Big picture summary

Ciprofloxacin, commonly called Cipro, belongs to the fluoroquinolone family of antibiotics. It works by disrupting bacterial DNA processes, preventing growth of susceptible organisms and in many cases killing them outright.

This antibiotic targets bacterial infections only and will not treat viral illnesses such as colds or influenza. Decisions to prescribe ciprofloxacin are guided by clinical assessment and, where possible, microbiology results that indicate the likely organism and its sensitivities.

Uses and Key Points

In the UK ciprofloxacin is used selectively for infections where its spectrum and pharmacology are appropriate. Common pointers include:

  • Complicated urinary tract infections, including some cases of pyelonephritis
  • Certain lower respiratory infections when other agents are unsuitable
  • Soft tissue and skin infections in specific contexts
  • Selected bone and joint infections under specialist care

Because of concerns about resistance and serious adverse symptoms, prescribers in the UK consider local antimicrobial stewardship recommendations and resistance data before selecting a fluoroquinolone. See Juridical standing and consumer buying rules in the UK for regulation-related notes.

Presentations and Typical Strengths

Ciprofloxacin is available in several preparations in the UK. The oral tablet strengths most commonly encountered are 250 mg, 500 mg and 750 mg. Injectable forms, eye drops and ear drops also exist for specific clues indicating.

Exact dosing schedules depend on the type and severity of infection, the patient age and weight, and kidney or liver function. Always follow the prescription provided by your clinician.

Before you enter Ciprofloxacin

Tell your prescriber or pharmacist about any relevant medical history, including:

  • Previous tendon problems or a diagnosis of myasthenia gravis
  • Any known heart rhythm disorders, especially prolonged QT, or electrolyte imbalance
  • Reduced renal or hepatic function
  • History noting seizures or conditions that increase seizure risk
  • Allergies to ciprofloxacin, other quinolones or any product excipient
  • Pregnancy, intent to conceive or breastfeeding
  • If the patient is a child or adolescent — specialist advice is usually required
  • Known G6PD deficiency or pre-existing peripheral neuropathy

If you have concerns about any of these items, discuss them with the clinician before taking the medicine.

A Guide for Taking Ciprofloxacin and Absorption Advice

Swallow tablets with a full glass of water and space the doses evenly through the day. Finish the complete course prescribed, even if symptoms improve before the course ends. Do not take extra doses to make up for missed ones.

Ciprofloxacin may be taken with or without food. It is generally fine to eat dairy as part of a meal, but avoid consuming the tablet at exactly the same time as a plain glass of milk or a calcium-fortified drink.

Certain minerals and antacids reduce ciprofloxacin absorption. Avoid products containing aluminium, magnesium, calcium, iron or zinc for 6 hours before and for 2 hours after a ciprofloxacin dose. For more details of the interacting with others session see Interaction Between Drugs and Hazard Warning alerts.

Paediatric dosing and formulations should be determined by a specialist clinician with experience in treating children.

Untaken dose and OD event Scenario

If you miss a scheduled dose, take it as soon as you remember unless the next dose is almost due. Do not double your intake of the medicine to compensate for a dose was not taken.

If you suspect an overdose event or the person develops severe symptoms after taking ciprofloxacin, seek urgent medical attention. In the UK call 999 for life-threatening emergencies or use NHS 111 for urgent advice. Attend the nearest emergency department when necessary.

Potential possible medication communication in action alerts during therapy with other medicines and Preventive steps

Some drugs pose a high risk when taken with ciprofloxacin and should only be combined under specialist supervision. Notable examples include:

  • Tizanidine capsule (concurrent use can cause severe sedation and low blood pressure)
  • Some drugs that prolong the QT interval or affect cardiac rhythm
  • Certain antiarrhythmics and drugs like cisapride or similar agents

Other frequently interacting categories are:

  • Antacids and mineral supplements containing aluminium, magnesium, calcium, iron or zinc
  • Sucralfate and certain formulations of didanosine
  • Warfarin and other oral anticoagulant drugs (observation and tracking of INR may be required)
  • The drug theophylline, phenytoin, methotrexate and some antiepileptics
  • Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen
  • Certain diabetes drugs that can predispose to low blood sugar
  • Caffeine-containing medicines and products (may enhance stimulant effects)
  • CsA therapy, probenecid and drugs metabolised by cytochrome P450 enzymes

This is not a full list. Provide a complete list of prescription medicines, over-the-counter remedies, herbal products and supplements to your healthcare team before starting ciprofloxacin.

