Ciprofloxacin

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Ciprofloxacin: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Drug interactions
11. Analogs
12. Terms and conditions of storage
13. Terms of dispensing from pharmacies
14. Reviews
15. Price in pharmacies

Latin name: Ciprofloxacinum

ATX code: S03AA07

Active ingredient: Ciprofloxacin (Ciprofloxacinum)

Producer: PJSC "Farmak", PJSC "Technolog", OJSC "Kievmedpreparat" (Ukraine), LLC "Ozon", OJSC "Veropharm", OJSC "Sintez" (Russia), CO Rompharm Company SRL (Romania)

Description and photo update: 2019-12-08

Prices in pharmacies: from 15 rubles.

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Ciprofloxacin is a broad-spectrum antimicrobial drug of bactericidal action from the group of fluoroquinolones.

Release form and composition

coated tablets / film-coated tablets (the appearance of the tablets and the form of the package depend on the manufacturer and the dose of the active substance);
solution for infusion: clear, colorless or slightly colored liquid (100 ml in vials; the number of vials in the package depends on the manufacturer);
concentrate for preparation of solution for infusion: transparent, colorless or slightly greenish-yellow liquid without mechanical impurities (10 ml in vials, 5 vials in a cardboard box);
eye drops 0.3%: clear liquid, yellowish-greenish or slightly yellow (1 ml, 1.5 ml, 2 ml, 5 ml or 10 ml each in vials or polyethylene dropper tubes with a valve / screw neck made of polyethylene, each 1 bottle, 1 or 5 dropper tubes in a cardboard box);
eye and ear drops 0.3%: transparent, colorless or slightly yellowish liquid (5 ml each in polymer dropper bottles, in a cardboard box 1 bottle).

Composition of 1 film-coated tablet:

active substance: ciprofloxacin - 250, 500 or 750 mg;
auxiliary components: starch 1500 or corn starch, lactose (milk sugar), magnesium stearate, crospovidone, MCC (microcrystalline cellulose), talc;
shell: content and quantity of components depends on the manufacturer.

Composition of 1 ml solution for infusion:

active substance: ciprofloxacin (in the form of monohydrate hydrochloride) - 2 mg (2.33 mg);
auxiliary components: lactic acid, sodium chloride, 1M sodium hydroxide solution, disodium salt of ethylenediaminetetraacetic acid, water for injection.

Composition of 1 ml of concentrate for preparation of solution for infusion:

active substance: ciprofloxacin (in the form of hydrochloride) - 100 mg (111 mg);
auxiliary components: disodium edetate dihydrate, lactic acid, hydrochloric acid, sodium hydroxide, water for injection.

Composition of 1 ml of 0.3% eye drops:

active substance: ciprofloxacin (in the form of monohydrate hydrochloride) - 3 mg;
auxiliary components: mannitol, disodium edetate, sodium acetate, benzalkonium chloride, acetic acid, water for injection.

Composition of 1 ml drops of eye and ear 0.3%:

active substance: ciprofloxacin (in the form of monohydrate hydrochloride) - 3 mg;
auxiliary components: mannitol, sodium acetate trihydrate, disodium edetate dihydrate, benzalkonium chloride, glacial acetic acid, purified water.

Pharmacological properties

Pharmacodynamics

Ciprofloxacin is a broad spectrum antimicrobial drug. This quinolone derivative inhibits bacterial DNA gyrase (topoisomerases II and IV, which are responsible for the process of supercoiling of chromosomal DNA around RNA nuclei, which ensures the reading of the necessary genetic information), disrupts DNA production, inhibits the growth and reproduction of bacteria, and leads to pronounced changes in morphological nature (in including cell membranes and walls) and the immediate death of bacterial cells.

The substance has a bactericidal effect against gram-negative microorganisms during division and rest (since it affects not only DNA gyrase, but also provokes lysis of cell walls). Ciprofloxacin affects gram-positive microorganisms only during the division period.

Low toxicity for cells of a macroorganism is due to the absence of DNA gyrase in them. During treatment with ciprofloxacin, parallel resistance to other antibiotics that are not included in the group of DNA gyrase inhibitors is not developed. This increases the effectiveness of the drug in relation to bacteria resistant to tetracyclines, aminoglycosides, cephalosporins, penicillins.

