Ciprofloxacin (Sanis Health, 250 mg, 500 mg): Uses, Side Effects and Dosage

What is CIPROFLOXACIN used for?

CIPROFLOXACIN are used to treat certain types of bacterial infections. They do not treat viral infections such as the common cold.

CIPROFLOXACIN are used to treat infections caused by bacteria. These include infections of the:

• Respiratory tract
• Urinary tract

Serious Warnings and Precautions

• Prostate
• Skin and soft tissues

• Bone and joint

  It is also used to remove meningococci (a type of bacteria) from the nasopharynx (upper throat area) in patients not infected with meningitis.

It is also used to treat the following conditions:

• Diarrhea caused by bacterial infections
• Typhoid fever
• Uncomplicated gonorrhea

How does CIPROFLOXACIN work?

CIPROFLOXACIN are antibiotics that kill the bacteria causing the infection.

What are the ingredients in CIPROFLOXACIN tablets?

Medicinal ingredients: ciprofloxacin as ciprofloxacin hydrochloride.

Non-medicinal ingredients: croscarmellose sodium, hypromellose, magnesium stearate, microcrystalline cellulose, polyethyelene glycol, povidone, silica colloidal anhydrous, sodium starch glycolate, stearic acid, talc, titanium oxide.

CIPROFLOXACIN tablets come in the following dosage forms:

CIPROFLOXACIN 250 mg tablet: White round film-coated tablet with breaking notch on one side. Embossed "cip" on top and "250" on the bottom of the breaking notch. Bottles of 100.

CIPROFLOXACIN 500 mg tablet: White oblong film-coated tablet with breaking notch on both sides. Embossed "cip" on one side of breaking notch and "500" on the other side, on one side of the tablet only. Bottles of 100.

Do not use CIPROFLOXACIN if:

• you are allergic to ciprofloxacin or other quinolone antibiotics
• you are allergic to any other ingredient in these products (see “What are the ingredients in CIPROFLOXACIN tablets?”).
• you are taking tizanidine (ZANAFLEX^®), a medication that relaxes muscles. Side effects such as drowsiness, sleepiness and low blood pressure may occur.

• you are currently taking agomelatine^a, a type of medication used to treat depression. Agomelatine concentrations may increase and may cause further side effects such as liver toxicity.

  ^aCurrently not marketed in Canada

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take CIPROFLOXACIN.

Talk about any health conditions or problems you may have, including if you:

• have a history of seizures or have any other medical conditions or are taking medicines that could cause seizures.
• have an irregular heart rhythm (such as QT prolongation).
• you are taking medications that can affect your heart rhythm such as class IA or III antiarrhythmics that can cause QT prolongation
• have hypokalemia (low potassium blood levels).
• have liver or kidney disease or damage.

• are pregnant, planning to become pregnant, breast feeding or planning to breast feed.

• are less than 18 years of age.
• have a history of tendon problems (such as pain, swelling or rupture of a tendon) related to the use of fluoroquinolone antibiotics.
• have myasthenia gravis (a muscle disease).
• have an aortic aneurysm (an abnormal bulge in a large blood vessel called the aorta.)
• have or if anyone in your family has a condition called aneurysm disease which is an abnormal bulge in any large blood vessel in the body.
• have an aortic dissection (a tear in the wall of the aorta.)
• have any of the following conditions: Marfan syndrome, vascular Ehlers-Danlos syndrome, Takayasu arteritis, giant cell arteritis or Behcet’s disease.
• have high blood pressure.
• have atherosclerosis, which is a hardening of your blood vessels.

Other warnings you should know about:

Using CIPROFLOXACIN for too long or not long enough may cause the bacteria to become resistant, and your infection may not be resolved. Your doctor will tell you exactly how long you should be taking CIPROFLOXACIN for.

Blood Sugar Changes

Medicines like CIPROFLOXACIN can cause blood sugar levels to rise and drop in patients with diabetes. Serious cases of hypoglycemia (low blood sugar levels) that caused coma or death have been seen with medicines like CIPROFLOXACIN. If you have diabetes, check your blood sugar levels often while taking CIPROFLOXACIN.

