2011501645 Health Library | Health and Wellness | Wellmont Health System
  • Ciprofloxacin and Hydrocortisone Otic

    (sip roe flox' a sin) (hye droe kor' ti sone)

    WHY is this medicine prescribed?

    Ciprofloxacin and hydrocortisone otic is used to treat outer ear infections in adults and children. Ciprofloxacin is in a class of medications called quinolone antibiotics. Hydrocortisone is in a class of medications called corticosteroids. The combination of ciprofloxacin and hydrocortisone works by killing the bacteria that cause infection and reducing swelling in the ear.

    HOW should this medicine be used?

    Ciprofloxacin and hydrocortisone otic comes as a suspension (liquid) to place into the ear. It is usually used twice a day, in the morning and evening, for 7 days. Use ciprofloxacin and hydrocortisone otic at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ciprofloxacin and hydrocortisone otic exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
    Ciprofloxacin and hydrocortisone otic is only for use in the ears. Do not use in the eyes.
    You should begin to feel better during the first few days of treatment with ciprofloxacin and hydrocortisone otic. If your symptoms do not improve after one week or get worse, call your doctor.
    Use ciprofloxacin and hydrocortisone otic until you finish the prescription, even if you feel better. If you stop using ciprofloxacin and hydrocortisone otic too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.
    To use the eardrops, follow these steps:
    1. Hold the bottle in your hand for 1 or 2 minutes to warm the solution.
    2. Shake the bottle well.
    3. Lie down with the affected ear upward.
    4. Place the prescribed number of drops into your ear.
    5. Be careful not to touch the tip to your ear, fingers, or any other surface.
    6. Remain lying down with the affected ear upward for 30-60 seconds.
    7. Repeat steps 1-6 for the opposite ear if necessary.

    Are there OTHER USES for this medicine?

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

    What SPECIAL PRECAUTIONS should I follow?

    Before using ciprofloxacin and hydrocortisone otic,
    • tell your doctor and pharmacist if you are allergic to ciprofloxacin (Cipro), hydrocortisone (Cortaid, Cortef, Cortizone, Hytone), cinoxacin (Cinobac) (not available in the U.S.), enoxacin (Penetrex) (not available in the U.S.), gatifloxacin (Tequin) (not available in the U.S.), gemifloxacin (Factive), levofloxacin (Levaquin), lomefloxacin (Maxaquin), moxifloxacin (Avelox), nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin), sparfloxacin (Zagam) (not available in the U.S.), trovafloxacin and alatrofloxacin combination (Trovan) (not available in the U.S.), or any other medications.
    • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
    • tell your doctor if you have a hole in your ear drum(s) or ear tube(s). Your doctor will tell you not to use this medication.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using ciprofloxacin and hydrocortisone otic, call your doctor.
    • you should know that you must keep your infected ear(s) clean and dry while using ciprofloxacin and hydrocortisone otic. Avoid getting the infected ear(s) wet while bathing, and avoid swimming unless your doctor has told you otherwise.

    What SPECIAL DIETARY instructions should I follow?

    Unless your doctor tells you otherwise, continue your normal diet.

    What should I do IF I FORGET to take a dose?

    Apply 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 use extra eardrops to make up for a missed dose.

    What SIDE EFFECTS can this medicine cause?

    Ciprofloxacin and hydrocortisone otic may cause side effects. Tell your doctor if the following symptom is severe or does not go away:
    • headache
    Some side effects can be serious. If you experience any of these symptoms, stop using ciprofloxacin and hydrocortisone otic and call your doctor immediately:
    • rash
    • hives
    • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
    • hoarseness
    • difficulty swallowing or breathing
    Ciprofloxacin and hydrocortisone otic may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

    What should I know about STORAGE and DISPOSAL of this medication?

    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). Avoid freezing and protect from light. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

    What should I do in case of OVERDOSE?

    If someone swallows ciprofloxacin and hydrocortisone otic, 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.

    What OTHER INFORMATION should I know?

    Keep all appointments with your doctor.
    Do not let anyone else use your medication. Your prescription is probably not refillable.
    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.

    Brand Names

    • Cipro® HC (as a combination product containing Ciprofloxacin, Hydrocortisone)

    Ciprofloxacin and Dexamethasone Otic

    (sip roe flox' a sin) (dex a meth' a sone)

    WHY is this medicine prescribed?

