Cipro, Cipro XR , ProquinXR

Ciprofloxacin is an antibiotic used to treat or prevent certain infections caused by bacteria. Ciprofloxacin is also used to treat or prevent anthrax in people who may have been exposed to anthrax germs in the air. Ciprofloxacin extended-release (long-acting) tablets are used only to treat certain types of urinary tract infections. Ciprofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing bacteria.

Antibiotics will not work for colds, flu, or other viral infections.

Ciprofloxacin comes as a tablet, a suspension (liquid) and an extended-release tablet to take by mouth. The tablet and suspension are usually taken twice a day in the morning and evening with or without food. The extended-release tablets are usually taken once a day.Cipro XR brand extended-release tablets may be taken with or without food. Proquin XR brand extended-release tablets should be taken with a main meal of the day, preferably the evening meal. Take ciprofloxacin at around the same time(s) every day. The length of your treatment depends on the type of infection you have. Your doctor will tell you how long to take ciprofloxacin. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ciprofloxacin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

One brand or type of ciprofloxacin cannot be substituted for another. Be sure that you receive only the brand of ciprofloxacin that was prescribed by your doctor. Ask your pharmacist if you have any questions about the type of ciprofloxacin you were given.

Swallow the extended-release tablets whole; do not split, crush, or chew them. If you cannot swallow tablets whole, tell your doctor.

If you are taking the liquid, shake the bottle very well for 15 seconds before each use to mix the medication evenly. Swallow the correct dose without chewing the granules in the liquid. Close the liquid ciprofloxacin bottle completely after each use. Do not give the liquid to a patient through a feeding tube.

You should begin feeling better during the first few days of treatment with ciprofloxacin. If your symptoms do not improve, or if they get worse, call your doctor. Fever and back pain may be symptoms of a worsening urinary tract infection. If you are being treated for this type of infection, call your doctor if you develop these symptoms during or after your treatment

Take ciprofloxacin until you finish the prescription, even if you feel better. If you stop taking ciprofloxacin too soon or if you skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Ciprofloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• stomach pain
• indigestion
• diarrhea
• headache
• nervousness
• agitation
• anxiety
• difficulty falling asleep or staying asleep
• nightmares or abnormal dreams
• feelings of not trusting others or feelings that others want to hurt you
• vaginal itching and/or discharge

Some side effects can be serious. If you experience any of these symptoms, stop taking ciprofloxacin, and call your doctor immediately:

• rash or blisters
• hives
• itching
• tingling or swelling of the face, neck, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• difficulty breathing or swallowing
• hoarseness
• rapid, irregular, or pounding heartbeat
• fainting
• fever
• joint or muscle pain
• unusual bruising or bleeding
• extreme tiredness
• lack of energy
• loss of appetite
• pain in the upper right part of the stomach
• yellowing of the skin or eyes
• flu-like symptoms
• seizures
• dizziness
• double vision
• pulsing sounds in the head or ringing in the ears
• confusion
• uncontrollable shaking of a part of the body
• hallucinations (seeing things or hearing voices that do not exist)
• depression
• thoughts about dying or killing yourself
• pain, burning, tingling, numbness, and/or weakness in a part of the body
• loss of ability to feel light touch, pain, heat or coldness, or vibration in a part of the body
• loss of ability to know position of a part of the body
• loss of muscle strength in a part of the body

Ciprofloxacin may cause joint damage in children. Ciprofloxacin should not normally be given to children younger than 18 years old unless they have certain serious infections that cannot be treated with other antibiotics or they have been exposed to anthrax in the air. If your doctor prescribes ciprofloxacin for your child, be sure to tell the doctor if your child has a history of joint-related problems. Call your doctor if your child develops joint problems while taking ciprofloxacin or after treatment with ciprofloxacin. Talk to your child's doctor about the risks of giving ciprofloxacin to your child.

