Ciprofloxacin  (Brand Name: Ciproxin) belongs to a group of broad-spectrum antimicrobial drugs known as fluoroquinolones.

It is the most active second-generation fluoroquinolone against a wide range of bacteria susceptible to Gram-negative aerobic rods, especially the Enterobacteriaceae Neisseria. [1]

Ciprofloxacin is effective against Staphylococcus aureus and Staphylococcus epidermidis. It is active against susceptible strains of Staphylococcus aureus and is not effective against Methicillin-Resistant Staphylococcus aureus.

Ciprofloxacin (Ciproxin) has excellent activity against gram-negative bacteria, but enterococci, Streptococcus group A, B, D and streptococcal viridans with moderate susceptibility to ciprofloxacin.

It is also very effective against Mycobacterium tuberculosis and M.Kansasii M.Fortuitum.If used alone is not effective against M. avium infections caused by M. avium infection. They must be combined with other tuberculosis drugs, rifampicin and ethambutol.

Ciprofloxacin (Ciproxin Tablet)

Other Brands:

• Novidat Manufactured By Sami Pharmaceutical Pvt Limited.
• Novidat is available in Dry Powder For Suspension. 125mg/5ml.
• Novidat Tablet 500mg.
• Novidat Injection 200 mg 1 Vialx100 mg.
• Mercip 500mg tablet manufactured By Merck.

Uses of Ciprofloxacin

Ciprofloxacin (Ciproxin) works against a variety of infections, some of which are difficult to treat. It’s broad-spectrum, its oral effectiveness, and its good tolerability is often used to treat infections. Still, it should not be used for minor infections. or anaerobes are mainly causative. In severe cases, treatment by intravenous infusion may be initiated, then continue with the oral. Ciproxin is used to treat bacterial infections, for example:

• Urinary tract infections (UTIs) caused by certain bacteria such as E. coli.
• Cervical and urethral gonorrhoea due to Neisseria gonorrhoeae
• Typhoid
• Skin infections
• Bone infections
• Joint infections
• Uncomplicated acute cystitis
• Chronic bacterial prostatitis
• Meningitis
• Pulmonary or respiratory tract infections, for example, tuberculosis, lower respiratory tract infections, and chronic bronchitis) Pneumonia and sepsis caused by Yersinia pestis (Y. pestis).
• Infectious diarrhoea caused by E. coli, Campylobacter jejuni, and Shigella.
• Prophylaxis of Infections in neutropenic / cancer patients and other sensitive patients.
• Patients with anthrax with fever and low white blood cell count as well as intra-abdominal infections.

Ciproxin Pharmacokinetics

Mechanism of action Of Ciprofloxacin (Ciproxin)

Ciprofloxacin ( Ciproxin ) inhibits DNA synthesis in microorganisms by inhibiting the bacterial topoisomerase enzyme DNA (DNA gyrase). This prevents relaxation of the supercoiled DNA and thus prevents normal transcription and replication in the body.

When we give the patient Ciprofloxacin (Ciproxin), ciprofloxacin enters into Bacteria through passive diffusion and approaches Topoisomerase enzyme. They bind to the enzyme’s DNA gyrase domain and block or inhibit it, so the other domain (nuclease) keeps on cutting the overtwisted DNA. Still, the Ligase point Can’t reseal it because of Ciprofloxacin (Ciproxin), and in the end, all the bacteria divided into fragments and bacterial death occur.

Side effects Of Ciprofloxacin (Ciproxin)

Ciprofloxacin ( Ciproxin ) has a good safety profile, and side effects are present in only 10% of cases, but they are generally mild. Here are some of the side effects associated with the use of Ciproxin.

• Nausea, vomiting, and diarrhoea may occur.
• Ciprofloxacin may affect the clearance of theophylline and cause an increase in serum concentration.
• Headaches, insomnia, dizziness, liver problems and rashes can sometimes occur.
• Ciprofloxacin can cause tendonitis, which is a serious complication in adults and can cause tendon rupture. Although tendonitis rarely occurs (some cases have been reported), but is more common in elderly failure, renal failure, and renal failure in people with corticosteroids.
• Skin / Hypersensitivity are rashes, itching, photosensitivity, swelling of the lips, urination, and swelling. Serious skin reactions are rare.
• Ciprofloxacin use for long periods can lead to oral candidiasis or a new yeast infection such as white spots in the mouth, a change in vaginal discharge.
• It can destroy your beneficial bacteria, so you need to take probiotics to flourish your gut flora. One such product is synbiotic 365.

