Ciprofloxacin - instructions for use, reviews, analogs and formulations (tablets 250 mg, 500 mg and 750 mg, eye drops and ear 0.3%, solution for injections) of the drug for the treatment of infections in adults, children and pregnancy

In this article, you can read the instructions for using the drug Ciprofloxacin. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Ciprofloxacin in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of ciprofloxacin in the presence of existing structural analogues.Use to treat infectious diseases of various organs and systems of the body in adults, children, as well as during pregnancy and lactation.

Ciprofloxacin - a broad-spectrum antimicrobial agent from the group of fluoroquinolones. It is bactericidal. The drug inhibits the DNA enzyme enzyme of bacteria, as a result of which DNA replication and the synthesis of bacterial cell proteins are disturbed. Ciprofloxacin acts both on multiplying microorganisms, and on being in a rest phase.

Ciprofloxacin is active against gram-negative and gram-positive aerobic bacteria; intracellular pathogens: Legionella pneumophila, Brucella spp., Chlamydia trachomatis, Listeria monocytogenes, Mycobacterium tuberculosis, Mycobacterium kansasii, Mycobacterium avium-intracellulare. The majority of staphylococci, resistant to methicillin, are resistant to ciprofloxacin.

The drug is moderately sensitive to Streptococcus pneumoniae, Enterococcus faecalis.

The drug is resistant to Corynebacterium spp., Bacteroides fragilis, Pseudomonas cepacia, Pseudomonas maltophilia, Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides.

The effect of the drug against Treponema pallidum has not been adequately studied.

Pharmacokinetics

Quickly absorbed from the digestive tract. Food intake has little effect on the absorption of ciprofloxacin. It is distributed in tissues and body fluids. Penetrates into the cerebrospinal fluid: the concentration of ciprofloxacin in non-inflamed cerebralShells reach 10%, with inflamed - up to 37%. High concentrations are achieved in bile. Excreted in urine and bile.

Indications

Infectious-inflammatory diseases caused by microorganisms sensitive to the preparation:

• respiratory tract;
• ear, nose and throat;
• kidney and urinary tract;
• genital organs (including gonorrhea, prostatitis);
• gynecological (including adnexitis) and postpartum infections;
• digestive system (including oral cavity, teeth, jaws);
• gallbladder and bile ducts;
• skin, mucous membranes and soft tissues;
• musculoskeletal system;
• sepsis;
• peritonitis;
• prevention and treatment of infections in patients with reduced immunity (with immunosuppressant therapy).

For topical application:

• acute and subacute conjunctivitis;
• blepharoconjunctivitis;
• blepharitis;
• bacterial ulcers of the cornea;
• keratitis;
• keratoconjunctivitis;
• chronic dacryocystitis;
• meibomites;
• infectious lesions of the eyes after injuries or ingress of foreign bodies;
• preoperative prophylaxis in ophthalmic surgery.

Forms of release

Tablets coated with 250 mg, 500 mg, 750 mg.

Eye and ear drops 0,3%.

Solution for intravenous administration (injections in ampoules for injection) 2 mg / ml.

Instructions for use and dosage

Pills

The dose of ciprofloxacin depends on the severity of the disease, type of infection, body condition, age, body weight and kidney function in the patient.

Uncomplicated diseases of the kidneys and urinary tracts - 250 mg, in complicated cases - 500 mg 2 times a day.

Diseases of the lower respiratory tract of medium severity - 250 mg, in more severe cases - 500 mg 2 times a day.

For the treatment of gonorrhea, a single administration of Ciprofloxacin in a dose of 250-500 mg is recommended.

Gynecological diseases, enteritis and colitis with severe and high temperature, prostatitis, osteomyelitis - 500 mg 2 times a day (for the treatment of banal diarrhea can be used at a dose of 250 mg 2 times a day).

The drug should be taken on an empty stomach, washed down with a sufficient amount of liquid.

Patients with severe renal dysfunction should be given a half dose of the drug.

The duration of treatment depends on the severity of the disease, but treatment should always last at least two more days after the disappearance of the symptoms of the disease. Usually the duration of treatment is 7-10 days.

Ampoules

The drug should be administered intravenously drip for 30 minutes (200 mg dose) and 60 min (400 mg dose). The infusion solution can be combined with 0.9% sodium chloride solution, Ringer's solution, 5% and 10% Dextrose solution (glucose), 10% fructose solution, a solution containing 5% dextrose solution with 0.225% or 0.45% sodium chloride solution.

The dose of ciprofloxacin depends on the severity of the disease, the type of infection, the condition of the body, the age, weight and function of the kidneys in the patient.

Single dose is 200 mg, with severe infections - 400 mg. Multiplicity of administration - 2 times a day; the duration of treatment is 1-2 weeks, if necessary, an increase in the course of treatment is possible.

In acute gonorrhea, the drug is administered intravenously once in a dose of 100 mg.

For the prevention of postoperative infections - for 30-60 minutes before the operation intravenously in a dose of 200-400 mg.