    Ciprofloxacin and dexamethasone otic is used to treat outer ear infections in adults and children and acute (suddenly occurring) middle ear infections in children with ear tubes. Ciprofloxacin is in a class of medications called quinolone antibiotics. Dexamethasone is in a class of medications called corticosteroids. The combination of ciprofloxacin and dexamethasone works by killing the bacteria that cause infection and reducing swelling in the ear.

    HOW should this medicine be used?

    Ciprofloxacin and dexamethasone otic comes as a suspension (liquid) to place into the ear. It is usually used twice a day, in the morning and evening, for 7 days. Use ciprofloxacin and dexamethasone otic at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ciprofloxacin and dexamethasone otic exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
    Ciprofloxacin and dexamethasone otic is only for use in the ears. Do not use in the eyes.
    You should begin to feel better during the first few days of treatment with ciprofloxacin and dexamethasone otic. If your symptoms do not improve after one week or get worse, call your doctor.
    Use ciprofloxacin and dexamethasone otic until you finish the prescription, even if you feel better. If you stop using ciprofloxacin and dexamethasone otic too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.
    To use the eardrops, follow these steps:
    1. Hold the bottle in your hand for one or two minutes to warm the solution.
    2. Shake the bottle well.
    3. Lie down with the affected ear upward.
    4. Place the prescribed number of drops into your ear.
    5. Be careful not to touch the tip to your ear, fingers, or any other surface.
    6. For middle ear infections, push the tragus (small flap of cartilage just in front of the ear canal near the face) of the ear inward four times so that the drops will enter the middle ear.
    7. Remain lying down with the affected ear upward for 60 seconds.
    8. Repeat steps 1-7 for the opposite ear if necessary.

    What SPECIAL PRECAUTIONS should I follow?

    Before using ciprofloxacin and dexamethasone otic,
    • tell your doctor and pharmacist if you are allergic to ciprofloxacin (Cipro), dexamethasone (Decadron), cinoxacin (Cinobac) (not available in the U.S.), enoxacin (Penetrex) (not available in the U.S.), gatifloxacin (Tequin) (not available in the U.S.), gemifloxacin (Factive), levofloxacin (Levaquin), lomefloxacin (Maxaquin), moxifloxacin (Avelox), nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin), sparfloxacin (Zagam) (not available in the U.S.), trovafloxacin and alatrofloxacin combination (Trovan) (not available in the U.S.), or any other medications.
    • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using ciprofloxacin and dexamethasone otic, call your doctor.
    • you should know that you must keep your infected ear(s) clean and dry while using ciprofloxacin and dexamethasone otic. Avoid getting the infected ear(s) wet while bathing, and avoid swimming unless your doctor has told you otherwise.

    What SPECIAL DIETARY instructions should I follow?

    Unless your doctor tells you otherwise, continue your normal diet.

    What should I do IF I FORGET to take a dose?

    Apply 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 use extra eardrops to make up for a missed dose.

    What SIDE EFFECTS can this medicine cause?

    Ciprofloxacin and dexamethasone otic may cause side effects. Tell your doctor if this symptom is severe or does not go away:
    • ear discomfort, pain, or itching
    Some side effects can be serious. If you experience any of these symptoms, stop using ciprofloxacin and dexamethasone otic and call your doctor immediately:
    • rash
    • hives
    • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
    • hoarseness
    • difficulty swallowing or breathing
    Ciprofloxacin and dexamethasone otic may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

    What should I know about STORAGE and DISPOSAL of this medication?

    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). Do not freeze and protect from light. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

    What should I do in case of OVERDOSE?

    If someone swallows ciprofloxacin and dexamethasone otic, 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.

    What OTHER INFORMATION should I know?

    Keep all appointments with your doctor.
    Do not let anyone else use your medication. Your prescription is probably not refillable.
    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.

    Brand Names

    • Ciprodex® (as a combination product containing Ciprofloxacin, Dexamethasone)

    Ciprofloxacin Ophthalmic

    (sip roe flox' a sin)

    WHY is this medicine prescribed?

    Ciprofloxacin ophthalmic solution is used to treat bacterial infections of the eye including conjunctivitis (pinkeye; infection of the membrane that covers the outside of the eyeball and the inside of the eyelid) and corneal ulcers (infection and loss of tissue in the clear front part of the eye). Ciprofloxacin ophthalmic ointment is used to treat conjunctivitis. Ciprofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing the bacteria that cause infection.

