CIPROCIN® (Ciprofloxacin): A Guide to Uses and Safety Warnings

MEDICAL INFORMATION: This is a prescription medication. The following information is for educational purposes only and does not replace professional medical advice. Do not use this product without a doctor's prescription and supervision. Misuse of antibiotics can lead to bacterial resistance and serious adverse effects.

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CIPROCIN® (Ciprofloxacin): A Guide to the Broad-Spectrum Antibiotic

Summary

CIPROCIN® is a branded formulation of ciprofloxacin, a fluoroquinolone antibiotic with broad-spectrum bactericidal activity against many Gram-negative and some Gram-positive organisms. Manufactured by E.I.P.I.CO. (Egyptian International Pharmaceutical Industries Co.), CIPROCIN® is supplied in multiple presentations (oral, topical ophthalmic/otic, and hospital IV formulations) for the treatment of infections caused by susceptible bacteria. Ciprofloxacin acts primarily by inhibiting bacterial DNA gyrase and topoisomerase IV, enzymes essential for DNA replication and cell division.

Manufacturer

E.I.P.I.CO. — Egyptian International Pharmaceutical Industries Co., Egypt.

Category & Active Ingredient

• Category: Fluoroquinolone antibiotic.
• Active Ingredient: Ciprofloxacin.

Available Forms & Strengths

• Oral tablets: 250 mg, 500 mg, 750 mg (film-coated tablets; pack sizes vary by market).
• Topical (ophthalmic/otic): 0.3% eye/ear drops (5 mL); 0.3% eye ointment (5 g).
• Intravenous (hospital): IV formulations are available in many markets—confirm local vial strengths and presentations with supplier/product leaflet (e.g., 200 mg vials may be used in some settings).
• Note: Confirm exact local presentations, concentrations, and pack sizes on the product carton or leaflet before use.

Mechanism of Action

Ciprofloxacin is bactericidal. It inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes required for DNA replication, transcription and repair. Inhibition of these enzymes prevents bacterial multiplication and leads to cell death in susceptible organisms.

Indications

• Complicated and selected uncomplicated urinary tract infections (including pyelonephritis).
• Certain respiratory tract infections (where susceptibility and local guidance permit).
• Gastrointestinal infections (e.g., selected cases of infectious diarrhea, enteric fever) when indicated.
• Skin, soft tissue, bone and joint infections (based on susceptibility).
• Prostatitis and specific sexually transmitted infections where recommended.
• Topical ophthalmic/otic use for bacterial eye/outer ear infections when indicated and per product license.
• Other serious infections due to susceptible organisms as directed by a physician.

Always verify organism susceptibility and follow local/national treatment guidelines and prescriber instructions.

Dosage & Administration

• Oral (general): Typical regimens range from 250–750 mg every 12 hours depending on infection type and severity. Some indications use 500 mg q12h; severe infections may use 750 mg q12h—follow the prescriber's order.
• Topical (eye/ear): Instill or apply the drops/ointment as directed by an ophthalmologist/ENT specialist or per leaflet. Do not use ear drops if tympanic membrane perforation is suspected unless product is licensed for that use.
• IV (hospital): Administer under hospital protocols by trained personnel; dosing and infusion rates differ from oral dosing and require renal adjustment.
• Renal impairment: Dose adjustment is required for reduced creatinine clearance—check product leaflet and consult a clinician/pharmacist.
• General: Complete the full prescribed course even if symptoms improve. Do not skip or double doses to compensate for missed ones without medical guidance.

Contraindications

• Known hypersensitivity to ciprofloxacin, other fluoroquinolones, or any component of the formulation.
• Concomitant use with tizanidine (contraindicated).
• History of tendon disorders related to fluoroquinolone use—avoid re-exposure.

⚠ Important Safety Warnings (Regulatory)

• Tendonitis and Tendon Rupture: Fluoroquinolones are associated with an increased risk of tendonitis and tendon rupture (especially the Achilles tendon). Risk is higher in the elderly, those on systemic corticosteroids, and transplant recipients. Stop ciprofloxacin and seek medical attention immediately if tendon pain, swelling, or inflammation occurs.
• Peripheral Neuropathy: May cause peripheral neuropathy (pain, burning, tingling, numbness); symptoms may be rapid in onset and potentially irreversible—discontinue if neuropathic signs appear.
• Central Nervous System Effects: Can cause dizziness, tremor, confusion, hallucinations and seizures in predisposed individuals. Use caution in patients with CNS disorders and discontinue if severe neuropsychiatric events occur.
• Use Restriction: Reserve fluoroquinolones for infections where alternatives are inappropriate because of potential for disabling adverse reactions and contribution to antimicrobial resistance.

