Ciprofloxacin is used to treat bacterial infections in many different parts of the body. Ciprofloxacin oral liquid and tablets are also used to treat anthrax infection after inhalational exposure. This medicine is also used to treat and prevent plague (including pneumonic and septicemic plague). Ciprofloxacin may mask or delay the symptoms of syphilis. It is not effective against syphilis infections.

Ciprofloxacin extended-release tablets are only used to treat urinary tract infections, including acute uncomplicated pyelonephritis.

Proquin® XR tablets are only used to treat uncomplicated or simple urinary tract infections (acute cystitis).

Ciprofloxacin belongs to the class of drugs known as quinolone antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.

This medicine is available only with your doctor's prescription.

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

This medicine works best when there is a constant amount in the blood or urine. To help keep the amount constant, do not miss any doses. Also, it is best to take the doses at evenly spaced times, day and night. For example, if you are to take one dose a day, try to take it at the same time each day.

If you need to take this medicine for anthrax infection, your doctor will want you to begin using it as soon as possible after you are exposed to anthrax.

Swallow the extended-release tablet whole. Do not crush, split, or chew it.

Shake the oral liquid for at least 15 seconds just before each use. The oral liquid has small microcapsules floating in it. These microcapsules may look like bubbles or small beads. Do not chew the microcapsules when you take the oral liquid. Measure the oral liquid with the marked measuring spoon that comes with the bottle.

You may take this medicine with or without food. However, Proquin® XR tablets should be taken with a main meal, preferably the evening meal.

Drink plenty of fluids while you are using this medicine. Drinking extra water will help prevent some unwanted effects of ciprofloxacin.

Do not take this medicine alone with milk, yogurt, or other dairy products. Do not drink any juice with calcium added when you take this medicine. It is okay to have dairy products or juice as part of a larger meal when you take this medicine.

If you are taking aluminum or magnesium-containing antacids, iron supplements, multivitamins, didanosine (Videx®), lanthanum carbonate (Fosrenol®), sevelamer (Renagel®), sucralfate (Carafate®), or any products containing calcium or zinc, do not take them at the same time that you take this medicine. It is best to take these medicines at least 2 hours before or 4 to 6 hours after taking ciprofloxacin. These medicines may keep ciprofloxacin from working properly.

Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Diarrhea

Rare

Bloody or black, tarry stools

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

changes in skin color

changes in urination

chest pain or discomfort

chest tightness or heaviness

chills

clumsiness or unsteadiness

confusion

continuing ringing or buzzing or other unexplained noise in the ears

coughing or spitting up blood

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

fast, irregular, pounding, or racing heartbeat or pulse

fever

headache, severe and throbbing

hearing loss

hives or welts, skin rash

joint stiffness

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals

light-colored stools

muscle pain or stiffness

nausea

nightmares

numbness of the hands

pain in the joints

pain or discomfort in the arms, jaw, back, or neck

painful, red lumps under the skin, mostly on the legs

pounding in the ears

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

redness of the face, neck, arms, and occasionally, upper chest

seizures

severe abdominal or stomach pain, cramping, or burning

shakiness in the legs, arms, hands, or feet

swelling of the face, feet, or lower legs

swollen, painful, or tender lymph glands in the neck, armpit, or groin

thick, white vaginal discharge with no odor or with a mild odor

unsteadiness, trembling, or other problems with muscle control or coordination

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

vomiting

white patches in the mouth or on the tongue

yellow eyes or skin

Incidence not known

Blistering, peeling, or loosening of the skin

bluish-colored lips, fingernails, or palms

bone pain

diarrhea, watery and severe, which may also be bloody

difficulty with breathing, chewing, or talking

double vision

excessive muscle tone

feeling of discomfort

feeling, seeing, or hearing things that are not there

increased sensitivity of the skin to sunlight

increased sensitivity to pain or touch

irregular or slow heart rate

mood changes

nosebleeds

rapid heart rate

red skin lesions, often with a purple center

seeing, hearing, or feeling things that are not there

sensation of skin burning

severe sunburn

sores, ulcers, or white spots on the lips or in the mouth

unusual bleeding or bruising

unusual excitement, nervousness, or restlessness

vaginal yeast infection

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Runny nose

sneezing

stuffy nose

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

It is very important that your doctor check your or your child's progress while you are using this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to use it. Blood and urine tests may be needed to check for unwanted effects.

