Ciprocin 250 mg

Description

Indications
Ciprocin is prescribed for the treatment of single or multiple infections caused by susceptible organisms. It is also effective in treating infections caused by bacteria resistant to other antibiotics, such as Aminoglycosides, Penicillins, and Cephalosporins.

Pharmacology
Ciprocin contains Ciprofloxacin, a synthetic quinolone antibacterial agent with broad-spectrum activity. It is effective against various gram-negative aerobic bacteria, including Enterobacteriaceae and Pseudomonas aeruginosa. Additionally, it is active against gram-positive aerobic bacteria, such as penicillinase-producing and non-penicillinase-producing staphylococci, including methicillin-resistant strains. However, many streptococcal strains exhibit relative resistance. The bactericidal effect of Ciprofloxacin results from interference with DNA gyrase, an enzyme essential for bacterial DNA synthesis. After oral administration, Ciprofloxacin is rapidly absorbed in the gastrointestinal tract and is widely distributed in body tissues and fluids. The elimination half-life is approximately 3.5 hours. Around 30% to 50% of the orally administered dose is excreted in the urine within 24 hours, either unchanged or as biologically active metabolites.

Dosage and Administration

General Dosage Guidelines: The dosage of Ciprocin depends on the severity and type of infection, the sensitivity of the causative bacteria, and the patient’s age, weight, and renal function.

Adults: 100-750 mg twice daily.

Urinary Tract Infections:

• Mild to moderate: 250-500 mg twice daily.

Respiratory Tract Infections:

• Upper and lower respiratory tract infections: 250-500 mg twice daily, depending on severity.
• For Streptococcus pneumoniae infection: 750 mg twice daily.

Gonorrhea:

• A single dose of 250 or 500 mg.

Other Infections:

• 500-750 mg twice daily.

Cystic Fibrosis:

• For Pseudomonas infections in adults, 750 mg twice daily.
• The patient’s low body weight should be considered when determining dosage.

Patients with Impaired Renal Function:

• Generally, no dose adjustment is necessary except for patients with severe renal impairment (serum creatinine >265 µmol/L or creatinine clearance <20 mL/min). If needed, the total daily dose may be reduced by half.

Elderly Patients:

• Higher serum levels may be observed, but dose adjustment is usually not required.

Pediatric Patients:

• Ciprofloxacin is not typically recommended for children and adolescents due to the risk of arthropathy. However, if the benefit outweighs the risk, a dosage of 7.5-15 mg/kg/day in two divided doses may be administered.

Treatment Duration:

• Acute infections: Typically, 5-10 days.
• Treatment should continue for at least three days after symptoms disappear.

Extended-Release Tablets:

• Uncomplicated urinary tract infections (acute cystitis): 1000 mg once daily for three days.

Intravenous Infusion:

• Urinary tract infections: 200 mg every 12 hours (mild/moderate) or 400 mg every 12 hours (severe/complicated) for 7-14 days.
• Lower respiratory tract infections: 400 mg every 12 hours (mild/moderate) or every 8 hours (severe) for 7-14 days.
• Nosocomial pneumonia: 400 mg every 8 hours for 10-14 days.
• Skin and soft tissue infections: 400 mg every 12 hours (mild/moderate) or every 8 hours (severe) for 7-14 days.
• Bone and joint infections: 400 mg every 12 hours (mild/moderate) or every 8 hours (severe) for at least 4-6 weeks.
• Complicated intra-abdominal infections: 400 mg every 12 hours for 7-14 days.
• Acute sinusitis: 400 mg every 12 hours for 10 days.
• Chronic bacterial prostatitis: 400 mg every 12 hours for 28 days.

Administration Instructions for IV Infusion:

• Check for leaks by squeezing the bag. If leakage or an unsealed port is detected, discard the bag.
• Do not use if the solution appears cloudy or contains precipitates.
• Do not connect multiple IV bags in series.
• Secure the administration set by inserting the piercing pin into the bag’s port.
• Suspend the bag and regulate flow using the clamp.

Drug Interactions

• Ciprocin should not be taken with magnesium or aluminum-containing antacids, sucralfate, or supplements containing calcium, iron, or zinc. These products may be taken at least two hours after or six hours before Ciprocin.
• Milk and dairy products should not be consumed concurrently, as they may reduce absorption. However, dietary calcium as part of a meal does not significantly affect absorption.

Contraindications

• Ciprocin is contraindicated in patients with known hypersensitivity to Ciprofloxacin or other quinolones.

Side Effects

• Gastrointestinal: Nausea, diarrhea, vomiting, dyspepsia, and abdominal pain.
• Central nervous system: Headache, dizziness, fatigue, confusion, convulsions, and retinal detachment risk.
• Hypersensitivity: Skin rash (rare cases of Stevens-Johnson syndrome and toxic epidermal necrolysis), pruritus, and systemic reactions.
• Other effects: Joint pain, mild photosensitivity, transient liver enzyme elevations, and altered serum bilirubin, urea, or creatinine levels.
• Risk of hypoglycemia and mental health-related adverse effects.

Pregnancy and Lactation

• Animal studies have not shown teratogenicity or fertility impairment. However, since Ciprofloxacin has been associated with arthropathy in immature animals, its use during pregnancy is not recommended.
• Ciprofloxacin is excreted in breast milk, so it is not advised for nursing mothers.

Precautions and Warnings

• Use with caution in patients with known or suspected central nervous system disorders, including arteriosclerosis and epilepsy, due to the potential risk of seizures and convulsions.
• Patients should drink plenty of fluids while taking Ciprocin.
• Avoid concurrent administration with magnesium/aluminum-containing antacids, sucralfate, calcium, iron, or zinc products.
• Do not take Ciprocin with milk or yogurt alone, as it may impair absorption. However, dietary calcium as part of a meal does not significantly affect absorption.

Use in Special Populations

• While clinically effective, Ciprocin is not a first-line drug for pediatric patients.

Overdose Effects

• Symptoms of overdose may include seizures, hallucinations, confusion, abdominal discomfort, renal and hepatic dysfunction, crystalluria, hematuria, and reversible kidney toxicity.

Therapeutic Class

• Quinolone antibiotics, Anti-diarrheal antimicrobial drugs.

Storage Conditions

• Store below 30°C, protected from light and moisture.
• Keep out of reach of children.