Ciprofloxacin Black Box Warning

Ciprofloxacin Interaction 

Some medicines may affect the action of ciprofloxacin, and ciprofloxacin may affect other medicines you ingest.

• Many antacids, vitamins, and supplements containing magnesium, calcium, aluminium, iron or zinc can interfere with ciprofloxacin.
• Other over-the-counter medicines, including painkillers and fever medicines such as ibuprofen and naproxen, may also interact with ciprofloxacin.
• Ciprofloxacin can increase the effects of caffeine.
• If you are taking caffeine-containing drinks or over-the-counter medications that contain caffeine while you are taking ciprofloxacin, you may have some side effects of caffeine, such as nervousness, insomnia, or anxiety.
• You may not be able to take Ciprofloxacin if you also take the drug Theophylline to treat asthma and wheezing.
• Severe reactions such as heart attack decreased the ability to breathe, and seizures have occurred when people have taken these drugs together.

Other drugs that interact with ciprofloxacin are:

• Anticoagulants like warfarin.
• Anticonvulsant drugs, including phenytoin.
• Certain antidepressants and drugs for the treatment of mental illnesses, such as clozapine.
• Caffeine-containing drugs
• The immunosuppressant cyclosporine.
• The muscle relaxant tizanidine
• Diuretics (water pills)
• Certain medications for an irregular heartbeat, such as amiodarone, disopyramide, and procainamide.
• The drug for arthritis methotrexate.
• A drug used to treat nausea, vomiting, heartburn, and reflux called metoclopramide.
• Type 2 diabetes drug Glyburide.
• Some nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.

Ciprofloxacin Use in Specific Population

Ciprofloxacin during Pregnancy

Ciprofloxacin Nursing Mothers

This antibiotic is excreted in milk, and therefore it is best to avoid it while breastfeeding or consult your doctor before using this medicine if you are a nursing mother.

Ciproxin in Pediatrics population

Although it is effective in paediatrics still it is not a drug of choice because of adverse effects caused by this medicine.  Always consult your doctor before using any medicine.

Ciprofloxacin Contraindications

This drug is contraindicated in people with hypersensitivity to Ciprofloxacin or any other similar drugs in this group.

Concomitant use of this drug with Tizanidine is contraindicated.

Dosage of Ciprofloxacin (Ciproxin)

• The usual recommended dose for urinary tract infections in adults is 200 to 400 mg IV every 8 to 12 hours for 7 to 14 days, while the oral dose once 250 to 500 mg orally every 12 hours for 7 to 14 days.
• The usual adult dose for a soft tissue infection or skin is 400 mg IV every 8 to 12 hours, and orally 500 to 750 mg orally every 12 hours for 7 to 14 days.
• The usual adult dose for infectious diarrhoea is 500 mg orally every 12 hours for 5-7 days.
• The usual adult dose for pneumonia is 400 mg iv every 8 to 12 hours, and the oral dose of 500 to 750 mg orally every 12 hours for 7 to 14 days.
• The usual adult dose for joint infection is 400 mg iv every 8 to 12 hours, and an oral dose of 500 to 750 mg orally every 12 hours for 4 to 8 weeks.
• The usual adult dose for sinusitis is 400 mg IV every 12 hours, and an oral dose of 500 mg orally every 12 hours for 10 days.
• The usual adult dose for typhoid fever is 500 mg orally every 12 hours for 10 days.
• The common adult dose for gonococcal infection – uncomplicated is 250 mg orally once.
• The usual adult dose for Chancroid is 500 mg orally, twice daily for 3 days.
• The usual preoperative dose for surgical prophylaxis is 400 mg intravenously, starting within 120 minutes of the surgical incision.

Ciprofloxacin Usage

To reduce the development of resistance and maintain the effectiveness of Ciprofloxacin and other antibiotics, it should be used only to treat or prevent infection that is proven to be caused by susceptible bacteria.

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