    HOW should this medicine be used?

    Ophthalmic ciprofloxacin comes as a solution (liquid) and an ointment to apply to the eyes. Ciprofloxacin ophthalmic solution is usually used often, between once every 15 minutes to once every 4 hours while awake for 7 to 14 days or longer. Ciprofloxacin ophthalmic ointment is usually applied 3 times a day for 2 days and then twice a day for 5 days. Use ophthalmic ciprofloxacin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ophthalmic ciprofloxacin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
    You should expect your symptoms to improve during your treatment. Call your doctor if your symptoms do not go away or get worse, or if you develop other problems with your eyes during your treatment.
    Use ophthalmic ciprofloxacin until you finish the prescription, even if you feel better. If you stop using ophthalmic ciprofloxacin too soon, your infection may not be completely cured and the bacteria may become resistant to antibiotics.
    To instill the eye drops, follow these steps:
    1. Wash your hands thoroughly with soap and water.
    2. Check the dropper tip to make sure that it is not chipped or cracked.
    3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
    4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
    5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
    6. Brace the remaining fingers of that hand against your face.
    7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
    8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
    9. Place a finger on the tear duct and apply gentle pressure.
    10. Wipe any excess liquid from your face with a tissue.
    11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.
    12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
    13. Wash your hands to remove any medication.
    To apply the eye ointment, follow these instructions:
    1. Wash your hands thoroughly with soap and water.
    2. Avoid touching the tip of the tube against your eye or anything else; the tube tip must be kept clean.
    3. Holding the tube between your thumb and forefinger, place it as near to your eyelid as possible without touching it.
    4. Brace the remaining fingers of that hand against your face.
    5. Tilt your head backward slightly.
    6. With your index finger, pull the lower eyelid down to form a pocket.
    7. Squeeze a 1/2-inch (1.25-centimeter) ribbon of ointment into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
    8. Blink your eye slowly; then gently close your eye for 1 to 2 minutes.
    9. With a tissue, wipe any excess ointment from the eyelids and lashes. With another clean tissue, wipe the tip of the tube clean.
    10. Replace and tighten the cap right away.
    11. Wash your hands to remove any medication.

    Are there OTHER USES for this medicine?

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

    What SPECIAL PRECAUTIONS should I follow?

    Before using ophthalmic ciprofloxacin,
    • tell your doctor and pharmacist if you are allergic to ciprofloxacin (Cipro, Ciloxan), other quinolone antibiotics such as cinoxacin (Cinobac) (not available in the United States), enoxacin (Penetrex) (not available in the United States), gatifloxacin (Tequin, Zymar), levofloxacin (Levaquin, Quixin, Iquix), lomefloxacin (Maxaquin), moxifloxacin (Avelox, Vigamox), nalidixic acid (NegGram) (not available in the United States), norfloxacin (Noroxin), ofloxacin (Floxin, Ocuflox), and sparfloxacin (Zagam), any other medications, or benzalkonium chloride.
    • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin), cyclosporine (Neoral, Sandimmune), and theophylline (Theo-Dur). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
    • tell your doctor if you have or have ever had any medical condition.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using ophthalmic ciprofloxacin, call your doctor.
    • you should know that your vision may be blurred during your treatment with ciprofloxacin ophthalmic ointment. Avoid rubbing your eyes even if your vision is blurred. Do not drive a car or operate machinery if you are unable to see clearly.
    • tell your doctor if you wear contact lenses. You should not wear contact lenses while you have symptoms of bacterial conjunctivitis or while you are applying eye drops or ointment.
    • you should know that bacterial conjunctivitis spreads easily. Wash your hands often, especially after you touch your eyes. When your infection goes away, you should wash or replace any eye makeup, contact lenses, or other objects that touched your infected eye(s).

    What SPECIAL DIETARY instructions should I follow?

    Talk to your doctor about drinking coffee or other beverages containing caffeine while you are taking this medication.

    What should I do IF I FORGET to take a dose?

    Place the missed dose in your eye(s) 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 use a double dose to make up for a missed one.

    What SIDE EFFECTS can this medicine cause?