If your or your child's symptoms do not improve within a few days, or if they become worse, check with your doctor.

Do not use this medicine if you are also taking tizanidine (Zanaflex®). Tell your doctor if you or your child are also using theophylline (Theo-Dur®) or other products that contain caffeine (eg, coffee, soda, chocolate). Using these medicines together may increase risks for more serious side effects.

Ciprofloxacin may rarely cause inflammation (tendinitis) or tearing of a tendon (the cord that attaches muscles to bones). This can occur while you are taking the medicine or after you finish taking it. The risk of having tendon problems may be increased if you are over 60 years of age, are using steroid medicines (eg, dexamethasone, prednisolone, prednisone, Medrol®), have severe kidney problems, have a history of tendon problems (eg, rheumatoid arthritis), or if you have received an organ transplant (eg, heart, kidney, or lung). Check with your doctor right away if you have sudden pain or swelling in a tendon after exercise (eg, ankle, back of the knee or leg, shoulder, elbow, or wrist), bruise more easily after an injury, or are unable to bear weight or move the affected area. Refrain from exercise until your doctor says otherwise.

Tell your doctor right away if you have any of the following symptoms while using this medicine: convulsions (seizures), feeling anxious, confused, or depressed, seeing, hearing, or feeling things that are not there, severe headache, trouble sleeping, or unusual thoughts or behaviors.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you or your child have a rash, itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat after you take this medicine.

Serious side effects can occur during treatment with this medicine. Sometimes serious side effects can occur without warning. However, possible warning signs include: black, tarry stools, blistering, peeling, or loosening of the skin, bloody or cloudy urine, chills, decreased urination, diarrhea, fever, joint or muscle pain, red skin lesions, often with a purple center, sores, ulcers, or white spots in the mouth or on the lips, severe stomach pain, skin rash, swelling of the face, fingers, feet, or lower legs, unusual bleeding or bruising, unusual weight gain, or yellow skin or eyes. Check with your doctor immediately if you or your child notice any of these warning signs.

Check with your doctor right away if you have dark urine, clay-colored stools, abdominal or stomach pain, or yellow eyes or skin. These maybe symptoms of a serious liver problem.

Ciprofloxacin may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you or your child stop taking this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Check with your doctor right away if you or your child start having numbness, tingling, or burning pain in your hands, arms, legs, or feet. These may be symptoms of a condition called peripheral neuropathy.

Some people who take ciprofloxacin may become more sensitive to sunlight than they are normally. Exposure to sunlight, even for brief periods of time, may cause severe sunburn, skin rash, redness, itching, or discoloration. When you begin using this medicine:

Stay out of direct sunlight, especially between the hours of 10:00 AM and 3:00 PM, if possible.
Wear protective clothing, including a hat and sunglasses.
Apply a sun block product that has a sun protection factor (SPF) of at least 15. Some people may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor.
Do not use a sun lamp or tanning bed or booth.
If you have a severe reaction from the sun, check with your doctor.

Ciprofloxacin may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. If these reactions are especially bothersome, check with your doctor.

If you are a diabetic patient taking diabetes medicine by mouth: Ciprofloxacin may cause hypoglycemia (low blood sugar) in some patients. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. If you experience symptoms of low blood sugar, check with your doctor right away.

Symptoms of low blood sugar can include: anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty with concentrating, drowsiness, excessive hunger, headache, nausea, nervousness, rapid heartbeat, shakiness, or unusual tiredness or weakness.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.