Ciprocin
Generic Name
Ciprofloxacin
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ciprocin 500 mg tablet | ৳ 15.05 | ৳ 150.50 |
Description
Overview of the medicine
Ciprofloxacin is a broad-spectrum antibiotic from the fluoroquinolone class, used to treat a wide range of bacterial infections.
Uses & Indications
Dosage
Adults
Typical dosage is 250-750 mg twice daily, depending on the severity and type of infection. Treatment duration varies, usually 5-14 days.
Elderly
No specific dose adjustment is required solely based on age; however, renal function should be assessed and dose adjusted accordingly.
Renal_impairment
For creatinine clearance 30-60 mL/min, 250-500 mg every 12 hours. For creatinine clearance <30 mL/min, 250-500 mg every 18-24 hours.
How to Take
Take orally with a glass of water, with or without food. Do not take with dairy products (milk, yogurt) or calcium-fortified juices, as these can reduce absorption. Antacids containing magnesium, aluminum, or calcium should be taken at least 2 hours before or 6 hours after ciprofloxacin.
Mechanism of Action
Ciprofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, enzymes essential for DNA replication, transcription, repair, and recombination, leading to bacterial cell death.
Pharmacokinetics
Onset
0.5-2 hours
Excretion
Primarily via renal excretion (50-70% as unchanged drug) and some fecal excretion (15-30%).
Half life
3-5 hours (in individuals with normal renal function)
Absorption
Rapidly and well absorbed from the gastrointestinal tract (bioavailability 70-80%). Peak plasma concentrations are reached within 0.5-2 hours.
Metabolism
Partially metabolized in the liver to four less active metabolites (desethyleneciprofloxacin, sulfociprofloxacin, oxociprofloxacin, and formylciprofloxacin).
Side Effects
Contraindications
- Hypersensitivity to ciprofloxacin or other fluoroquinolones.
- Co-administration with tizanidine due to increased risk of hypotension and somnolence.
Drug Interactions
Caffeine
Decreased clearance of caffeine, leading to increased half-life and potential for adverse effects.
Warfarin
May enhance the anticoagulant effect of warfarin, requiring INR monitoring.
Cyclosporine
Increased serum creatinine and potential nephrotoxicity.
Methotrexate
Increases methotrexate levels, potentially increasing its toxicity.
Theophylline
Increases plasma concentrations of theophylline, leading to increased risk of toxicity.
Antacids (Mg, Al, Ca), Iron, Zinc supplements
Reduced oral absorption of ciprofloxacin. Administer these agents at least 2 hours before or 6 hours after ciprofloxacin.
Storage
Store in a cool, dry place below 30°C, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In case of overdose, gastric lavage and activated charcoal may be used. Maintain adequate hydration. Monitor vital signs and provide supportive care. Ciprofloxacin is poorly removed by hemodialysis or peritoneal dialysis.
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 into breast milk and may cause serious adverse reactions in nursing infants, including potential cartilage damage. Therefore, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Side Effects
Contraindications
- Hypersensitivity to ciprofloxacin or other fluoroquinolones.
- Co-administration with tizanidine due to increased risk of hypotension and somnolence.
Drug Interactions
Caffeine
Decreased clearance of caffeine, leading to increased half-life and potential for adverse effects.
Warfarin
May enhance the anticoagulant effect of warfarin, requiring INR monitoring.
Cyclosporine
Increased serum creatinine and potential nephrotoxicity.
Methotrexate
Increases methotrexate levels, potentially increasing its toxicity.
Theophylline
Increases plasma concentrations of theophylline, leading to increased risk of toxicity.
Antacids (Mg, Al, Ca), Iron, Zinc supplements
Reduced oral absorption of ciprofloxacin. Administer these agents at least 2 hours before or 6 hours after ciprofloxacin.
Storage
Store in a cool, dry place below 30°C, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
In case of overdose, gastric lavage and activated charcoal may be used. Maintain adequate hydration. Monitor vital signs and provide supportive care. Ciprofloxacin is poorly removed by hemodialysis or peritoneal dialysis.
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 into breast milk and may cause serious adverse reactions in nursing infants, including potential cartilage damage. Therefore, a decision should be made whether to discontinue nursing or 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
2 to 3 years from the date of manufacture, depending on the manufacturer.
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Ciprofloxacin has undergone extensive clinical trials demonstrating its efficacy and safety across various bacterial infections and patient populations. Post-marketing surveillance continues to monitor its long-term effects.
Lab Monitoring
- Renal function (creatinine, BUN) in patients with impaired renal function
- Liver function tests (ALT, AST) if liver impairment is suspected
- Complete Blood Count (CBC) with prolonged use
- INR for patients on warfarin
Doctor Notes
- Assess renal function before initiating treatment and adjust dose as necessary, especially in elderly patients.
- Counsel patients on the black box warnings, particularly regarding tendon rupture and neurological adverse events, and instruct them to discontinue the drug and seek immediate medical attention if symptoms occur.
- Be mindful of significant drug interactions, especially with warfarin, theophylline, and antacids.
- Avoid use in children and adolescents unless the benefits outweigh the risks due to potential cartilage damage.
Patient Guidelines
- Complete the full course of treatment as prescribed by your doctor, even if your symptoms improve.
- Drink plenty of fluids to prevent crystalluria.
- Avoid excessive exposure to sunlight or artificial UV light, as it can cause photosensitivity reactions.
- Do not take with dairy products, antacids, or mineral supplements.
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, lightheadedness, or vision disturbances. Exercise caution when driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Stay well-hydrated throughout the treatment period.
- Avoid strenuous exercise that might stress tendons if you experience any tendon pain.
- Consult your doctor if you experience any unusual symptoms, especially severe joint pain, muscle weakness, or changes in sensation.
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