They are distinguished by increased sensitivity to ciprofloxacin:

gram-negative aerobic bacteria: enterobacteria (Yersinia spp., Escherichia coli, Vibrio spp., Salmonella spp., Morganella morganii, Shigella spp., Providencia spp., Citrobacter spp., Edwardsiella tarda, Klebsiella spp., Protegar alus vulnia mirabilis, Serratia marcescens), some intracellular pathogens (Mycobacterium kansasii, Mycobacterium tuberculosis, Legionella pneumophila, Listeria monocytogenes, Brucella spp.);
gram-positive aerobic bacteria: Streptococcus spp. (Streptococcus agalactiae, Streptococcus pyogenes), Staphylococcus spp. (Staphylococcus saprophyticus, Staphylococcus aureus, Staphylococcus hominis, Staphylococcus haemolyticus).

Ciprofloxacin is active against Bacillus anthracis. Most staphylococci, which are characterized by resistance to methicillin, show similar resistance to ciprofloxacin. The sensitivity of Mycobacterium avium, Enterococcus faecalis, Streptococcus pneumoniae (localized intracellularly) is moderate: high concentrations of the drug are required to suppress the vital activity of these microorganisms.

The drug has no effect on Nocardia asteroids, Bacteroides fragilis, Clostridium difficile, Ureaplasma urealyticum, Pseudomonas maltophilia, Pseudomonas cepacia. It is also not effective enough against Treponema pallidum.

Resistance develops rather slowly, since ciprofloxacin almost completely destroys persistent microorganisms, and bacterial cells lack enzymes that inactivate it.

Pharmacokinetics

When taken orally, ciprofloxacin is almost completely and at a high rate absorbed from the gastrointestinal tract (mainly in the jejunum and duodenum). Food intake inhibits absorption, but does not affect bioavailability and maximum concentration. Bioavailability is 50–85%, and the volume of distribution is 2–3.5 l / kg. Ciprofloxacin binds to plasma proteins by about 20-40%. The maximum level of the substance in the body when taken orally is reached after about 60-90 minutes. The maximum concentration is associated with the value of the dose taken by a linear relationship and is at doses of 1000, 750, 500 and 250 mg, respectively, 5.4, 4.3, 2.4 and 1.2 μg / ml. 12 hours after oral administration of 750, 500 and 250 mg, the content of ciprofloxacin in plasma decreases to 0.4, 0.2 and 0.1 μg / ml, respectively.

The substance is well distributed in body tissues (excluding tissues rich in fats, such as nervous tissue). Its content in tissues is 2–12 times higher than in blood plasma. Therapeutic concentrations are found in the skin, saliva, peritoneal fluid, tonsils, articular cartilage and synovial fluid, bone and muscle tissue, intestines, liver, bile, gallbladder, kidneys and urinary system, abdominal and pelvic organs (uterus, ovaries and fallopian tubes, endometrium), tissues of the prostate gland, seminal fluid, bronchial secretions, lung tissue.

Ciprofloxacin penetrates into the cerebrospinal fluid in small concentrations, where its content in the absence of an inflammatory process in the meninges is 6-10% of that in the blood serum, and in the presence of inflammatory foci - 14-37%.

Ciprofloxacin also penetrates well into the lymph, pleura, ocular fluid, peritoneum and through the placenta. Its concentration in blood neutrophils is 2-7 times higher than in blood serum. The compound is metabolized in the liver by about 15-30%, forming low-activity metabolites (formylcyprofloxacin, diethylcyprofloxacin, oxocyprofloxacin, sulfocyprofloxacin).

The half-life of ciprofloxacin is about 4 hours, with chronic renal failure, increasing to 12 hours. It is excreted mainly through the kidneys through tubular secretion and tubular filtration unchanged (40-50%) and in the form of metabolites (15%), the rest is excreted through the gastrointestinal tract. Small amounts of ciprofloxacin are excreted in breast milk. Renal clearance is 3-5 ml / min / kg, and total clearance is 8-10 ml / min / kg.

