Cipro-A
Generic Name
Ciprofloxacin
Manufacturer
Various (Generic)
Country
Multiple countries
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cipro a 250 mg suspension | ৳ 100.30 | N/A |
Description
Overview of the medicine
Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic used to treat a variety of bacterial infections, including those of the urinary tract, respiratory tract, skin, bone, and gastrointestinal system. The 250 mg/5 mL suspension form is typically used for pediatric patients or those who have difficulty swallowing tablets.
Uses & Indications
Dosage
Adults
The usual dosage for adults is 250 mg to 750 mg orally, twice daily, depending on the type and severity of the infection. For suspension, the equivalent volume should be administered. Consult a physician for specific dosing.
Elderly
No specific dose adjustment is needed for elderly patients with normal renal function. However, renal function should be monitored and dose adjusted if impairment is present.
Renal_impairment
Dose adjustment is necessary for patients with impaired renal function (creatinine clearance less than 50 mL/min). Consult product literature or a physician for specific recommendations.
How to Take
Take orally, with or without food. However, it's best to take it at least 2 hours before or 6 hours after antacids, iron supplements, zinc supplements, or sucralfate. Do not take with dairy products (e.g., milk, yogurt) or calcium-fortified juices alone; these can reduce absorption. Shake the suspension well before each use.
Mechanism of Action
Ciprofloxacin exerts its bactericidal action by inhibiting bacterial DNA gyrase and topoisomerase IV, enzymes essential for bacterial DNA replication, transcription, repair, and recombination. This leads to disruption of bacterial DNA and cell death.
Pharmacokinetics
Onset
Within 1-2 hours of administration.
Excretion
Primarily renal excretion (approximately 40-50% as unchanged drug) and to a lesser extent, fecal excretion (20-35%).
Half life
Approximately 3-5 hours in adults with normal renal function.
Absorption
Rapid and well-absorbed from the gastrointestinal tract following oral administration, with bioavailability of approximately 70-80%. Peak plasma concentrations are reached within 0.5-2 hours.
Metabolism
Undergoes partial hepatic metabolism to four active metabolites (desethyleneciprofloxacin, sulfociprofloxacin, oxociprofloxacin, and formylciprofloxacin) which possess less antimicrobial activity than the parent compound.
Side Effects
Contraindications
- Hypersensitivity to ciprofloxacin or other quinolones (e.g., nalidixic acid, norfloxacin)
- Co-administration with tizanidine due to increased risk of tizanidine-related adverse reactions
Drug Interactions
Warfarin
Enhanced anticoagulant effects of warfarin may occur. Monitor INR/PT carefully.
Theophylline
Ciprofloxacin can increase theophylline plasma concentrations, leading to toxicity. Monitor theophylline levels.
Corticosteroids
Increased risk of tendon disorders, especially in elderly patients.
Antacids, Iron, Zinc, Sucralfate
These agents can significantly reduce the absorption of ciprofloxacin. Administer ciprofloxacin at least 2 hours before or 6 hours after these products.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Concurrent use may increase the risk of CNS stimulation and convulsive seizures.
Storage
Store at room temperature (20-25°C or 68-77°F), away from moisture and light. Do not freeze. Keep out of reach of children. After reconstitution, store as directed on the label (e.g., at room temperature or refrigerated).
Overdose
In case of acute overdose, gastric emptying (e.g., induced vomiting or gastric lavage) may be considered. Maintain adequate hydration. Hemodialysis or peritoneal dialysis remove only small amounts of ciprofloxacin. Symptomatic and supportive treatment should be initiated.
Pregnancy & Lactation
Pregnancy Category C. Ciprofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Ciprofloxacin is excreted into breast milk. Nursing mothers should avoid ciprofloxacin or consider an alternative feeding method during treatment.
Side Effects
Contraindications
- Hypersensitivity to ciprofloxacin or other quinolones (e.g., nalidixic acid, norfloxacin)
- Co-administration with tizanidine due to increased risk of tizanidine-related adverse reactions
Drug Interactions
Warfarin
Enhanced anticoagulant effects of warfarin may occur. Monitor INR/PT carefully.
Theophylline
Ciprofloxacin can increase theophylline plasma concentrations, leading to toxicity. Monitor theophylline levels.
Corticosteroids
Increased risk of tendon disorders, especially in elderly patients.
Antacids, Iron, Zinc, Sucralfate
These agents can significantly reduce the absorption of ciprofloxacin. Administer ciprofloxacin at least 2 hours before or 6 hours after these products.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Concurrent use may increase the risk of CNS stimulation and convulsive seizures.
Storage
Store at room temperature (20-25°C or 68-77°F), away from moisture and light. Do not freeze. Keep out of reach of children. After reconstitution, store as directed on the label (e.g., at room temperature or refrigerated).
Overdose
In case of acute overdose, gastric emptying (e.g., induced vomiting or gastric lavage) may be considered. Maintain adequate hydration. Hemodialysis or peritoneal dialysis remove only small amounts of ciprofloxacin. Symptomatic and supportive treatment should be initiated.
Pregnancy & Lactation
Pregnancy Category C. Ciprofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Ciprofloxacin is excreted into breast milk. Nursing mothers should avoid ciprofloxacin or consider an alternative feeding method during treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture when unopened. Once reconstituted or opened, the shelf life may be shorter (e.g., 14 days). Check product label.
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by major regulatory bodies globally
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Ciprofloxacin has been extensively studied since its introduction, with ongoing clinical trials exploring its efficacy in new indications, optimal dosing regimens, and addressing antimicrobial resistance patterns. Post-marketing surveillance also continuously monitors its safety profile.
Lab Monitoring
- Renal function (creatinine clearance) in patients with impaired renal function or elderly.
- Liver function tests if hepatic impairment is suspected.
- Blood counts (rarely causes blood dyscrasias).
- ECG monitoring in patients with risk factors for QT prolongation.
Doctor Notes
- Counsel patients thoroughly about the black box warnings, particularly the risk of tendinopathy, peripheral neuropathy, and CNS effects. Advise immediate discontinuation if these symptoms develop.
- Consider the risk-benefit carefully, especially for uncomplicated infections where alternative treatments are available. Avoid use in children except for specific approved indications due to potential effects on cartilage.
- Monitor for drug interactions, especially with warfarin, theophylline, and agents that reduce absorption. Advise patients on proper administration regarding food and supplements.
- Ensure appropriate dose adjustment in patients with renal impairment.
Patient Guidelines
- Complete the full course of medication even if symptoms improve.
- Report any tendon pain, weakness, numbness, or tingling immediately to your doctor.
- Avoid excessive sun exposure and use sunscreen, as ciprofloxacin can increase photosensitivity.
- Maintain adequate hydration to prevent crystalluria.
- Avoid driving or operating machinery if you experience dizziness or lightheadedness.
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 go back to your regular dosing schedule. Do not double dose to make up for a missed one.
Driving Precautions
Ciprofloxacin may cause dizziness, lightheadedness, or visual disturbances. Patients should be advised to know how they react to ciprofloxacin before driving a car or operating machinery.
Lifestyle Advice
- Stay well-hydrated throughout the treatment period.
- Limit intake of caffeine-containing products as ciprofloxacin may increase caffeine levels.
- Protect skin from sun exposure due to increased photosensitivity.
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