Ciprox 500 mg

Indications

Ciprox is prescribed for the treatment of infections caused by one or more susceptible organisms. It is effective against both single and mixed infections and can also be used in cases where infections are caused by bacteria resistant to other antibiotic classes, including Aminoglycosides, Penicillins, and Cephalosporins.

Important Note:
Always follow the guidance of a registered medical professional before taking this medicine.

Pharmacology

Ciprox contains Ciprofloxacin, a synthetic quinolone antibiotic with broad-spectrum activity. It is particularly effective against many gram-negative aerobic bacteria such as Enterobacteriaceae and Pseudomonas aeruginosa. Ciprofloxacin also demonstrates activity against certain gram-positive aerobic bacteria, including penicillinase-producing, non-penicillinase-producing, and methicillin-resistant Staphylococcus strains. However, some strains of Streptococcus may show resistance to this drug.

The drug works by inhibiting the bacterial enzyme DNA gyrase, crucial for DNA replication, thereby killing the bacteria. After oral administration, Ciprofloxacin is rapidly absorbed from the gastrointestinal tract and is well distributed throughout the body tissues and fluids. The drug has a half-life of approximately 3.5 hours. Within 24 hours of administration, between 30% to 50% of an oral dose is excreted unchanged in the urine along with biologically active metabolites.

Dosage

The dosage of Ciprox depends on the severity and type of infection, as well as the patient’s age, weight, and kidney function.

• Adults:
  The general dose for adults ranges from 100 mg to 750 mg, taken twice daily.

  • Urinary Tract Infections:
    250–500 mg twice daily (adjusted based on infection severity).

  • Respiratory Tract Infections:
    250–500 mg twice daily for both upper and lower respiratory infections. For Streptococcus pneumoniae, 750 mg twice daily is recommended.

  • Gonorrhea:
    A single dose of 250 mg or 500 mg.

  • Other Infections:
    Typically, 500–750 mg twice daily.

  • Cystic Fibrosis (Pseudomonal Infections):
    750 mg twice daily.

  • Impaired Renal Function:
    No dosage adjustment is generally needed unless severe renal impairment occurs (creatinine clearance <20 ml/min). In such cases, reduce the daily dose by half.

  • Elderly Patients:
    No dosage modification is needed despite the potential for higher serum levels in older adults.

  • Pediatric Use:
    Not recommended for children or adolescents due to potential adverse effects on joint development. If deemed necessary, the dosage should range from 7.5–15 mg/kg/day depending on infection severity.

• Extended-Release Tablets:
  For uncomplicated urinary tract infections (acute cystitis), the recommended dosage is 1000 mg once daily for three days.

• Intravenous Infusion:

  • Urinary Tract Infection (Mild to Moderate):
    200 mg every 12 hours for 7–14 days.
    Severe or Complicated:
    400 mg every 12 hours for 7–14 days.
  • Lower Respiratory Tract Infection (Mild to Moderate):
    400 mg every 12 hours for 7–14 days.
    Severe or Complicated:
    400 mg every 8 hours for 7–14 days.
  • Skin and Soft Tissue Infections (Mild to Moderate):
    400 mg every 12 hours for 7–14 days.
    Severe or Complicated:
    400 mg every 8 hours for 7–14 days.
  • Bone and Joint Infections:
    400 mg every 12 hours for 4–6 weeks (mild to moderate).
    Severe or Complicated:
    400 mg every 8 hours for more than 4–6 weeks.
  • 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

• For Intravenous Infusion:
  1. Check the infusion bag for leaks. If leaks are present or the seal is broken, discard the solution.
  2. Do not use if the solution is cloudy or contains precipitates.
  3. Do not connect flexible bags in series.
  4. Attach the infusion set, ensuring it is securely in place.
  5. Administer the infusion at the prescribed flow rate using the flow control clamp.

Drug Interactions

• Avoid concurrent use of Ciprox with magnesium or aluminum-containing antacids, sucralfate, and products containing calcium, iron, or zinc. These should be taken at least two hours after or six hours before Ciprox.
• Ciprox should not be taken with milk or dairy products, as this can significantly reduce its absorption. However, dietary calcium within meals does not have a major impact on absorption.

Contraindications

• Hypersensitivity:
  Ciprox is contraindicated in patients with a known allergy to Ciprofloxacin or other quinolone antibiotics.

Side Effects

Common side effects include:

• Gastrointestinal: Nausea, diarrhea, vomiting, dyspepsia, and abdominal discomfort.
• Central Nervous System: Headache, dizziness, confusion, tiredness, seizures, and risk of retinal detachment.
• Hypersensitivity: Skin rash (rarely, Stevens-Johnson syndrome or toxic epidermal necrolysis), itching, and systemic reactions.
• Others: Joint pain, photosensitivity, and transient increases in liver enzymes, bilirubin, urea, or creatinine.

Pregnancy & Lactation

• Pregnancy:
  Ciprofloxacin is not recommended during pregnancy due to potential adverse effects on fetal development.
• Lactation:
  Ciprofloxacin is excreted in breast milk, so it is not recommended for use in nursing mothers.

Precautions & Warnings

• Use caution in patients with CNS disorders (e.g., epilepsy or arteriosclerosis) or those at risk for seizures.
• Stay well-hydrated while using Ciprox, and it may be taken with or without food.
• Interaction with Antacids and Dairy: Avoid taking with antacids, sucralfate, or dairy products to ensure optimal absorption.

Overdose Effects

• Symptoms of overdose may include seizures, hallucinations, confusion, abdominal pain, and renal or hepatic impairment. Treatment for overdose is symptomatic.

Therapeutic Class

Ciprox belongs to the class of 4-Quinolone preparations and is used as an antimicrobial and anti-diarrheal agent.

Storage Conditions

Store below 30°C in a dry, light-protected place. Keep out of reach of children.