In chronic renal failure (CC more than 20 ml / min), the degree of excretion of ciprofloxacin through the kidneys decreases, but it does not accumulate in the body due to a compensatory increase in the metabolism of this substance and its excretion through the gastrointestinal tract.

When carrying out intravenous infusion of the drug in a dose of 200 mg, the maximum concentration of ciprofloxacin, which is 2.1 μg / ml, is reached after 60 minutes. After intravenous administration, the content of ciprofloxacin in urine during the first 2 hours after infusion is almost 100 times higher than in blood plasma, which significantly exceeds the minimum inhibitory concentration for most causative agents of urinary tract infections.

When applied topically, ciprofloxacin penetrates well into the tissues of the eye: the anterior chamber and the cornea, especially if the epithelial cover of the cornea is damaged. When it is damaged, the substance accumulates in it in concentrations that can destroy most of the causative agents of corneal infections.

After a single instillation, the content of ciprofloxacin in the moisture of the anterior chamber of the eye is determined after 10 minutes and is 100 μg / ml. The maximum concentration of the compound in the moisture of the anterior chamber is reached after 1 hour and is equal to 190 μg / ml. After 2 hours, the concentration of ciprofloxacin begins to decrease, but its antibacterial effect in the tissues of the cornea is prolonged and lasts for 6 hours, in the moisture of the anterior chamber - up to 4 hours.

After instillation, systemic absorption of ciprofloxacin may be observed. When used in the form of eye drops 4 times a day in both eyes for 7 days, the average concentration of the substance in the blood plasma does not exceed 2–2.5 ng / ml, and the maximum concentration is less than 5 ng / ml.

Indications for use

Systemic use (tablets, solution for infusion, concentrate for preparation of solution for infusion)

In adult patients, Ciprofloxacin is used for the treatment and prevention of infectious and inflammatory diseases caused by sensitive microorganisms:

bronchitis (chronic in the acute stage and acute), bronchiectasis, pneumonia, cystic fibrosis and other respiratory tract infections;
frontal sinusitis, sinusitis, pharyngitis, otitis media, sinusitis, tonsillitis, mastoiditis and other infections of the ENT organs;
pyelonephritis, cystitis and other infections of the kidneys and urinary tract;
adnexitis, gonorrhea, prostatitis, chlamydia and other infections of the pelvic organs and genitals;
bacterial lesions of the gastrointestinal tract (gastrointestinal tract), bile ducts, intraperitoneal abscess, and other infections of the abdominal organs;
ulcerative infections, burns, abscesses, wounds, phlegmon, and other infections of the skin and soft tissues;
septic arthritis, osteomyelitis, and other infections of bones and joints;
surgical operations (to prevent infection);
pulmonary anthrax (for prevention and therapy);
infections against the background of immunodeficiency resulting from therapy with immunosuppressive drugs or with neutropenia.

For children aged 5 to 17 years, Ciprofloxacin is prescribed systemically for cystic fibrosis of the lungs for the treatment of complications caused by Pseudomonas aeruginosa, as well as for the prevention and treatment of pulmonary anthrax (Bacillus anthracis).

Solution for infusion and concentrate for preparation of solution for infusion are also used for eye infections and severe general infection of the body - sepsis.

Tablets are prescribed for CDC (selective intestinal decontamination) in patients with reduced immunity.

Topical application (eye drops, eye drops and ear drops)

Ciprofloxacin drops are used to treat and prevent the following infectious inflammation caused by microorganisms sensitive to ciprofloxacin:

ophthalmology (eye drops, eye and ear drops): blepharitis, subacute and acute conjunctivitis, blepharoconjunctivitis, keratitis, keratoconjunctivitis, meibomitis (barley), chronic dacryocystitis, bacterial corneal ulcer, bacterial or perioperative eye infections due to traumatic infection ophthalmic surgery;
otorhinolaryngology (eye and ear drops): otitis externa, therapy of infectious complications in the postoperative period.

