Ciprofloxacin

Infections ciprofloxacin is used for

Ciprofloxacin is a fluoroquinolone antibiotic, and it kills a wide range of bacteria: those behind urine and kidney infections, prostate infections, gut infections, chest and sinus infections, and skin, bone and joint infections. It blocks two enzymes bacteria need in order to copy and repair their DNA, so they stop multiplying. Colds and flu are viral, and ciprofloxacin does nothing for them.

Tablets, eye drops and a combination bottle

Tablets handle infections inside the body. Cipro comes in 250mg, 500mg, 750mg and 1000mg; Ciprofloxacin tablets cover 250mg and 500mg. Cipro is the brand name for the same medicine, and the number on the pack is the amount of ciprofloxacin itself, whether or not the label adds hydrochloride.

For the eye, Ciloxan is a 0.3% ciprofloxacin drop for bacterial conjunctivitis (the red, sticky infected eye): a drop every two hours while you are awake for the first two days, then four times a day, for about a week. Ciprodex bottles hold ciprofloxacin 0.3% with dexamethasone 0.1%, a steroid that calms swelling and itching, and go into an infected eye or ear for roughly the same stretch.

If an antacid or iron tablet sits next to your dose

Swallow a tablet with a full glass of water, usually twice a day about twelve hours apart; food makes little difference. What else is in the stomach does: antacids, sucralfate, calcium, iron, zinc and magnesium supplements, multivitamins, milk and calcium-fortified drinks hold ciprofloxacin in the gut, so less of it gets through. Leave roughly two hours before, or six hours after, any of those. Tablets keep best in their foil somewhere dry, and the drop bottle should stay capped and out of direct sunlight. Finish the whole course, even once you feel better.

Side effects, from the everyday to the serious

Nausea, diarrhoea, headache, dizziness, a rash, a metallic taste and thrush are the usual complaints, and drops can sting, taste bitter or crust the eye. Tendons are the concern with this group: pain or swelling in one — the Achilles at the back of the ankle is the common spot — can appear during treatment or months afterwards, and a snap or pop with bruising needs emergency treatment. Tingling, numbness or burning in the hands and feet, confusion, agitation or nightmares are uncommon but recognised. Skin burns more easily in strong sun. A severe watery or bloody diarrhoea that starts during the course or in the weeks after it needs treatment. A spreading rash, or swelling of the lips or throat with trouble breathing, is an emergency.

Medicines that clash with it

Warfarin can act more strongly, showing up as bruising or bleeding. Theophylline, used for asthma, builds up and can bring a racing heart or shaky hands. Tizanidine, a muscle relaxant, is not taken with ciprofloxacin at all. Ibuprofen and similar anti-inflammatories raise the seizure risk, steroid tablets raise the tendon risk, and blood sugar can swing either way on diabetes medicines.