Alerts, Side Effect Supervision and When to Contact a Clinician

  • If your infection does not get better or becomes worse, contact the prescriber promptly.
  • Avoid over-the-counter anti-diarrhoeal medicines without medical advice. Severe or persistent diarrhea should be evaluated for Clostridioides difficile infection.
  • Ciprofloxacin can cause dizziness, drowsiness or blurred vision. Do not drive or operate heavy machinery until you know how it affects you.
  • Photosensitivity can occur: avoid intense sunlight and use sun protection.
  • Stop the medicine and seek immediate medical advice if you develop tendon pain, swelling, new numbness or persistent tingling, or new severe mood or behavior changes.

Undesired reactions and Signals to Keep an Eye On

Get prompt medical attention for difficulty breathing signs of a serious reaction. Serious events can include:

  • Severe allergic responses such as widespread rash, facial or throat swelling, or breathing difficulties
  • Major psychiatric effects: hallucinations, severe confusion or drastic mood swings
  • Marked lightheadedness, fainting episodes or repeated falls
  • Tendon rupture, persistent tendon pain or marked joint and muscle swelling
  • Epilepsy-related seizures
  • New or worsening peripheral neuropathy: persistent tingling, numbness or weakness
  • Severe skin reactions including blistering or peeling

More common and usually less severe effects that often resolve include diarrhoea, nausea, abdominal discomfort and oral thrush. Report suspected adverse reactions via the MHRA Yellow Card scheme; see Reporting, Help and Advice.

Hazardous Block data at rest resides in storage until it is accessed. and Disposal

  • Store tablets at normal room temperature, away from direct sunlight and moisture, and keep containers tightly closed.
  • Do not store medicines above 30 degrees C. Store all medicines where children cannot reach or see them.
  • Do not use any product beyond the expiry date on the packaging.
  • Return unwanted or expired antibiotics to a pharmacy for safe disposal. Do not keep leftover antibiotics for future use or share them with others.

Different Options and Side by side price comparison (GBP)

Other fluoroquinolones related to ciprofloxacin include levofloxacin, ofloxacin and moxifloxacin. Each has its own licensed uses, safety profile and recommended vigilant monitoring.

Common non-fluoroquinolone additional an alternate paths depend on the infection:

  • Urinary tract infection: nitrofurantoin, trimethoprim, pivmecillinam or fosfomycin
  • Respiratory infections: amoxicillin, doxycycline or clarithromycin
  • Skin infections: flucloxacillin, doxycycline or clindamycin

Indicative price notes in Great Britain (approximate retail ranges in GBP; private purchase, variable between pharmacies):

  • Ciprofloxacin 250 mg tablets, pack 10: about 4 to 15 GBP
  • Ciprofloxacin 500 mg tablets, pack 10: about 7 to 25 GBP
  • Ciprofloxacin 750 mg tablets, pack 10: about 10 to 35 GBP
  • Nitrofurantoin 100 mg, pack 14: about 7 to 20 GBP
  • Trimethoprim 200 mg, pack 14: about 4 to 12 GBP
  • Doxycycline 100 mg, pack 14: about 4 to 15 GBP

NHS prescriptions in England are typically charged per item; check the current NHS prescription charge as it changes from time to time. You do not pay for prescriptions in Scotland, Wales and Northern Ireland. Prices shown here are for guidance only; confirm costs with your chosen pharmacy and ask whether consultation fees apply.

Reporting, Help and Advice

  • In a life-threatening emergency call 999 immediately. For urgent but non-life-threatening health concerns contact NHS 111.
  • To report suspected adverse drug reactions in the UK use the MHRA Yellow Card scheme online. Include as much clinical information as possible.
  • Your GP, community pharmacist or official NHS websites can provide patient information leaflets and tailored mentorship.

Note: the information on this page is for general guidance only. It does not replace professional medical assessment, diagnosis or treatment. Always follow the directions on your prescription as well as the patient information leaflet provided with your medication.

Additional aspects about Cipro