Contraindications

Systemic application

Absolute:

co-administration with tizanidine [due to the high likelihood of a pronounced decrease in blood pressure (blood pressure) and drowsiness];
pseudomembranous colitis;
pregnancy and the period of breastfeeding;
children and adolescents up to 18 years old, except for cases of therapy and prevention of pulmonary anthrax (Bacillus anthracis), as well as treatment of complications caused by Pseudomonas aeruginosa in children with cystic fibrosis of the lungs aged 5 to 17 years;
lactase deficiency, lactose intolerance, glucose-galactose malabsorption (for tablets);
hypersensitivity to Ciprofloxacin, other fluoroquinolones and auxiliary ingredients of the drug.

Relative: systemically Ciprofloxacin is used with caution in severe atherosclerosis of the cerebral vessels, cerebrovascular accident, mental illness, epilepsy, severe renal / hepatic failure, in old age, with a history of tendon lesions during therapy with fluoroquinolones. The solution for infusion (additionally) is used with caution in case of an increased risk of prolongation of the QT interval / development of arrhythmias such as pirouette, including with heart failure, bradycardia, myocardial infarction, congenital prolongation of the QT interval syndrome and electrolyte imbalance (hypokalemia, hypomagnesemia).

Local application

Absolute contraindications for topical use of ciprofloxacin:

ophthalmomycosis and viral eye lesions;
pregnancy and the period of breastfeeding (for eye instillations);
age up to 1 year (for eye instillations);
increased individual sensitivity to components.

The use of the drug in otorhinolaryngology (eye and ear drops) during pregnancy and during breastfeeding is permissible only if the possible benefit of therapy for the mother justifies the potential risk to the fetus or child.

Instructions for the use of Ciprofloxacin: method and dosage

After the disappearance of the clinical symptoms of the disease and the normalization of body temperature, therapy with Ciprofloxacin is continued for at least 3 more days.

Film-coated / film-coated tablets

Ciprofloxacin tablets are taken orally after meals, swallowing whole with a small amount of liquid. Taking tablets on an empty stomach accelerates the absorption of the active substance.

Recommended dosage: 250 mg 2-3 times a day, in severe infections - 500-750 mg 2 times a day (1 time in 12 hours).

Dosage according to disease / condition:

urinary tract infections: twice a day, 250-500 mg for a course of 7 to 10 days;
chronic prostatitis: twice a day, 500 mg for 28 days;
uncomplicated gonorrhea: 250–500 mg once;
gonococcal infection in combination with chlamydia and mycoplasmosis: twice a day (once every 12 hours), 750 mg for a course of 7 to 10 days;
chancroid: twice a day, 500 mg for several days;
meningococcal carriage in the nasopharynx: 500-750 mg once;
chronic carriage of Salmonella: twice a day, 500 mg (if necessary, increase to 750 mg) for a course of up to 28 days;
severe infections (recurrent cystic fibrosis, infections of the abdominal cavity, bones, joints) caused by pseudomonads or staphylococci, acute pneumonia caused by streptococci, chlamydial infections of the urinary tract: twice a day (1 time in 12 hours) at a dose of 750 mg (course of therapy for osteomyelitis can last up to 60 days);
infections of the gastrointestinal tract caused by Staphylococcus aureus: twice a day (1 time in 12 hours) at a dose of 750 mg for a course of 7 to 28 days;
complications caused by Pseudomonas aeruginosa in children 5–17 years old with cystic fibrosis of the lungs: twice a day, 20 mg / kg (maximum daily dose - 1500 mg) for a course of 10 to 14 days;
pulmonary anthrax (treatment and prevention): twice a day for children at 15 mg / kg, for adults - 500 mg (maximum doses: single - 500 mg, daily - 1000 mg), course of treatment - up to 60 days, start taking the drug follows immediately after infection (suspected or confirmed).

The maximum daily dose of Ciprofloxacin for renal failure:

creatinine clearance (CC) 31-60 ml / min / 1.73 m ² or serum creatinine concentration 1.4-1.9 mg / 100 ml - 1000 mg;
CC <30 ml / min / 1.73 m ² or serum creatinine concentration> 2 mg / 100 ml - 500 mg.

Patients on hemo- or peritoneal dialysis should take the tablets after the dialysis session.

Elderly patients require a dose reduction of 30%.

