Ciprofloxacin is a broad-spectrum antibiotic used to treat a wide range of bacterial infections such as UTI, eye, ear, lung, joint, heart, skin, stomach, and intestinal infections. It is a member of a group of antibiotics called quinolones.
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What is ciprofloxacin hcl 500 mg used for?
Ciprofloxacin hcl is a fluoroquinolone antibiotic whose chemical structure makes it effective against both gram-positive and gram-negative bacteria. It is and has been one of the most widely used antibiotics worldwide. Its use and misuse contributed to the development of drug-resistant strains of bacteria, which paired with the risk of serious side effects caused by this medication made the use of ciprofloxacin as first line treatment not recommended anymore in many cases of infections.
Ciprofloxacin may be indicated in the treatment of:
- Lower respiratory tract infections due to gram-negative bacteria
- Pneumonia
- Urinary tract infections (UTI)
- Genital tract infections such as urethritis, orchitis, and pelvic inflammatory disease (PID) due to Neisseria Gonorrhoeae
- Gastrointestinal (GI) infections
- Bone and joint infections
- Sinusitis due to gram-negative bacteria
- Skin infections due to gram-negative bacteria
- Prophylaxis for meningitis after exposure to Neisseria Meningitidis
- Anthrax inhalation
Ciprofloxacin should not be used to treat streptococcal infections, severe infections by gram-positive anaerobic pathogens, fluoroquinolone-resistant bacteria, or viral infections, nor should be used for children, pregnant or breast-feeding women unless directed by a specialist.
Ciprofloxacin dosages and formulations
Ciprofloxacin is a prescription-only medication and is available both as branded and generic drug. It is available in different forms and formulations such as eardrops, eyedrops, eye ointment, tablets, tablet extended release, suspension and combination formulation with other drugs. Some of the most common ones are:
- Ciprofloxacin 250 mg tablets
- Ciprofloxacin 500 mg tablets
- Ciprofloxacin 750 mg tablets
- Ciprofloxacin 250mg/5ml liquid
- Ciprofloxacin 0.3% w/v eye drops solution
- Ciprofloxacin ophthalmic ointment 0.3%
- Ciprofloxacin otic solution 0.3% (eardrops)
Ciprofloxacin is widely known by the brand names Ciproxin (tablets), Cipro (tablets), Proquin XR (extended release tablet), Ciloxan (eyedrops and eye ointment) and Cetraxal (ear drops).
How to take ciprofloxacin hcl?
Ciprofloxacin should be taken at the same time every day and at evenly spaced intervals, as directed by your doctor. Tablets should not be chewed and should be swallowed with water or other fluid.
The posology (formulation, dose and length of treatment) is determined by your doctor according to the condition you are being treated for, your own individual characteristics and your response to treatment. It varies between 250 mg as single dose, to 500 mg twice daily for 3-7-14-21-90 days depending on the indications.
It can be taken both with and without food but should not be taken with dairy foods or drinks, nor with calcium-fortified products such as some orange juices (see precautions below). If you take it without food, it will be absorbed more rapidly, but it may cause gastrointestinal side effects.
Ciprofloxacin 500 mg to treat UTI – Acute Cystitis
Ciprofloxacin can be prescribed to treat acute uncomplicated UTIs (Urinary Tract Infections).
In these cases, ciprofloxacin should be taken as directed by your doctor, usually as follows:
- Ciprofloxacin 250 mg, twice daily for 3 days
- Ciprofloxacin 500 mg XR (extended release), once daily for 3 days
For complicated UTI, ciprofloxacin is prescribed at a stronger dosage for a longer period of time, such as 500 mg twice daily for 7-14 days.
Ciprofloxacin should be used for uncomplicated UTIs only if no other treatment options are available for the patient, because the risk of potential serious side effects outweighs the benefits.
Ciprofloxacin against biological warfare agents: anthrax and plague
Ciprofloxacin is stocked by some government agencies to prepare for biological warfare emergencies. Ciprofloxacin may be used to treat anthrax inhalation (bacillus anthracis), pneumonic plague (Yersinia Pestis) and tularemia (Francisella Tularensis).
Ciprofloxacin for gonorrhea, chlamydia and syphilis (STDs)
Bacterial STD infections are on the rise. According to the CDC, in the USA every year since 2014 the number of STD cases has been steadily climbing. Due to the large number of cases of gonorrhea, chlamydia and syphilis around the world and of the use and misuse of antibiotic therapies, most bacteria are now resistant to one or more treatment options. It is extremely important to not try and cure any of these diseases by self-administering antibiotic therapy: antibiotic resistance varies according to your geographic location and so treatment protocols vary as well. While ciprofloxacin was once used to treat gonorrhea, now it is rarely the case with some areas of the world reporting an almost 100% rate of quinolone-resistant gonorrhea; ciprofloxacin 500 mg was also used in some cases for the treatment of chlamydia, but has never been considered the first line treatment for chlamydia infection and its use in this infection is limited to a small number of cases. Ciprofloxacin has never been used, nor has any effectiveness, against syphilis and Treponema Pallidum, for which only penicillins are indicated.
