Ciproted

Wide range of infections including anthrax, infected bites & stings, brucellosis, cat scratch disease, chancroid, exacerbations of cystic fibrosis, gastroenteritis, gonorrhea, neutropenia, Legionnaire's disease, otitis externa, otitis media, peritonitis, Q-fever, septicemia, spotted fevers, typhoid & paratyphoid fever, typhus, biliary tract, bone & joint, lower resp tract & skin infections, & UTI. Surgical infection & meningococcal meningitis prophylaxis.

Adult 250-750 mg bid. Gonorrhea 250 or 500 mg as single dose. Meningococcal meningitis prophylaxis 500 mg as single dose. Surgical infection prophylaxis 750 mg as single dose given 60-90 min pre-op.

May be taken with or without food: Administer either 1-2 hr prior to or at least 4 hr after multivalent cation-containing drugs & mineral supplements (eg, Ca, Mg, Al, Fe), polymeric phosphate binders (eg, sevelamer or lanthanum carbonate), sucralfate or antacids, & highly buffered drugs (eg, didanosine tab) containing Mg, Al or Ca. Avoid concurrent administration of dairy products or mineral-fortified drinks alone eg, milk, yoghurt, Ca-fortified orange juice.

Hypersensitivity to ciprofloxacin or other quinolones. Concomitant administration w/ tizanidine.

Discontinue use if hypersensitivity & allergic reactions occur; at 1st signs or symptoms of any adverse reaction, & tendinitis; if seizures, rare cases of depression or psychosis, & severe & persistent diarrhea (during or after treatment, which may indicate antibiotic-associated colitis) occur; any signs & symptoms of hepatic disease. Avoid use in patients who have experienced serious adverse reactions in the past when using quinolone or fluoroquinolone-containing products; patients w/ G6PD deficiency. Not suited as monotherapy for severe infections & infections that might be due to gm +ve or anaerobic pathogens. Not recommended for streptococcal infections. Not to be used in patients w/ history of tendon disease/disorder related to quinolone treatment. Resistance. Limited efficacy in post-surgical intra-abdominal infections. Treatment of bronchopulmonary infections in cystic fibrosis; complicated UTI & pyelonephritis; other specific severe infections. Increased risk of tendinitis & tendon rupture in the elderly, patients w/ renal impairment or w/ solid organ transplants, & those treated concurrently w/ corticosteroids. Sensory or sensorimotor polyneuropathy resulting in paraesthesia, hypoaesthesia, dysesthesia, or weakness; aortic aneurysm & dissection, & heart valve regurgitation/incompetence; hepatic necrosis & life-threatening hepatic failure; vision disorders. Patients w/ myasthenia gravis; CNS disorders which may be predisposed to seizure; known risk factors for prolongation of the QT interval; women. Avoid direct exposure to extensive sunlight or UV irradiation during treatment. Carefully monitor blood glucose in diabetic patients receiving concomitant oral hypoglycemic agent (eg, glibenclamide) or insulin during treatment. Ensure adequate hydration & avoid excessive alkalinity of urine in patients. Avoid concomitant use w/ corticosteroids. Not recommended in concomitant use w/ MTX. Concomitant use w/ substances metabolized by CYP1A2 eg, theophylline, clozapine, olanzapine, ropinirole, tizanidine, duloxetine, agomelatine. In vitro against Mycobacterium tuberculosis might give false -ve bacteriological test results in specimens from patients during treatment. Renal impairment. Avoid use during pregnancy. Not to be used during lactation. Childn & adolescents. Elderly.

Nausea, diarrhea.

Concomitant use w/ drugs known to prolong QT interval eg, class IA or III antiarrhythmics, TCAs, macrolides, antipsychotics. Reduced absorption w/ multivalent cation-containing drugs & mineral supplements (eg, Ca, Mg, Al, Fe), polymeric phosphate binders (eg, sevelamer or lanthanum carbonate), sucralfate or antacids, & highly buffered drugs (eg, didanosine tab) containing Mg, Al or Ca. Absorption may be reduced w/ dairy products or mineral-fortified drinks alone eg, milk, yoghurt, Ca-fortified orange juice. Increased serum conc w/ probenecid. Accelerated absorption w/ metoclopramide. Slight reduction in C_max & AUC w/ omeprazole. Increased serum conc of tizanidine; theophylline; clozapine. May increase plasma levels of MTX & risk of MTX-associated toxic reactions. Raised serum conc of other xanthine derivatives eg, caffeine or pentoxifylline (oxpentiphylline). May result in increased or reduced serum levels of phenytoin. Transient rise in serum creatinine conc of cyclosporin. May augment anticoagulant effects of vit K antagonist. May result in increase of AUC & C_max of duloxetine. Increased C_max & AUC of ropinirole; sildenafil. Reduced clearance of lidocaine IV. Increased exposure of agomelatine. May increase blood levels of zolpidem.

Quinolones

J01MA02 - ciprofloxacin ; Belongs to the class of fluoroquinolones. Used in the systemic treatment of infections.

Rx