Solution for infusion, concentrate for preparation of solution for infusion

The drug is administered by intravenous drip, slowly, into a large vein, this reduces the risk of complications at the injection site. With the introduction of 200 mg of ciprofloxacin, the infusion lasts 30 minutes, 400 mg - 60 minutes.

The concentrate for the preparation of a solution for infusion must be diluted to a minimum volume of 50 ml before use in the following infusion solutions: 0.9% sodium chloride solution, Ringer's solution, 5% or 10% dextrose solution, 10% fructose solution, 5% dextrose solution with 0.225 –0.45% sodium chloride solution.

The solution for infusion is administered separately or together with compatible solutions for infusion: 0.9% sodium chloride solution, Ringer's and Ringer's Lactate solution, 5% or 10% dextrose solution, 10% fructose solution, 5% dextrose solution with 0.225-0.45 % sodium chloride solution. The solution obtained after mixing should be used as soon as possible in order to maintain its sterility.

In case of unconfirmed compatibility with another solution / drug, Ciprofloxacin infusion solution is administered separately. Visible signs of incompatibility are precipitation, turbidity or discoloration of the liquid. The pH of the ciprofloxacin infusion solution is 3.5-4.6, therefore it is incompatible with all solutions / drugs that are physically or chemically unstable at such pH values (heparin solution, penicillins), especially with agents that change pH values to the alkaline side. Due to the storage of the solution at low temperatures, a precipitate may form, which is soluble at room temperature. It is not recommended to store the infusion solution in the refrigerator and freeze it, since only a clear and transparent solution is suitable for use.

The recommended dosage regimen of Ciprofloxacin for adult patients:

respiratory tract infections: depending on the patient's condition and the severity of the course of the infection - 2 or 3 times a day, 400 mg;
infections of the genitourinary system: acute, uncomplicated - 2 times a day from 200 to 400 mg, complicated - 2 or 3 times a day, 400 mg;
adnexitis, chronic bacterial prostatitis, orchitis, epididymitis: 2 or 3 times a day, 400 mg;
diarrhea: 2 times a day, 400 mg;
other infections listed in the section "Indications for use": 2 times a day, 400 mg;
severe life-threatening infections, especially those caused by Staphylococcus spp., Pseudomonas spp., Streptococcus spp., including pneumonia caused by Streptococcus spp., peritonitis, infections of bones and joints, septicemia, recurrent infections in cystic fibrosis: 3 times a day, 400 mg;
pulmonary (inhalation) form of anthrax: 2 times a day, 400 mg for a course of 60 days (for therapy and prevention).

Correction of the dose of ciprofloxacin in elderly patients is carried out downward, depending on the severity of the disease and the CC index.

For the treatment of complications caused by Pseudomonas aeruginosa caused by cystic fibrosis of the lungs in children aged 5–17 years, a dose of 10 mg / kg (maximum daily dose of 1200 mg) is recommended 3 times a day for a course of 10–14 days. For the treatment and prevention of pulmonary anthrax, 2 infusions per day at 10 mg / kg of ciprofloxacin are recommended (maximum single - 400 mg, daily - 800 mg), course - 60 days.

The maximum daily dose of ciprofloxacin for renal failure:

creatinine clearance (CC) 31-60 ml / min / 1.73 m ² or serum creatinine concentration 1.4-1.9 mg / 100 ml - 800 mg;
CC <30 ml / min / 1.73 m ² or serum creatinine concentration> 2 mg / 100 ml - 400 mg.

For patients on hemodialysis, ciprofloxacin is administered immediately after the session.

Average duration of therapy:

acute uncomplicated gonorrhea - 1 day;
infections of the kidneys, urinary tract and abdominal cavity - up to 7 days;
osteomyelitis - no more than 60 days;
streptococcal infections (due to the risk of late complications) - at least 10 days;
infections against the background of immunodeficiency resulting from therapy with immunosuppressive drugs - during the entire period of neutropenia;
other infections - 7-14 days.

Eye drops, eye drops and ear drops

In ophthalmic practice, drops of Ciprofloxacin (eye, eye and ear) are instilled into the conjunctival sac.