Ciprofloxacin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

• tell your doctor and pharmacist if you are allergic or have had a severe reaction to ciprofloxacin; or any other quinolone or fluoroquinolone antibiotics such as gatifloxacin (Tequin, not available in the U.S.), gemifloxacin (Factive), levofloxacin (Levaquin), lomefloxacin (Maxaquin), moxifloxacin (Avelox), nalidixic acid (NegGram), norfloxacin (Noroxin), and ofloxacin (Floxin); if you are allergic to any other medications; or if you are allergic to any of the ingredients in ciprofloxacin tablets or liquid. Ask your pharmacist for a list of the ingredients.
• tell your doctor if you are taking tizanidine (Zanaflex). Your doctor will probably tell you not to take ciprofloxacin while you are taking this medication.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: acetazolamide (Diamox); anticoagulants ('blood thinners') such as warfarin (Coumadin); brinzolamide (Azopt); caffeine (NoDoz, Vivarin, others); cyclosporine (Neoral, Sandimmune); dorzolamide (Trusopt); glyburide (DiaBeta, Glucovance, Micronase, others); medications for diarrhea such as dicyclomine (Bentyl), diphenoxylate (Lomotil), and loperamide (Imodium); methazolamide; methotrexate (Rheumatrex, Trexall); metoclopramide (Reglan); nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); phenytoin (Dilantin, Phenytek); potassium citrate and citric acid (Cytra-K, Polycitra-K); probenecid(Benemid);sodium bicarbonate (Soda Mint, baking soda); sodium citrate and citric acid (Bicitra, Oracit, Shohl's Solution); sodium lactate; or theophylline (Theobid, Theo-Dur, Slo-bid, others). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with ciprofloxacin, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• if you are taking antacids (Maalox, Mylanta, Tums, others) or didanosine (Videx) oral solution (liquid); calcium, iron, zinc, or vitamin supplements; or sucralfate (Carafate); you will need to allow some time to pass between when you take a dose of any of these medications and when you take a dose of ciprofloxacin. Ask your doctor or pharmacist how many hours before or after you take ciprofloxacin you may take these medications.
• tell your doctor if you have or have ever had arthritis; asthma; cerebral palsy (CP, a condition of abnormal muscle or motor function); dementia (a condition associated with memory loss and personality changes); recent head injury; seizures; stroke or ministroke; or kidney or liver disease.
• tell your doctor if you have ever had tendonitis (swelling or tearing of the fiber that connects a bone to a muscle) and if you participate in regular athletic activity. There is a risk that you will develop tendonitis while you are taking ciprofloxacin, especially if you are also taking oral steroid medications. If you experience symptoms of tendonitis, such as pain, swelling, tenderness, stiffness, or difficulty in moving a muscle stop taking ciprofloxacin, rest, and call your doctor immediately.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking ciprofloxacin, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ciprofloxacin.
• if you are having a radiologic test (X-ray, CT scan) that involves dye, tell the doctor or health care professional that you are taking ciprofloxacin.
• you should know that ciprofloxacin may cause confusion, dizziness, lightheadedness, and tiredness. Do not drive a car or operate machinery or participate in activities requiring alertness or coordination until you know how this medication affects you.
• plan to avoid unnecessary or prolonged exposure to sunlight or ultraviolet light (tanning beds) and to wear protective clothing, sunglasses, and sunscreen. Ciprofloxacin may make your skin sensitive to sunlight or ultraviolet light. If your skin becomes reddened, like a bad sunburn, stop taking ciprofloxacin and call your doctor.
• you should know that ciprofloxacin may cause diarrhea during or after your treatment. You should not treat this diarrhea with over the counter medications. If diarrhea does not go away, call your doctor to find out what to do.

Do not take ciprofloxacin with dairy products (like milk, ice cream, cheese, or yogurt) or calcium-added juices alone. You may take ciprofloxacin with a meal that includes these foods.

Do not drink or eat a lot of caffeine-containing products such as coffee, tea, energy drinks, cola, or chocolate. Ciprofloxacin may increase nervousness, sleeplessness, heart pounding, and anxiety caused by caffeine.

Make sure you drink plenty of water or other fluids every day while you are taking ciprofloxacin.

If you miss a dose of ciprofloxacin tablets or suspension, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

If you miss a dose of the extended-release tablets and remember that same day, take the missed dose as soon as you remember it. However, if you do not remember until the next day, skip the missed dose and continue your regular dosing schedule. Do not take more than one ciprofloxacin extended-release tablet in one day.

In the event of biological warfare, ciprofloxacin may be used to treat and prevent dangerous illnesses that are deliberately spread such as plague, tularemia, and anthrax of the skin or mouth. Talk to your doctor about the possible risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Store the suspension in the refrigerator or at room temperature, closed tightly, for up to 14 days. Do not freeze ciprofloxacin suspension. Throw away any liquid that is left over after 14 days and any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to ciprofloxacin.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the ciprofloxacin, call your doctor.

Keep a list of all the medications you are taking and show it to your doctor and pharmacist during each visit.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.