CIPROFLOXACIN can make your skin more sensitive to the sun. While taking CIPROFLOXACIN:

• Avoid too much sunlight or artificial ultraviolet light (such as sunlamps).

  • Stop taking CIPROFLOXACIN and contact your doctor if a sunburn or rash occurs.

• Do not drive or use machinery if you feel dizzy or lightheaded.

Quinolones, including CIPROFLOXACIN have been associated with an enlargement or “bulge” of a large blood vessel called the aorta (aortic aneurysm) and a tear in the aorta wall (aortic dissection)

• The risk of these problems is higher if you:

  • are elderly
  • have or anyone in your family has had an aneurysm
  • have an aortic aneurysm or an aortic dissection
  • have any of the following conditions: Marfan syndrome, vascular Ehlers-Danlos syndrome, Takayasu arteritis or giant cell arteritis or Behcet’s disease
  • have high blood pressure or atherosclerosis

• Get immediate help If you experience:

  • sudden, severe pain in your abdomen, chest or back,
  • a pulsating sensation in your abdomen,
  • dizziness or loss of consciousness.

Tendon problems can happen within the first 48 hours of treatment.

Clostridium difficile-associated disease (CDAD)

CIPROFLOXACIN can cause infections of the colon caused by a bacteria called clostridium difficile. These infections can vary in severity from mild diarrhea to fatal colitis (inflammation of the colon). If you experience diarrhea or other symptoms of colitis, talk to your doctor. Symptoms of colitis can include stomach pain or cramping, rectal bleeding, urgency or inability to pass stool, fatigue, weight loss and fever.

Allergic Reactions

Serious allergic reactions can happen from taking CIPROFLOXACIN. Stop taking CIPROFLOXACIN and talk to your doctor if you experience any of the following allergic reactions;

• severe hypotension (low blood pressure)
• seizure
• loss of consciousness
• tingling
• angioedema (swelling of the deeper layers of the skin including swelling of the tongue, throat or face)
• shortness of breath
• hives, itching, rashes and other skin reactions.

Psychiatric (Mental) Adverse Reactions

Psychiatric (mental) adverse reactions can happen from taking CIPROFLOXACIN. Stop taking CIPROFLOXACIN and talk to your doctor if you experience any of the following adverse reactions:

• psychosis, hallucinations, paranoia (see, hear, or believe things that are not real)
• depression or suicidal thoughts
• anxiety, agitation, restlessness, or nervousness
• confusion, disorientation, or disturbances in attention
• insomnia or nightmares
• problems with your memory

Ophthalmic (Eye) Problems

If you experience any problems with your vision while taking CIPROFLOXACIN, contact an eye doctor immediately.

Peripheral Neuropathy (damaged nerves outside of the brain and spinal cord)

Nerve damage can happen from taking CIPROFLOXACIN. Stop taking CIPROFLOXACIN and talk to your doctor if you experience any of the following symptoms:

• pain, burning, tingling, numbness, weakness in your hands or feet
• decreased sensation of light touch, pain, temperature, position sense, vibration, and/or motor strength

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

The following may interact with CIPROFLOXACIN:

• Theophylline or didanosine chewable/buffered tablets or pediatric powder. Serious and fatal reactions have been reported in patients receiving ciprofloxacin, including CIPROFLOXACIN, and theophylline.
• Antacids, multivitamins, and other dietary supplements containing magnesium, calcium, aluminum, iron or zinc (see “How to take CIPROFLOXACIN:”).
• Antidiabetic agents (such as glyburide, glibenclamide, glimepiride, insulin); the combination of any of these agents with ciprofloxacin may cause lower blood sugar.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
• Caffeine (such as coffee) and other xanthine derivatives (such as pentoxifylline).
• Certain heart medications known as antiarrhythmics (such as quinidine, procainamide, amiodarone, sotalol).