    Ophthalmic ciprofloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
    • burning, red, itchy, crusty, or irritated eyes
    • eye pain
    • feeling that something is in your eye
    • unpleasant taste
    Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
    • rash
    • hives
    • itching
    • tingling
    • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
    • difficulty breathing or swallowing
    • hoarseness
    Ophthalmic ciprofloxacin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
    If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I know about STORAGE and DISPOSAL of this medication?

    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). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

    What should I do in case of OVERDOSE?

    If you instill too many drops of the ophthalmic solution in your eye, wash your eye with plenty of warm tap water.

    What OTHER INFORMATION should I know?

    Keep all appointments with your doctor
    Do not let anyone else use your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the ciprofloxacin ophthalmic solution or ointment, call your doctor.
    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.

    Brand Names

    • Ciloxan®

    Ciprofloxacin

    (sip roe flox' a sin)

    IMPORTANT WARNING:

    Taking ciprofloxacin increases the risk that you will develop tendinitis (swelling of a fibrous tissue that connects a bone to a muscle) or have a tendon rupture (tearing of a fibrous tissue that connects a bone to a muscle) during your treatment or for up to several months afterward. These problems may affect tendons in your shoulder, your hand, the back of your ankle, or in other parts of your body. Tendinitis or tendon rupture may happen to people of any age, but the risk is highest in people over 60 years of age. Tell your doctor if you have or have ever had a kidney, heart, or lung transplant; kidney disease; a joint or tendon disorder such as rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function); or if you participate in regular physical activity. Tell your doctor and pharmacist if you are taking oral or injectable steroids such as dexamethasone (Decadron, Dexpak), methylprednisolone (Medrol), or prednisone (Sterapred). If you experience any of the following symptoms of tendinitis, stop taking ciprofloxacin, rest, and call your doctor immediately: pain, swelling, tenderness, stiffness, or difficulty in moving a muscle. If you experience any of the following symptoms of tendon rupture, stop taking ciprofloxacin and get emergency medical treatment: hearing or feeling a snap or pop in a tendon area, bruising after an injury to a tendon area, or inability to move or to bear weight on an affected area.
    Taking ciprofloxacin may worsen muscle weakness in people with myasthenia gravis (a disorder of the nervous system that causes muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. Your doctor may tell you not to take ciprofloxacin. If you have myasthenia gravis and your doctor tells you that you should take ciprofloxacin, call your doctor immediately if you experience muscle weakness or difficulty breathing during your treatment.
    Talk to your doctor about the risks of taking ciprofloxacin.
    Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with ciprofloxacin. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( http://www.fda.gov/Drugs) or the manufacturer's website to obtain the Medication Guide.

    WHY is this medicine prescribed?

    Ciprofloxacin is used to treat or prevent certain infections caused by bacteria. Ciprofloxacin is also used to treat or prevent anthrax (a serious infection that may be spread on purpose as part of a bioterror attack) 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 that cause infections. Antibiotics will not work for colds, flu, or other viral infections.

    HOW should this medicine be used?

    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 or type of ciprofloxacin that was prescribed by your doctor. Ask your pharmacist if you have any questions about the type of ciprofloxacin you were given.
    Do not take ciprofloxacin with dairy products or calcium-fortified juices alone. However, you may take ciprofloxacin with a meal that includes these foods or drinks.
    Swallow the tablets whole; do not split, crush, or chew them. If you cannot swallow tablets whole, tell your doctor.
    If you are taking the suspension, 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 suspension. Close the bottle completely after each use. Do not give the suspension to a patient through a feeding tube.
    You should begin feeling better during the first few days of your treatment with ciprofloxacin. If your symptoms do not improve or if they get worse, call your doctor. If you are being treated for a urinary tract infection, call your doctor if you develop fever or back pain during or after your treatment. These symptoms may be signs that your infection is worsening.
    Take ciprofloxacin until you finish the prescription, even if you feel better. Do not stop taking ciprofloxacin unless you experience the symptoms of tendinitis or tendon rupture described in the IMPORTANT WARNING section or the symptoms of allergic reaction described in the SIDE EFFECTS section. 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.

    Are there OTHER USES for this medicine?

    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 risks of using this medication for your condition.
    This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

    What SPECIAL PRECAUTIONS should I follow?

