Ciprofloxacin
Introduction
Ciprofloxacin is a synthetic antibiotic in the fluoroquinolone class used to treat a variety of bacterial infections. It is the most commonly prescribed antibiotic in the United States and Canada for skin, respiratory, urinary tract, and abdominal infections.
Uses
Ciprofloxacin may be used to treat a wide range of bacterial infections, such as: Bronchitis, Skin infections, Sinusitis, Urinary tract infections, Gonorrhea, Typhoid fever, Cholera, Prostatitis, and others.
Mechanism of Action
Ciprofloxacin works by inhibiting bacterial DNA gyrase (an enzyme responsible for DNA replication) resulting in cellular death and clearance of bacteria. Additionally, it may interfere with the ability of bacterial cells to synthesize proteins, which is also necessary for survival.
Absorption
Ciprofloxacin is rapidly and completely absorbed after oral administration. Its bioavailability is about 70-80%.
Route of Elimination
Ciprofloxacin and its metabolites are eliminated predominantly in the urine, with 80-90% of a dose being accounted for in 24 hours.
Dosage
The dosage of ciprofloxacin varies depending on the condition it is being used to treat. It may be given in either oral or intravenous (IV) forms.
Administration
Ciprofloxacin may be administered orally or intravenously. When taken orally, the drug should be taken with a full glass of water, one hour before or two hours after meals.
Side Effects
- Nausea
- Diarrhea
- Headache
- Abdominal pain
- Rash
- Dizziness
- Insomnia
Toxicity
Ciprofloxacin is generally well tolerated, but like any drug, it can cause side effects. Overdose of ciprofloxacin may cause severe liver damage and neurotoxicity.
Precautions
- Ciprofloxacin should not be used in patients younger than 18 years of age.
- Patients with a history of seizures or CNS disorder should not take ciprofloxacin.
- Ciprofloxacin should not be used in pregnant women.
- Inform your doctor if you have any liver or kidney condition.
Interactions
- Ciprofloxacin may interact with other drugs such as antacids, oral contraceptives, theophylline, certain antibiotics, caffeine, probenecid, metoclopramide, warfarin, cyclosporine, and other drugs.
- Inform your doctor if you are taking any of the above medications before taking this drug.
Disease Interactions
- Ciprofloxacin should not be used in patients with a history of epilepsy, seizures or epilepsy-like events.
- Patients with a history of tendon problems or kidney, heart or lung transplant should not take this drug.
Drug Interactions
- NSAIDs such as ibuprofen, naproxen, and celecoxib
- Warfarin
- Anticonvulsants such as phenytoin and carbamazepine
- Cyclosporine
- Corticosteroids
- Theophylline
Food Interactions
Ciprofloxacin should be taken with food to reduce stomach upset. Iron supplements, antacids, and certain foods can reduce the absorption of ciprofloxacin.
Pregnancy Use
Ciprofloxacin should not be used during pregnancy as it may cause harm to the unborn baby. It is classified as pregnancy category C.
Lactation Use
Ciprofloxacin has not been studied in breastfeeding women and should be avoided in breastfeeding mothers.
Acute Overdose
Symptoms of ciprofloxacin overdose may include confusion, drowsiness, vomiting, abdominal pain, nausea, and rapid heart rate. In case of overdose, contact a healthcare provider right away.
Contraindication
Certain conditions may preclude the use of ciprofloxacin. These conditions include: hypersensitivity to the drug, pregnancy, breastfeeding, and a history of tendon rupture or myasthenia gravis.
Use Direction
Ciprofloxacin should be taken exactly as prescribed by your doctor; do not take it in larger or smaller amounts or for longer or shorter time than prescribed. Additionally, it is important to finish the full course of treatment prescribed, even if your symptoms improve.
Storage Conditions
Ciprofloxacin should be stored at room temperature, away from heat, light, and moisture.
Volume of Distribution
The volume of distribution of ciprofloxacin is 0.45-1.3 L/kg.
Half Life
The half-life of ciprofloxacin is 4-5 hours.
Clearance
The clearance of ciprofloxacin is approximately 2.5-3.5 mL/min/kg.
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