supplements
Reduced absorption of Ciprofloxacin. Take Cicol-D at least 2 hours before or 6 hours after.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of Ciprofloxacin overdose, symptoms may include nausea, vomiting, diarrhea, headache, dizziness, tremors, hallucinations, and seizures. Dexamethasone acute overdose is unlikely to cause life-threatening effects but chronic overdose can lead to Cushingoid features, hyperglycemia, and fluid retention. Treatment is symptomatic and supportive, including gastric lavage and adequate hydration.
Pregnancy & Lactation
Ciprofloxacin is generally not recommended during pregnancy due to potential effects on fetal cartilage development. Dexamethasone may be used if benefits outweigh risks, but is also generally avoided. Both Ciprofloxacin and Dexamethasone are excreted in breast milk. Use during pregnancy and lactation should only be considered if clearly necessary and with careful risk-benefit assessment by a physician.
Side Effects
Contraindications
- Hypersensitivity to ciprofloxacin, other fluoroquinolones, dexamethasone, or any component of the formulation.
- History of tendinitis or tendon rupture associated with quinolone use.
- Concurrent use with Tizanidine.
- Systemic fungal infections (for dexamethasone).
Drug Interactions
NSAIDs
May increase the risk of CNS stimulation and convulsive seizures with Ciprofloxacin; increased risk of gastrointestinal ulceration with Dexamethasone.
Warfarin
Potentiation of anticoagulant effects, increasing bleeding risk.
Theophylline
Increased plasma levels of Theophylline, potentially leading to toxicity.
Oral Hypoglycemics/Insulin
Dexamethasone may increase blood glucose levels, requiring dose adjustment of antidiabetic agents.
Antacids/Mineral Supplements
Reduced absorption of Ciprofloxacin. Take Cicol-D at least 2 hours before or 6 hours after.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of Ciprofloxacin overdose, symptoms may include nausea, vomiting, diarrhea, headache, dizziness, tremors, hallucinations, and seizures. Dexamethasone acute overdose is unlikely to cause life-threatening effects but chronic overdose can lead to Cushingoid features, hyperglycemia, and fluid retention. Treatment is symptomatic and supportive, including gastric lavage and adequate hydration.
Pregnancy & Lactation
Ciprofloxacin is generally not recommended during pregnancy due to potential effects on fetal cartilage development. Dexamethasone may be used if benefits outweigh risks, but is also generally avoided. Both Ciprofloxacin and Dexamethasone are excreted in breast milk. Use during pregnancy and lactation should only be considered if clearly necessary and with careful risk-benefit assessment by a physician.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months from manufacturing date
Availability
Available in pharmacies with a valid prescription
Approval Status
Approved (for individual components; combination status varies by region)
Patent Status
Off-patent (for individual active ingredients)
WHO Essential Medicine
YesClinical Trials
While both Ciprofloxacin and Dexamethasone have undergone extensive clinical trials individually, specific trials for this exact oral fixed-dose combination might be limited or specific to niche indications.
Lab Monitoring
- Renal function tests (creatinine, BUN)
- Liver function tests (ALT, AST)
- Complete blood count (CBC)
- Blood glucose levels (especially in diabetic patients or with prolonged Dexamethasone use)
- Electrolyte levels (potassium, sodium) with prolonged Dexamethasone use
Doctor Notes
- This combination should be used judiciously, reserving it for infections where a significant inflammatory component warrants corticosteroid use in conjunction with Ciprofloxacin.
- Monitor patients for signs of tendonitis/tendon rupture, especially in elderly patients or those on concomitant corticosteroids.
- Consider the potential for adrenal suppression with prolonged Dexamethasone use; advise patients against abrupt discontinuation.
Patient Guidelines
- Complete the entire course of medication, even if symptoms improve.
- Do not stop Dexamethasone abruptly; consult your doctor for tapering instructions.
- Avoid dairy products, calcium-fortified juices, and antacids for at least 2 hours before or 6 hours after taking this medicine.
- Stay well-hydrated during treatment.
- Avoid excessive sun exposure due to increased photosensitivity.
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 continue your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
This medicine may cause dizziness, lightheadedness, or visual disturbances. Avoid driving or operating machinery until you know how it affects you.
Lifestyle Advice
- Maintain good hygiene to prevent further infections.
- Follow a balanced diet.
- Inform your doctor about all other medications you are taking.
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