Instillation regimen depending on the type of infection and the severity of the inflammatory process:

acute bacterial conjunctivitis, blepharitis (simple, scaly and ulcerative), meibomitis: 1-2 drops 4-8 times a day for 5-14 days;
keratitis: 1 drop from 6 times a day for a course of 14-28 days;
bacterial corneal ulcer: 1st day - 1 drop every 15 minutes for the first 6 hours of treatment, then during waking hours, 1 drop every 30 minutes; 2nd day - during waking hours, 1 drop every hour; 3-14 days - during waking hours, 1 drop every 4 hours. If epithelialization has not occurred after 14 days of therapy, treatment is allowed to continue for another 7 days;
acute dacryocystitis: 1 drop 6–12 times a day for a course of no more than 14 days;
eye injuries, including ingress of foreign bodies (prevention of infectious complications): 1 drop 4–8 times a day for 7–14 days;
preoperative preparation: 1 drop 4 times a day for 2 days before the operation, 1 drop 5 times with an interval of 10 minutes immediately before the operation;
postoperative period (prevention of infectious complications): 1 drop 4-6 times a day for the entire period, usually from 5 to 30 days.

In otorhinolaryngology, the drug (eye and ear drops) is instilled into the external auditory canal, after carefully cleaning it.

Recommended dosing regimen: 2-4 times a day (or more often, as needed) 3-4 drops. The duration of therapy should not exceed 5-10 days, except in cases where the local flora is sensitive, then prolongation of the course is allowed.

For the procedure, it is recommended to bring the solution to room temperature or body temperature in order to avoid vestibular stimulation. The patient should lie on the side opposite to the sore ear, and remain in this position for 5-10 minutes after instillation.

Sometimes, after local cleansing of the external auditory canal, it is allowed to put a cotton swab moistened with Ciprofloxacin solution into the ear and keep it there until the next instillation.

Side effects

Systemic application

digestive system: nausea / vomiting, diarrhea, flatulence, abdominal pain, impaired appetite and decreased food intake, cholestatic jaundice (especially in patients with a history of liver disease), hepatitis, hepatonecrosis;
nervous system: headache, dizziness, migraine, anxiety, increased fatigue, tremors, heavy dreams (nightmares), insomnia, peripheral paralgesia, hyperhidrosis, cerebral artery thrombosis, increased intracranial pressure, fainting, depression, confusion, hallucinations psychotic reactions, occasionally progressing to states in which the patient is able to harm himself;
sense organs: impairment of smell and taste, visual impairment (change in color perception, diplopia), noise and ringing in the ears, hearing impairment up to and including loss;
cardiovascular system: heart rhythm disturbances, tachycardia, decrease in blood pressure; for the solution additionally - vasodilation, benign intracranial hypertension, cardiovascular collapse;
hematopoietic system: anemia, leukopenia, thrombocytopenia, granulocytopenia, leukocytosis, hemolytic anemia, thrombocytosis, inhibition of bone marrow hematopoiesis, pancytopenia;
laboratory parameters: increased activity of liver enzymes, hyperglycemia, hypoglycemia, hypoprothrombinemia, hyperbilirubinemia, hypercreatininemia;
urinary system: crystalluria, hematuria, glomerulonephritis, urinary retention, dysuria, polyuria, albuminuria, urethral bleeding, interstitial nephritis, decreased nitrogen excretion function of the kidneys;
musculoskeletal system: arthritis, arthralgia, tendovaginitis, myalgia, tendon ruptures;
hypersensitivity reactions: dyspnea, urticaria, pruritus, increased photosensitivity, angioedema, blisters (accompanied by bleeding), small nodules (forming scabs), petechiae (punctate hemorrhages on the skin), drug fever, edema of the face / larynx, eosculinophilia, nodules erythema, exudative erythema multiforme (including Stevens-Johnson syndrome), Lyell's syndrome (toxic epidermal necrolysis);
other reactions: superinfections (including candidiasis), asthenia, flushing of the face;
local reactions (for solution): swelling, soreness and phlebitis at the injection site.

In case of aggravation of the above or the manifestation of any other adverse reactions not specified in the instructions, you should seek the advice of a doctor.

