Ciprofloxacin (Cipro), or ciprofloxacin hydrochloride, is a broad spectrum fluoroquinolone antibiotic used to treat many types of infections including respiratory infections, urinary tract infections (UTIs), and gastrointestinal (GI) infections. It may also be indicated in the treatment of gonorrhea.
Ciprofloxacin is a prescription medication that is available at most pharmacies and drug stores. It is sold as the generic "ciprofloxacin" and under the brand name Cipro, among others. It comes in pill, liquid, and injectable forms as well as eye drops and ear drops.
As with any antibiotic, ciprofloxacin should only be taken as prescribed by a doctor or your primary care provider.
What it's used for
Ciprofloxacin is indicated for the treatment of various infections, including:
- Eye infections: blepharitis, conjunctivitis, and corneal abscess;
- Respiratory infections: pneumonia, bronchitis, and sinusitis;
- Genital tract infections: gonorrhea, cervicitis, epididymitis, and pelvic inflammatory disease (PID);
- Urinary tract infections (UTIs): cystitis, non-gonococcal urethritis, and acute pyelonephritis;
- Abdominal infections: infectious diarrhea and intra-abdominal infections.
Ciprofloxacin is also used to treat infections of the skin, soft tissues, bones, and joints. It may also be used to treat ear infections. Ciprofloxacin is also indicated for antibiotic prophylaxis in cases of anthrax exposure, and as treatment for confirmed cases of anthrax.
It is important to stress that ciprofloxacin does not work against viruses and is therefore not indicated in the treatment of viral infections.
Also recommended: Pneumonia Treatment: 8 Treatment Approaches tuasaude.com/en/pneumonia-treatmentDosing instructions
Ciprofloxacin is prescribed in different doses and preparations depending on the condition being treated. These include:
1. Ciprofloxacin 500 mg pills
Ciprofloxacin comes in 250 mg or 500 mg pills and should be taken by mouth, with a full glass of water, before or after a meal, following the dosing scheduled indicated by your doctor or healthcare provider.
Recommended doses for adults vary according to the condition being treated, and include:
- Respiratory infections: doses vary according to the type of infection and are typically 250 to 750 mg every 12 hours;
- Acute sinusitis: the typical recommended dose is 500 mg every 12 hours for 10 days, or as prescribed by your doctor;
- Urinary tract infections (UTIs): the usual dose is 250 mg every 12 hours;
- Uncomplicated cystitis: the usual recommended dose is 250 mg every 12 hours;
- Gonorrhea: a single dose of 250 to 500 mg is typically recommended;
- Infectious diarrhea: a typical dose is 500 mg every 12 hours.
Dosing may be adjusted by the prescribing provider, especially in the case of liver or kidney disease, as ciprofloxacin has the potential to worsen liver and kidney function.
Treatment duration will vary based on the condition being treated, ranging from a single dose in the case of gonorrhea to a treatment course of up to 7 to 14 days for the treatment of other infections. In more serious cases, such as osteomyelitis, treatment with ciprofloxacin may last a month or more.
Also recommended: UTI Treatment: Antibiotics and Home Remedies tuasaude.com/en/uti-treatment2. Ciprofloxacin eye drops
Ciprofloxacin eye drops should be applied directly to the affected eye. It is important to avoid contact of the bottle with your eye to prevent contamination of the solution.
Typical dosing for adults is:
Dosing and treatment duration may be adjusted by your provider based on the type of infection and response to treatment.
To administer the eye drops, tilt your head back slightly and pull down on your lower eyelid to form a small pouch. Hold the bottle over the eye with the tip facing down toward the pouch, gaze up, and squeeze the bottle gently so that a drop falls into the affected eye.
After administering the eye drops, keep the eye closed for 1 to 2 minutes and apply gentle pressure over the inner corner of the eye to prevent the fluid from leaking out of the tear duct.
If more than 1 drop at a time is indicated by your provider, make sure to wait about 5 minutes between administering each drop.
Ciprofloxacin eye drops are good for 28 days after opening, and should be discarded after that time.
3. Ciprofloxacin eye ointment
Ciprofloxacin eye ointment is often sold under the brand name Ciloxan and is applied only to the affected eye.
The usual dose for adults is a 0.5 in (1.25 cm) ribbon of ointment applied to the conjunctival sac every 8 hours on days 1 and 2 of treatment, and a 0.5 in (1.25 cm) ribbon of ointment applied to the conjunctival sac every 12 hours on days 3-7, or as directed by the prescribing provider.
To apply the ointment, tilt your head back slightly and pull down on the lower eyelid to form a small pouch (the conjunctival sac). Next, hold the tube above the eye with the tip pointing down toward the conjunctival sac. Gaze up and squeeze the tube gently to apply a ribbon of ointment to the affected eye.
After applying the ointment, blink the eye gently than close the eye for 1 to 2 minutes. Your vision may be cloudy or blurry for a short period of time after opening your eye, but this is normal.
Ciprofloxacin ointment is good for 60 days after opening and should be discarded after this time.
4. Ciprofloxacin ear drops
Ciprofloxacin ear drops come in various formulations, including ciprofloxacin hydrochloride (Cetraxal, Otiprio), ciprofloxacin + hydrocortisone (Cipro HC otic), and ciprofloxacin + dexamethasone (Ciprodex).
Typical doses for adults and children over 1 year of age are:
To administer the ear drops, first wash your hands with soap and water and then lie down on your side, with the affected ear facing up. Pull the ear back slightly and administer the drops one at a time. Stay lying on your side for the next 5 to 10 minutes.
Place a cotton ball in the ear after 5 to 10 minutes to help keep the medication inside the ear and prevent it from leaking out. The cotton ball should be switched out with each application.
It is important to warm the bottle up between your hands before use to make sure the medication is not too cold going in, as this can lead to symptoms like vertigo.
5. Ciprofloxacin IV
Ciprofloxacin can be given as an intravenous injection for the treatment of serious infections such as acute intra-abdominal infections, complicated UTIs, and anthrax. It comes in solutions of 200mg/100mL, 200mg/20mL, 400 mg/40mL, and 400mg/200mL.
The intravenous form of ciprofloxacin is given in the hospital by a nurse and is injected directly into the vein. It is given only under a doctor's supervision. Dosing will depend on the type of infection being treated and will be determined by your doctor.
Side effects
Some of the most common side effects from ciprofloxacin are nausea, vomiting, diarrhea, and abdominal pain.
Other possible side effects include rupture of the Achilles tendon, decreased appetite, agitation, headache, dizziness, seizures, hallucinations, changes in taste, pancreatitis, blistering of the skin, itching, hives, body pain, malaise, fever, and acute kidney injury.
Ciprofloxacin can cause joint pain in children. To avoid complications, it is important to only use ciprofloxacin for children when recommended by a pediatrician.
Contraindications to use
Ciprofloxacin should be avoided during pregnancy and lactation. Make sure to talk to your doctor if you are pregnant or breastfeeding to discuss the risks and benefits of treatment as well as alternatives.
In addition, ciprofloxacin should not be used in people who are allergic to ciprofloxacin or to any of its components, or to other fluoroquinolones such as levofloxacin or norfloxacin.
Ciprofloxacin should not be used in people with a history of tendon problems related to the use of fluoroquinolones or in people with myasthenia gravis, as it may cause a worsening of symptoms.