Side effect

• nausea, vomiting;
• diarrhea;
• stomach ache;
• flatulence;
• anorexia;
• dizziness;
• headache;
• increased fatigue;
• anxiety;
• tremor;
• insomnia;
• "nightmarish" dreams;
• peripheral paralgesia (anomaly of perception of a feeling of pain);
• sweating;
• increased intracranial pressure;
• depression;
• hallucinations;
• impairment of taste and smell;
• impaired vision (diplopia, change in color perception);
• noise in ears;
• hearing loss;
• tachycardia;
• heart rhythm disturbances;
• a decrease in blood pressure;
• flushes of blood to the skin of the face;
• leukopenia, granulocytopenia, anemia, thrombocytopenia, leukocytosis, thrombocytosis, hemolytic anemia;
• hematuria (blood in the urine);
• glomerulonephritis;
• retention of urine;
• arthralgia;
• ruptures of tendons;
• myalgia;
• itching;
• hives;
• the formation of blisters accompanied by bleeding;
• drug fever;
• point hemorrhages (petechiae);
• swelling of the face or larynx;
• dyspnea;
• increased photosensitivity;
• vasculitis;
• nodal erythema;
• Pain and burning at the injection site;
• general weakness;
• superinfection (candidiasis, pseudomembranous colitis).

Contraindications

• deficiency of glucose-6-phosphate dehydrogenase;
• pseudomembranous colitis;
• children's age to 18 years (until the completion of the process of skeleton formation);
• pregnancy;
• lactation period (breastfeeding).

Application in pregnancy and lactation

Ciprofloxacin is contraindicated in pregnancy and lactation (breastfeeding).

special instructions

If a severe and prolonged diarrhea occurs during or after treatment with ciprofloxacin, the diagnosis of pseudomembranous colitis should be ruled out, which requires immediate discontinuation of the drug and the appointment of appropriate treatment.

If pain occurs in the tendons or when the first signs of tendovaginitis appear, treatment should be discontinued.

During the treatment with ciprofloxacin it is necessary to provide a sufficient amount of fluid while observing normal diuresis.

During treatment with ciprofloxacin, avoid direct exposure to sunlight.

With the simultaneous use of alcohol, the hepatotoxic effect of the drug is enhanced.

Impact on the ability to drive vehicles and manage mechanisms

Patients taking Ciprofloxacin should be careful when driving a car and engaging in other potentially hazardous activities that require increased attention and speed of psychomotor reactions (especially when using alcohol at the same time).

Drug Interactions

Due to a decrease in the activity of microsomal oxidation in hepatocytes, ciprofloxacin increases the concentration and lengthens the half-life of theophylline and other xanthines (eg, caffeine),oral hypoglycemic drugs, indirect anticoagulants, helps to reduce the prothrombin index.

When used simultaneously with non-steroidal anti-inflammatory drugs (with the exception of acetylsalicylic acid), the risk of seizures increases.

Metoclopramide accelerates the absorption of ciprofloxacin, which leads to a decrease in the time to reach the maximum concentration of the latter.

Joint appointment of uricosuric drugs leads to a delay in excretion (up to 50%) and an increase in the plasma concentration of ciprofloxacin.

When combined with other antimicrobial agents (beta-lactam antibiotics, aminoglycosides, clindamycin, metronidazole), synergy is usually observed. Therefore, ciprofloxacin can be successfully used in combination with azlocillin and ceftazidime in infections caused by Pseudomonas spp .; with mezlocillin, azlocillin and other beta-lactam antibiotics - with streptococcal infections; with isoxazole penicillins and Vancomycin - with staphylococcal infections; with Metronidazole and Clindamycin - with anaerobic infections.

Ciprofloxacin increases the nephrotoxic effect of cyclosporine, there is also an increase in serum creatinine, so these patients need to monitor this indicator 2 times a week.

With simultaneous administration of ciprofloxacin increases the effect of indirect anticoagulants.

Pharmaceutical interaction

The infusion solution of the drug is pharmaceutically incompatible with all infusion solutions and preparations that are physico-chemically unstable under acidic conditions (the pH of the infusion solution of ciprofloxacin is 3.5-4.6). Do not mix intravenous solution with solutions that have a pH of more than 7.

Analogues of the drug Ciprofloxacin

Structural analogs for the active substance:

• Altsipro;
• Afenoxin;
• Basijen;
• Betaciprol;
• Vero-Ciprofloxacin;
• Zindolin 250;
• Isfipro;
• Quintor;
• Quipro;
• Liprokhin;
• Microfleks;
• Oftotsipro;
• Recipro;
• Siflox;
• Ceprova;
• Ciloxane;
• Cipraz;
• Ciprinol;
• Ciprobay;
• Ciprobide;
• Ciprobrin;
• Citrodox;
• Ciprolake;
• Tsiprolet;
• Ciprolone;
• Cipromed;
• Cipropane;
• Ciprosan;
• Ciprosine;
• Ciprosol;
• Ciprofloxabol;
• Ciprofloxacin Buffus;
• Ciprofloxacin-ACOS;
• Ciprofloxacin-promed;
• Ciprofloxacin-Teva;
• Ciprofloxacin-FPO;
• Cifloxinal;
• Tsifran;
• The figure of OD;
• Ecocylol.

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