Local application

hypersensitivity reactions: burning and itching, hyperemia and slight soreness of the conjunctiva (when instilled into the eyes) or in the area of the outer ear and tympanic membrane (when instilled into the ear), the development of superinfection;
other reactions (when instilled into the eyes): nausea, an unpleasant taste in the mouth immediately after instillation, photophobia, eyelid edema, lacrimation, a feeling of being in the eye of a foreign body, decreased visual acuity, white crystalline precipitate (formed in patients with corneal ulcers), keratopathy, keratitis, corneal macular formation / corneal infiltration.

Overdose

Symptoms of an overdose of Ciprofloxacin when taken orally or intravenously are nausea, vomiting, mental agitation, blurred consciousness.

The specific antidote is unknown. When taking the drug inside, it is recommended to wash the stomach. You should also carefully monitor the patient's condition, if necessary, resort to emergency measures and ensure the flow of a large amount of fluid into the body. Through hemo- or peritoneal dialysis, only a small (less than 10%) amount of Ciprofloxacin is excreted.

Overdose cases of Ciprofloxacin when applied topically have not been reported. If the drug is accidentally taken orally, the occurrence of symptoms of an overdose is unlikely, since the content of ciprofloxacin in 1 bottle of drops is negligible and is only 15 mg with a maximum daily dose for adult patients of 1000 mg, for children - 500 mg. However, if the drug is inadvertently ingested, you should consult your doctor.

special instructions

Systemic application

Ciprofloxacin is not the drug of choice for the treatment of suspected / established pneumococcal Streptococcus pneumoniae pneumonia.

Exceeding the recommended daily doses is unacceptable; in order to avoid the development of crystalluria, it is also required to consume a sufficient amount of fluid and maintain an acidic urine reaction.

In the event of prolonged severe diarrhea during or after therapy, the presence of pseudomembranous colitis should be excluded, in which it is required to immediately discontinue the drug and conduct appropriate treatment.

Pain that appears in the tendons, or the first signs of tendovaginitis, require immediate discontinuation of therapy, there is some evidence of inflammation and even tendon rupture during the use of fluoroquinolones.

During therapy with Ciprofloxacin, it is recommended to avoid intense artificial ultraviolet radiation and direct sunlight, and in the event of a photosensitivity reaction (scalded skin rash), stop taking the drug.

With prolonged therapy, regular monitoring of a complete blood count and kidney / liver function is required.

The solution and concentrate of Ciprofloxacin contains sodium chloride, which should be taken into account in patients who limit sodium intake (with heart and renal failure, nephrotic syndrome).

During treatment, due to the possibility of developing undesirable effects on the part of the nervous system, such as dizziness, convulsions, drowsiness, care must be taken when driving vehicles and complex mechanisms and engaging in other potentially hazardous activities.

Local application

Eye and ear drops (eye drops) are not intended for intraocular injection.

With the simultaneous use of drops of Ciprofloxacin with other ophthalmic drugs, the interval between injections should be at least 5 minutes.

If any symptoms of hypersensitivity appear, the use of drops should be discontinued.

In the case of conjunctival hyperemia observed for a long time or increasing due to therapy with Ciprofloxacin, you should stop using drops and consult a doctor.

The use of soft contact lenses in conjunction with the use of drops of Ciprofloxacin is not recommended. When wearing hard contact lenses, they should be removed before instillation and reinserted 15–20 minutes after instillation.

Due to the possible blurred visual perception as a result of instillation of the drug, it is recommended to start working with complex mechanisms and driving vehicles 15 minutes after the procedure.

Application during pregnancy and lactation

According to the instructions, Ciprofloxacin is contraindicated during pregnancy and lactation, since it penetrates the placental barrier and into breast milk. Studies have confirmed that the drug is capable of provoking the development of arthropathy.

Drug interactions

Due to the high pharmacological activity of Ciprofloxacin and the risk of adverse effects of drug interactions, the attending physician decides on a possible joint administration with other drugs / drugs.

Analogs

Analogues of Ciprofloxacin in the form of tablets: Quintor, Procipro, Tseprova, Tsiprinol, Tsiprobay, Tsiprobid, Tsiprodoks, Tsiprolet, Tsipropan, Tsifran, etc.