• Other medications including:

  • oral anticoagulants (like warfarin and acenocoumarol),
  • phenytoin, tizanidine, duloxetine, methylxanthines, sevelamer,
  • sucralfate, omeprazole, clozapine, ropinirole, lidocaine, sildenafil, probenecid,
  • ferrous sulfate, calcium-fortified products (including food and dairy products),
  • histamine H2-receptor antagonists
  • methotrexate, metoclopramide, cyclosporine, lanthanum carbonate, zolpidem.

How to take CIPROFLOXACIN:

• Take CIPROFLOXACIN as prescribed by your doctor at almost the same times each day. Take CIPROFLOXACIN with food or on an empty stomach.

• Do not take CIPROFLOXACIN with dairy products (like milk or yogurt) or calcium-fortified juices alone. However, you may take CIPROFLOXACIN with a meal that contains these products (see “The following may interact with CIPROFLOXACIN”).
• Do not take CIPROFLOXACIN with antacids that contain magnesium or aluminum.
• You should avoid excessive caffeine consumption while taking CIPROFLOXACIN.
• You should drink lots of water while taking CIPROFLOXACIN.
• Swallow the CIPROFLOXACIN tablets whole, with water as needed. DO NOT SPLIT, CRUSH, OR CHEW THE TABLET.
• After treatment has been completed, any remaining CIPROFLOXACIN should not be reused.

• If you are taking the following medicines, take them at least 2 hours before or 6 hours after CIPROFLOXACIN;

  • antacids or mineral supplements containing magnesium or aluminum
  • sucralfate
  • didanosine chewable/buffered tablets or pediatric powder
  • supplements containing iron or zinc
  • any product (supplement or food) with more than 800 mg calcium
• Do not use CIPROFLOXACIN for another condition or give it to others.

Although you may feel better early in treatment, CIPROFLOXACIN should be taken exactly as directed. Misuse or overuse of CIPROFLOXACIN could lead to the growth of bacteria that will not be killed by CIPROFLOXACIN (resistance). This means that CIPROFLOXACIN may not work for you in the future. Do not share your medicine.

You should take CIPROFLOXACIN for as long as your doctor prescribes it, even after you start to feel better. Stopping an antibiotic too early may result in failure to cure your infection.

Usual dose:

Your doctor (health care provider) will tell you how much of the medicine to take and for how long.

This information does not take the place of discussions with your doctor or health care professional about your medication or treatment.

Overdose:

Missed Dose:

If you forget to take CIPROFLOXACIN and it is:

• 6 hours or more until your next scheduled dose, take your missed dose right away. Then take the next dose at your regular time.
• Less than 6 hours until your next scheduled dose, do not take the missed dose. Take the next dose at your regular time.

Do not take a double dose to make up for a forgotten dose. If you are unsure about what to do, consult your healthcare professional.

What are possible side effects from using CIPROFLOXACIN?

All medicines, including CIPROFLOXACIN, can cause side effects, although not everyone gets them.

These are not all the possible side effects you may feel when taking CIPROFLOXACIN. If you have any side effects not listed here, tell your healthcare professional.

Stop taking CIPROFLOXACIN and contact your doctor if:

• you have sunburn-like skin reaction when exposed to sunlight or ultraviolet light

Self-Limiting Side Effects:

• feeling lightheaded
• insomnia (difficulty sleeping)
• nightmares

If any of these affect you severely, tell your doctor or pharmacist.

Serious side effects and what to do about them

Serious side effects and what to do about them

Serious side effects and what to do about them

Serious side effects and what to do about them

Serious side effects and what to do about them

Serious side effects and what to do about them

Serious side effects and what to do about them

Serious side effects and what to do about them

Serious side effects and what to do about them

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.

Reporting Side Effects

Storage:

Store between 15 and 30°C.

Keep out of reach and sight of children.

If you want more information about CIPROFLOXACIN:

• Talk to your healthcare professional.
• Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html ); the manufacturer’s website https://www.sanis.com/products/,or by calling 1-866-236-4076.

Last revised: September 5, 2023