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Cipro

Cipro is a broad-spectrum antimicrobial agent from the group of fluoroquinolones. It has bactericidal properties. The drug inhibits the bacterial DNA gyrase enzyme, as a result of which DNA replication and the synthesis of bacterial cellular proteins are disrupted. The main component is ciprofloxacin. It acts both on breeding organisms and those in the rest phase.

Composition

One tablet contains the active substance:

  • ciprofloxacin – 250 mg or 500 mg;
  • excipients: povidone, anhydrous colloidal silicon dioxide, talc, croscarmellose sodium, corn starch, magnesium stearate, opadra II (contains polyvinyl alcohol, talc, macrogol 3350, lecithin, titanium dioxide).

Indications for use

Infections caused by drug-sensitive microorganisms:

  • lower respiratory tract infections caused by gram-negative bacteria (pneumonia, except pneumococcal, bronchopulmonary infections in chronic obstructive pulmonary disease, cystic fibrosis, bronchiectasis);
  • infections of the middle ear and paranasal sinuses caused by gram-negative bacteria;
  • kidney and urinary tract infections;
  • infections of the skin and soft tissues caused by gram-negative bacteria;
  • infections of bones and joints;
  • pelvic infections (including adnexitis and prostatitis);
  • gonorrhea;
  • infections of the gastrointestinal tract (including diarrhea caused by enterotoxigenic strains of E. coli, Campylobacter jejuni);
  • intra-abdominal infections;
  • infections in patients with reduced immunity (with neutropenia).

Dosage and administration

  • For adults. The tablets are swallowed whole with a small amount of water, after eating.
  • For urinary system infections of mild to moderate severity, the dose for adults is 250 mg (1 tab.) 2 times/day; in severe and combined forms of infections – adult dose 500mg (2tab.) 2 times/day.

The course of treatment is 7-14 days.

  • In acute infections of the respiratory tract, joints, skin, and soft tissues, the dose is 500 mg (2tab.) 2 times/day. In extremely severe forms of acute infections, 2 times/day for 750 mg (3tab.).
  • Doses are defined individually, taking into account the severity of the infectious process and the functional state of the kidneys.

The course of treatment is 7-14 days.

  • In acute septicemia, abscess, pneumonia, endocarditis, osteomyelitis – 750 mg (3tab.) 2 times/day. The course of treatment is 4 to 6 weeks.
  • With gonorrhea, a single dose is 250 mg (1 tab.). In the presence of clinical and bacteriological improvement, it is recommended to continue treatment for 2 to 3 days.
  • With streptococcal infections, the course of treatment is at least 10 days.

Contraindications

  • Hypersensitivity to ciprofloxacin and other components of the drug;
  • Pregnancy and lactation;
  • Children and adolescents under 18 years;
  • Concomitant use of Cipro and Tizanidine.

Precautions: severe cerebral arteriosclerosis, cerebrovascular accident, mental diseases, epilepsy, epileptic syndrome, severe renal and/or liver failure, advanced age.

Side effects

  • The skin and subcutaneous tissues: erythema multiforme.
  • The cardiovascular system: prolongation of the QT interval, ventricular arrhythmias (including pirouette type), vasculitis, hot flashes, migraine, fainting.
  • The gastrointestinal tract and liver: flatulence, anorexia.
  • The nervous system: intracranial hypertension, insomnia, agitation, tremor, in very rare cases, peripheral disturbances of sensitivity, sweating, paresthesia and dysesthesia, impaired coordination, impaired gait, convulsions, a feeling of fear, nightmares, depression, hallucinations, taste and smell disturbances, visual disturbances (diplopia, chromatopsia), tinnitus, temporary hearing loss. If these reactions occur, immediately discontinue the drug and notify the attending physician.
  • The hemopoietic system: thrombocytopenia, very rarely – leukocytosis, thrombocytosis, hemolytic anemia, agranulocytosis, pancytopenia (life-threatening), bone marrow depression (life-threatening).
  • Allergic and immunopathological reactions: drug fever, as well as photosensitivity; rarely – bronchospasm, very rarely – anaphylactic shock, myalgia, Lyell syndrome, interstitial nephritis, hepatitis.
  • Musculoskeletal system: arthritis, increased muscle tone and cramps. Very rarely – muscle weakness, tendonitis, tendon ruptures (mainly Achilles tendon), exacerbation of symptoms of myasthenia gravis.
  • Respiratory system: dyspnea (including asthmatic conditions).
  • General condition: asthenia, fever, edema, sweating (hyperhidrosis).
  • Effect on laboratory parameters: hyperglycemia, a change in the concentration of prothrombin, an increase in amylase activity.

Overdose

  • Symptoms: no specific symptoms. In several cases, a reversible toxic effect on the renal parenchyma was noted. It is recommended to monitor renal function.
  • Treatment: it is necessary to lavage the stomach, to ensure a sufficient flow of fluid.
  • If symptoms of an overdose manifest, you should immediately consult a doctor.

Interactions

The simultaneous use of ciprofloxacin with didanosine results in reduced absorption of ciprofloxacin due to the formation of complexes of ciprofloxacin with aluminum and magnesium salts contained in didanosine.

The simultaneous administration of ciprofloxacin and theophylline can lead to an increase in theophylline concentration in blood plasma due to competitive inhibition in the cytochrome P 450 binding sites, which leads to an increase in the half-life of theophylline and an increased risk of developing toxic effects associated with theophylline.

The simultaneous administration of antacids, as well as drugs containing aluminum, zinc, ferrum or magnesium ions, can cause a decrease in the absorption of ciprofloxacin, so the interval between the appointment of these drugs should be at least 4 hours.

With the simultaneous use of ciprofloxacin and anticoagulants, the bleeding time is prolonged.

With the simultaneous use of ciprofloxacin and cyclosporine, the nephrotoxic effect of the latter is enhanced.