Analogs of solution for infusions and concentrate for preparation of solution for infusion of Ciprofloxacin: Basidzhen, Ifficpro, Quintor, Procipro, Tseprova, Tsiprinol, Tsiprobid, etc.

Analogs of eye / eye and ear drops Ciprofloxacin: Betacyprol, Rocip, Ciprolet, Ciprolone, Cipromed, Ciprofloxacin-AKOS.

Terms and conditions of storage

Store in a dry, dark place at temperatures up to 25 ° C, solution for infusion, concentrate and drops - do not freeze. Keep out of the reach of children.

Shelf life of tablets is from 2 to 5 years (depending on the manufacturer), solution and concentrate - 2 years, eye / eye and ear drops - 3 years.

After opening the bottle, keep eye and ear drops for no more than 28 days, eye drops - no more than 14 days.

Terms of dispensing from pharmacies

Any form of ciprofloxacin is available with a prescription.

Reviews of Ciprofloxacin

Reviews of Ciprofloxacin in tablet form are rather ambiguous. Some patients are enthusiastic about its effectiveness, while others did not notice any changes in their condition during treatment. Almost all patients note the presence of adverse reactions, expressed to one degree or another.

According to those who used drops for topical application, they have no drawbacks, they successfully and quickly cope with infectious diseases.

According to experts, the advantages of Ciprofloxacin are increased bactericidal activity, good tolerance, a wide range of antibacterial action (the drug acts on gram-positive and gram-negative microorganisms, mycobacteria, chlamydia, mycoplasma). Also, the substance is able to penetrate the cells and tissues of the body, accumulating in them at concentrations close to those in serum or exceeding them.

Ciprofloxacin can be used for severe infectious diseases (in a hospital setting) as an empirical antibiotic therapy. Its effectiveness has been proven in the treatment of hospital and community-acquired infections of almost any localization (infections of the skin, bones, UTI, tonsillitis, etc.). The drug has a long half-life and is characterized by a postantibiotic effect: taking only 2 times a day will be sufficient.

Price for Ciprofloxacin in pharmacies

The price of Ciprofloxacin tablets depends on their dosage and is approximately 12–20 rubles (dosage is 250 mg, 10 tablets are included in the package) or 33–40 rubles (dosage is 500 mg, the package includes 10 tablets). The solution for infusion will cost 24-30 rubles (for 1 bottle of 100 ml). Eye drops 0.3% cost about 38–42 rubles (per 10 ml bottle). Eye and ear drops 0.3% can be bought for about 22-28 rubles (for a 10 ml bottle).

Ciprofloxacin: prices in online pharmacies

Drug name

Price

Pharmacy

Ciprofloxacin 250 mg film-coated tablets 10 pcs.

RUB 15

Buy

Ciprofloxacin 250 mg film-coated tablets 10 pcs.

RUB 16

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Ciprofloxacin 250 mg film-coated tablets 10 pcs.

RUB 17

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Ciprofloxacin (eye drops) 0.3% eye drops 5 ml 1 pc.

RUB 19

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Ciprofloxacin (eye drops) 0.3% eye drops 2 ml 5 pcs.

RUB 20

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Ciprofloxacin (for infusion) 2 mg / ml solution for infusion 100 ml 1 pc.

RUB 27

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Ciprofloxacin (eye drops) 0.3% eye drops 10 ml 1 pc.

RUB 31

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Ciprofloxacin 2 mg / ml solution for infusion 100 ml 1 pc.

32 RUB

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Ciprofloxacin 500 mg film-coated tablets 10 pcs.

32 RUB

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Ciprofloxacin 500 mg film-coated tablets 10 pcs.

RUB 33

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Ciprofloxacin 2 mg / ml solution for infusion 100 ml 1 pc.

RUB 36

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Ciprofloxacin 500 mg film-coated tablets 10 pcs.

RUB 37

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Ciprofloxacin tab. p / o film. 0.5 g No. 10

RUB 47

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Ciprofloxacin (eye drops) 0.3% eye and ear drops 5 ml 1 pc.

RUB 47

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Ciprofloxacin 500 mg film-coated tablets 10 pcs.

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Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!