Side Effects & Precautions

• Common: Nausea, diarrhea, abdominal pain, headache, dizziness.
• Serious (less common): Tendon rupture, peripheral neuropathy, severe hypersensitivity reactions, hepatotoxicity, QT prolongation, seizures, severe dermatologic reactions (rare).
• Clostridioides difficile–associated diarrhea (CDAD): May occur with antibiotic use; report severe or persistent diarrhea immediately.
• Photosensitivity: May increase sun sensitivity—advise avoidance of excessive sun and use of sunscreen/protective clothing.
• Pediatric considerations: Generally avoided in children/adolescents unless benefit outweighs risks (specific serious infections).

Drug Interactions

• Cation-containing products: Antacids, sucralfate, iron, zinc, calcium supplements and dairy products can chelate ciprofloxacin and reduce absorption. Separate administration (commonly take ciprofloxacin ≥2 hours before or ≥6 hours after such products; follow specific leaflet guidance).
• Warfarin and other coumarin anticoagulants: Ciprofloxacin may potentiate anticoagulant effects—monitor INR and bleeding.
• Theophylline: Ciprofloxacin may increase theophylline levels—monitor for toxicity or avoid combination.
• Tizanidine: Concomitant use is contraindicated (markedly increases tizanidine exposure causing severe hypotension and sedation).
• CYP1A2 substrates: Ciprofloxacin inhibits CYP1A2 and may increase levels of substrates (e.g., caffeine, clozapine, olanzapine)—monitor for adverse effects.
• Probenecid: May reduce renal elimination of ciprofloxacin, increasing exposure—monitor or adjust dose.
• Other QT-prolonging drugs: Use with caution; combined QT effects may increase arrhythmia risk.

Pharmacokinetics (Summary)

• Absorption: Oral bioavailability approximately 70% (variable); peak plasma concentrations within ~1–2 hours after oral dosing.
• Distribution: Widely distributed into tissues and fluids (including lungs, urine); moderate protein binding (~20–40%).
• Metabolism: Partially metabolized in the liver to minor inactive metabolites.
• Elimination: Eliminated primarily by the kidneys as unchanged drug and metabolites; elimination half-life ~3–5 hours in adults with normal renal function (approximate). Dose adjustment needed in significant renal impairment.
• Note: Parameters vary with patient factors and formulation; consult product leaflet for full PK details.

Patient Counseling

• Take CIPROCIN® exactly as prescribed and finish the full course even if you feel better earlier.
• For oral tablets: take with a full glass of water and maintain good hydration during therapy.
• Avoid taking ciprofloxacin together with antacids, sucralfate, iron, zinc, calcium supplements or large amounts of dairy—separate dosing as advised.
• Avoid strenuous exercise while on therapy and for some time after, particularly if you experience tendon pain; report any tendon discomfort or swelling immediately.
• Report any new numbness, tingling, weakness, severe diarrhea, psychiatric symptoms, or allergic reactions promptly.
• Use sun protection because of potential photosensitivity reactions.
• Do not take tizanidine with ciprofloxacin.

Storage

• Store oral tablets at room temperature as stated on the carton (generally below 25–30°C), protected from moisture and light.
• Keep ophthalmic/otic preparations sterile; follow vial storage and expiry instructions after opening (do not use beyond recommended period once opened).
• Keep all medicines out of the reach of children.

Frequently Asked Questions (FAQ)

1. Can I stop taking CIPROCIN® when I feel better?
   No. Complete the full prescribed course to prevent relapse and antibiotic resistance.
2. Can I take CIPROCIN® with milk or antacids?
   Avoid taking it at the same time as dairy products or cation-containing antacids/supplements—these can reduce absorption. Space dosing as instructed by your healthcare provider.
3. What should I do if I miss a dose?
   Take it as soon as you remember. If the next dose is near, skip the missed dose. Do not double doses to make up for a missed one.
4. Is CIPROCIN® safe in pregnancy or breastfeeding?
   Use in pregnancy and lactation is generally avoided unless the physician determines that benefits outweigh potential risks. Discuss with your healthcare provider.
5. What signs require immediate medical attention?
   Sudden tendon pain or swelling, signs of peripheral neuropathy (numbness, tingling), severe diarrhea, signs of allergic reaction (rash, swelling, breathing difficulty), or sudden changes in mood or mental state—seek urgent care.

References

1. FDA Prescribing Information — Ciprofloxacin (Cipro) label.
2. European Medicines Agency (EMA) — Fluoroquinolone safety review.
3. Local product leaflet and internal information from E.I.P.I.CO. (consult the leaflet for exact local indications, concentrations and presentations).