    Before taking ciprofloxacin,
    • tell your doctor and pharmacist if you are allergic or have had a severe reaction to ciprofloxacin; any other quinolone or fluoroquinolone antibiotic such as gatifloxacin (Tequin) (not available in the U.S.), gemifloxacin (Factive), levofloxacin (Levaquin), lomefloxacin (Maxaquin) (not available in the U.S.), moxifloxacin (Avelox), nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin), and sparfloxacin (Zagam) (not available in the U.S.); or any other medications, or if you are allergic to any of the ingredients in ciprofloxacin tablets or suspension. Ask your doctor or 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 the medications listed in the IMPORTANT WARNING section and any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); certain antidepressants; antipsychotics (medications to treat mental illness); caffeine or medications that contain caffeine (Excedrin, NoDoz, Vivarin, others); clozapine (Clozaril, Fazaclo); cyclosporine (Gengraf, Neoral, Sandimmune); diuretics ('water pills'); glyburide (DiaBeta, in Glucovance, Micronase, others); certain medications for irregular heartbeat such as amiodarone (Cordarone), disopyramide (Norpace), procainamide (Procanbid), quinidine, and sotalol (Betapace, Betapace AF, Sorine); methotrexate (Rheumatrex, Trexall); metoclopramide (Reglan); certain nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others); phenytoin (Dilantin, Phenytek); probenecid (in Col-Probenecid, Probalan); ropinirole (Requip); or theophylline (Elixophyllin, Theo-24, Uniphyl, 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 containing aluminum hydroxide or magnesium hydroxide (Maalox, Mylanta, Tums, others); didanosine (Videx); 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 or anyone in your family has or has ever had a prolonged QT interval (a rare heart problem that may cause irregular heartbeat, fainting, or sudden death) or an irregular heartbeat, and if you have or have ever had nerve problems, a low level of potassium in your blood, cerebral arteriosclerosis (narrowing of blood vessels in or near the brain that can lead to stroke or ministroke), seizures, or liver disease.
    • 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.
    • you should know that ciprofloxacin may cause confusion, dizziness, lightheadedness, and tiredness. Do not drive a car, 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 sunlamps) and to wear protective clothing, sunglasses, and sunscreen. Ciprofloxacin may make your skin sensitive to sunlight or ultraviolet light. If your skin becomes reddened, swollen, or blistered, like a bad sunburn, call your doctor.

    What SPECIAL DIETARY instructions should I follow?

    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.

    What should I do IF I FORGET to take a dose?

    If you miss a dose of ciprofloxacin, 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.Do not take more than two doses of the tablets or suspension or more than one dose of the extended-release tablets in one day.

    What SIDE EFFECTS can this medicine cause?

    Ciprofloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
    • nausea
    • vomiting
    • stomach pain
    • heartburn
    • diarrhea
    • feeling an urgent need to urinate
    • headache
    • vaginal itching and/or discharge
    Some side effects can be serious. If you experience any of these symptoms, or those mentioned in the IMPORTANT WARNING section, stop taking ciprofloxacin and call your doctor immediately:
    • severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment)
    • 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 or throat tightness
    • wheezing
    • 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
    • dark urine
    • flu-like symptoms
    • seizures
    • dizziness
    • confusion
    • nervousness
    • restlessness
    • anxiety
    • difficulty falling asleep or staying asleep
    • nightmares or abnormal dreams
    • not trusting others or feeling that others want to hurt you
    • hallucinations (seeing things or hearing voices that do not exist)
    • depression
    • thoughts about dying or killing yourself
    • uncontrollable shaking of a part of the body
    • pain, burning, tingling, numbness, and/or weakness in a part of the body
    Ciprofloxacin may cause problems with bones, joints, and tissues around joints in children. Ciprofloxacin should not normally be given to children younger than 18 years of age 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 or has ever had joint-related problems. Call your doctor if your child develops joint problems such as pain or swelling 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.
    If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I know about STORAGE and DISPOSAL of this medication?

    Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets and extended-release tablets 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 suspension 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.

    What should I do in case of OVERDOSE?

    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.

    What OTHER INFORMATION should I know?

    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 taking ciprofloxacin, call your doctor.
    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.