Ciprofloxacin in pregnancy and while lactating
Although data suggests that ciprofloxacin is safe to use during pregnancy, as a precautionary measure it is generally avoided due to the potential for cartilage, tendon and joint damage to the developing fetus. Ciprofloxacin is also excreted in breast milk and for the potential risk of joint damage to the baby should not be used by breast-feeding women unless otherwise directed by your specialist.
Ciprofloxacin 500 mg to prevent meningitis
People exposed to patients infected with meningitis caused by the bacteria Neisseria Meningitidis may be advised to take a post-exposure prophylaxis treatment with Ciprofloxacin 500 mg as a single dose.
How fast does ciprofloxacin work?
Ciprofloxacin starts working within a couple of hours from the moment you take it. After 36-48 hours you should be able to see some improvement already or even an apparent resolution of all symptoms within 72 hours: do not stop the treatment and finish your entire course of antibiotic as directed by your doctor; if you don’t, the infection may come back and this time it may have become resistant to ciprofloxacin treatment.
Precautions when taking ciprofloxacin
Before taking ciprofloxacin 500 mg you should tell your doctor and/or pharmacist if you ever had any allergic reaction after taking it, or after taking other quinolone antibiotics such as levofloxacin, or other medications or if you are allergic to any of the other ingredients in the formulations.
Before taking ciprofloxacin 500 mg you should also tell your doctor and/or pharmacist all other prescription and non-prescription medications you are taking, as well as supplements, vitamins, herbs due to possible drug interactions.
Calcium-rich foods, calcium supplements and antacids medications containing calcium as well as other minerals such as magnesium, aluminum, iron and zinc can cause a decreased absorption of ciprofloxacin and reduce its effectiveness. You are advised to take ciprofloxacin 2-4 hours before or 4-6 hours after any supplement, medication or calcium-rich meal. Talk to your healthcare provider about it.
Drink plenty of water while taking ciprofloxacin to prevent some of the unwanted effects caused by the antibiotic.
Alcohol does not make ciprofloxacin ineffective, but it may make side effects such as dizziness more serious. It is always best to eliminate, or at least limit, alcohol intake. Marijuana may make you dizzy as well while taking this medication, talk to your doctor if you are a cannabis user.
Always finish a course of antibiotics. Even if you start feeling better, it is very important to follow the posology prescribed; if you don’t, the infection may come back, and you may develop a difficult to treat antibiotic-resistant bacterial infection.
Ciprofloxacin may make your skin more sensitive to UV light. Avoid tanning beds, always use sunscreen outdoors and limit your time in the sun.
Never take antibiotics unless directed by a doctor. If you have some leftover ciprofloxacin, do not take it just because you think the symptoms you are experiencing now are the same that were treated by it in the past. Let your GP evaluate your symptoms and prescribe an appropriate treatment to avoid the risk of developing antibiotic-resistant difficult to treat bacterial infections.
Warnings and side effects
Like any other medication, ciprofloxacin may cause side effects such as nausea, vomiting, diarrhea, stomach pain, sleepiness and tiredness. Other rarer and more serious symptoms that may occur are:
- Rash
- Fever
- Tendinitis or tendon rupture
- Swelling (face, tongue, throat, hands, feet, …)
- Peeling or blistering of the skin
- Difficulty breathing or swallowing
If you experience any serious side effect call your doctor or seek emergency medical attention.
How to store ciprofloxacin?
Ciprofloxacin should be stored in the original box and container it came in; the container should be tightly closed and kept out of sight and reach of children. Tablets should be kept at room temperature and away from moisture or heat. The suspension form of this medication should be kept in the refrigerator for up to 14 days and then discarded. Do not freeze the ciprofloxacin suspension.
What to do if I skip a ciprofloxacin 500 mg pill?
In general, if you missed a dose you should take the pill as soon as you remember. If it is almost time for your next dose, then you should skip the missed dose and keep taking the medication according to your schedule. Do not take a double dose to make-up for the one you missed. For more information consult the patient information leaflet or ask your family doctor or pharmacist.
Important disclaimer: this is a summary with some useful information about ciprofloxacin and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for your specific case. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Sources
- Guidelines for the management of sexually transmitted infections.
World Health Organization, Jun 2021
https://www.who.int/hiv/pub/sti/en/STIGuidelines2003.pdf - Summary of Biological Warfare Agents.
New York State Department of Health
https://www.health.ny.gov/environmental/emergency/attachment_2f.htm - Ciprofloxacin HCl Highlights of Prescribing Information
US Food and Drug Administration (FDA)
https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019537s086lbl.pdf - Ciprofloxacin
UK National Health Service (NHS)
https://www.nhs.uk/medicines/ciprofloxacin/ - Ciprofloxacin
US National Library of Medicine – MedlinePlus
https://medlineplus.gov/druginfo/meds/a688016.html