    Brand Names

    • Cipro®
    • Cipro XR®
    • Proquin XR®
    • Also available generically

    Ciprofloxacin Injection

    (sip roe flox' a sin)

    IMPORTANT WARNING:

    Using ciprofloxacin injection increases the risk that you will develop tendinitis (swelling of a fibrous tissue that connects a bone to a muscle) or have a tendon rupture (tearing of a fibrous tissue that connects a bone to a muscle) during your treatment or for up to several months afterward. These problems may affect tendons in your shoulder, your hand, the back of your ankle, or in other parts of your body. Tendinitis or tendon rupture may happen to people of any age, but the risk is highest in people over 60 years of age. Tell your doctor if you have or have ever had a kidney, heart, or lung transplant; kidney disease; a joint or tendon disorder such as rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function); or if you participate in regular physical activity. Tell your doctor and pharmacist if you are taking oral or injectable steroids such as dexamethasone (Decadron, Dexpak), methylprednisolone (Medrol), or prednisone (Sterapred). If you experience any of the following symptoms of tendinitis, stop using ciprofloxacin injection, rest, and call your doctor immediately: pain, swelling, tenderness, stiffness, or difficulty in moving a muscle. If you experience any of the following symptoms of tendon rupture, stop using ciprofloxacin injection and get emergency medical treatment: hearing or feeling a snap or pop in a tendon area, bruising after an injury to a tendon area, or inability to move or bear weight on an affected area.
    Using ciprofloxacin injection may worsen muscle weakness in people with myasthenia gravis (a disorder of the nervous system that causes muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. Your doctor may tell you not to use ciprofloxacin injection. If you have myasthenia gravis and your doctor tells you that you should use ciprofloxacin injection, call your doctor immediately if you experience muscle weakness or difficulty breathing during your treatment.
    Talk to your doctor about the risks of using ciprofloxacin injection.
    Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with ciprofloxacin injection. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( http://www.fda.gov/Drugs) or the manufacturer's website to obtain the Medication Guide.

    WHY is this medicine prescribed?

    Ciprofloxacin injection is used to treat certain infections caused by bacteria. Ciprofloxacin injection is also used to prevent or treat anthrax (a serious infection that may be spread on purpose as part of a bioterror attack) in people who may have been exposed to anthrax germs in the air. Ciprofloxacin injection is in a class of antibiotics called fluoroquinolones. It works by killing bacteria that cause infections. Antibiotics will not work for colds, flu, or other viral infections.

    HOW should this medicine be used?

    Ciprofloxacin injection comes as a solution (liquid) to be given through a needle or catheter placed in your vein. It is usually infused (injected slowly) intravenously (into a vein) over a period of 60 minutes, usually once every 8–12 hours. The length of your treatment depends on the type of infection you have. Your doctor will tell you how long to use ciprofloxacin injection.
    You may receive ciprofloxacin injection in a hospital or you may use the medication at home. If you are using ciprofloxacin injection at home, use it at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or other health care provider to explain any part you do not understand. Use ciprofloxacin injection exactly as directed. Do not infuse it more quickly than directed. Do not use more or less of it or use it more often than prescribed by your doctor.
    If you will be using ciprofloxacin injection at home, your healthcare provider will show you how to infuse the medication. Be sure that you understand these directions, and ask your healthcare provider if you have any questions. Ask your healthcare provider what to do if you have any problems infusing ciprofloxacin injection.
    You should begin feeling better during the first few days of your treatment with ciprofloxacin injection. If your symptoms do not improve, or if they get worse, call your doctor.
    Use ciprofloxacin injection until you finish the prescription, even if you feel better. Do not stop using ciprofloxacin injection unless you experience the symptoms of tendinitis or tendon rupture described in the IMPORTANT WARNING section or the symptoms of allergic reaction described in the SIDE EFFECTS section. If you stop using ciprofloxacin injection too soon or if you skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

    Are there OTHER USES for this medicine?

    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 risks of using this medication for your condition.
    This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

    What SPECIAL PRECAUTIONS should I follow?

    Before using ciprofloxacin injection,
    • tell your doctor and pharmacist if you are allergic or have had a severe reaction to ciprofloxacin or any other quinolone or fluoroquinolone antibiotic such as gatifloxacin (Tequin) (not available in the U.S.), gemifloxacin (Factive), levofloxacin (Levaquin), lomefloxacin (Maxaquin) (not available in the U.S.), moxifloxacin (Avelox), nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin), and sparfloxacin (Zagam) (not available in the U.S.), or if you are allergic to any other medications.
    • tell your doctor if you are taking tizanidine (Zanaflex). Your doctor will probably tell you not to use ciprofloxacin injection 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 the medications listed in the IMPORTANT WARNING section and any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); certain antidepressants; antipsychotics (medications to treat mental illness); caffeine or medications that contain caffeine (Excedrin, NoDoz, Vivarin, others); clozapine (Clozaril, Fazaclo); cyclosporine (Gengraf, Neoral, Sandimmune); diuretics ('water pills'); glyburide (DiaBeta, in Glucovance, Micronase, others); certain medications for irregular heartbeat such as amiodarone (Cordarone), disopyramide (Norpace), procainamide (Procanbid), quinidine, and sotalol (Betapace, Betapace AF, Sorine); methotrexate (Rheumatrex, Trexall); metoclopramide (Reglan); certain nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Naprosyn, others); phenytoin (Dilantin, Phenytek); probenecid (in Col-Probenecid, Probalan); ropinirole (Requip); or theophylline (Elixophyllin, Theo-24, Uniphyl 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.
    • tell your doctor if you or anyone in your family has or has ever had prolonged QT interval (a rare heart problem that may cause irregular heartbeat, fainting, or sudden death) or an irregular heartbeat, and if you have or have ever had nerve problems; a low level of potassium in your blood; cerebral arteriosclerosis (narrowing of blood vessels in or near the brain that can lead to stroke or ministroke); seizures; or liver disease.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using ciprofloxacin injection, call your doctor.
    • you should know that ciprofloxacin injection may cause confusion, dizziness, lightheadedness, and tiredness. Do not drive a car, 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 sunlamps) and to wear protective clothing, sunglasses, and sunscreen. Ciprofloxacin injection may make your skin sensitive to sunlight or ultraviolet light. If your skin becomes reddened, swollen, or blistered, like a bad sunburn, call your doctor.

    What SPECIAL DIETARY instructions should I follow?

    Do not drink or eat a lot of caffeine-containing products such as coffee, tea, energy drinks, cola, or chocolate. Ciprofloxacin injection 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 using ciprofloxacin injection.

    What should I do IF I FORGET to take a dose?

    Infuse 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 infuse a double dose to make up for a missed one.

    What SIDE EFFECTS can this medicine cause?

    Ciprofloxacin injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
    • nausea
    • vomiting
    • stomach pain
    • heartburn
    • diarrhea
    • headache
    • irritation, pain, tenderness, redness, warmth, or swelling at the injection spot
    • vaginal itching and/or discharge
    Some side effects can be serious. If you experience any of these symptoms, or those mentioned in the IMPORTANT WARNING section, stop using ciprofloxacin injection and call your doctor immediately:
    • severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment)
    • 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 or throat tightness
    • wheezing
    • 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
    • dark urine
    • flu-like symptoms
    • seizures
    • dizziness
    • confusion
    • nervousness
    • restlessness
    • anxiety
    • not trusting others or feeling that others want to hurt you
    • difficulty falling asleep or staying asleep
    • nightmares or abnormal dreams
    • hallucinations (seeing things or hearing voices that do not exist)
    • depression
    • thoughts about dying or killing yourself
    • uncontrollable shaking of a part of the body
    • pain, burning, tingling, numbness, and/or weakness in a part of the body
    Ciprofloxacin injection may cause problems with bones, joints, and tissues around joints in children. Ciprofloxacin injection should not normally be given to children younger than 18 years of age 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 injection for your child, be sure to tell the doctor if your child has or has ever had joint-related problems. Call your doctor if your child develops joint problems, such as pain or swelling, while using ciprofloxacin injection or after treatment with ciprofloxacin injection. Talk to your child's doctor about the risks of giving ciprofloxacin injection to your child.
    Ciprofloxacin injection may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
    If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I know about STORAGE and DISPOSAL of this medication?

    Your healthcare provider will tell you how to store your medication. . Store your medication only as directed. Make sure you understand how to store your medication properly. Throw away any medication that is outdated or no longer needed. Talk to your healthcare provider about the proper disposal of your medication.
    Keep your supplies in a clean, dry place out of the reach of children when you are not using them. Your healthcare provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

    What should I do in case of OVERDOSE?

    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.

    What OTHER INFORMATION should I know?

    Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to ciprofloxacin injection.
    Do not let anyone else use your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish using ciprofloxacin, call your doctor.
    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.

    Brand Names

    • Cipro® I.V.
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