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Ciprofloxacin: Brands, Price & Uses in Bangladesh
Ciprofloxacin is a fluoroquinolone antibiotic used to treat a range of bacterial infections caused by susceptible organisms.
About Ciprofloxacin
Indications of Ciprofloxacin
Ciprofloxacin is a fluoroquinolone antibiotic used to treat a range of bacterial infections caused by susceptible organisms. Indications vary in the strength of supporting evidence, and fluoroquinolones should generally be reserved for infections with no other treatment option due to safety concerns (see Precautions and Warnings).
FDA-Approved / Established Uses
- Uncomplicated and complicated urinary tract infections (UTIs), including acute pyelonephritis
- Acute uncomplicated cystitis in women
- Chronic bacterial prostatitis
- Lower respiratory tract infections, including acute exacerbations of chronic bronchitis and nosocomial pneumonia
- Acute sinusitis
- Skin and skin-structure infections
- Bone and joint infections
- Complicated intra-abdominal infections (used in combination with metronidazole)
- Infectious diarrhea (including traveler's diarrhea) caused by susceptible organisms
- Typhoid fever (enteric fever) caused by susceptible Salmonella typhi
- Inhalational anthrax (post-exposure prophylaxis and treatment, as part of a combination regimen)
- Plague (treatment and post-exposure prophylaxis)
Guideline-Supported / Adjunct Uses
- Complicated intra-abdominal infections — used together with an antianaerobic agent (e.g., metronidazole), not as monotherapy
- Certain sexually transmitted infections in regions with documented local susceptibility (increasingly limited by resistance; local guidelines should be followed)
Ciprofloxacin should be reserved for infections proven or strongly suspected to be caused by susceptible bacteria, and should not be used for infections that are typically self-limiting or non-bacterial (e.g., most acute bronchitis) unless no other treatment option is suitable.
Dosage & Administration of Ciprofloxacin
Ciprofloxacin dosing is indication-specific and depends on infection severity and renal function. Representative adult and pediatric regimens are summarized below; the prescribing physician's instructions should always take precedence.
| Indication | Adult Dose | Typical Duration |
|---|---|---|
| Acute uncomplicated cystitis (UTI) | 250 mg orally every 12 hours | 3 days |
| Complicated UTI / acute pyelonephritis | 500 mg orally every 12 hours, or 400 mg IV every 12 hours | 7–14 days |
| Chronic bacterial prostatitis | 500 mg orally every 12 hours | 28 days |
| Lower respiratory tract infections | 500–750 mg orally every 12 hours, or 400 mg IV every 8–12 hours | 7–14 days |
| Acute sinusitis | 500 mg orally every 12 hours | 10 days |
| Skin/skin-structure infections | 500–750 mg orally every 12 hours | 7–14 days |
| Bone and joint infections | 500–750 mg orally every 12 hours | 4–6 weeks |
| Complicated intra-abdominal infections (with metronidazole) | 500 mg orally every 12 hours, or 400 mg IV every 12 hours | 7–14 days |
| Infectious diarrhea | 500 mg orally every 12 hours | 5–7 days |
| Typhoid (enteric) fever* | 500 mg orally every 12 hours | 10 days |
| Inhalational anthrax (post-exposure prophylaxis/treatment) | 500 mg orally every 12 hours, or 400 mg IV every 12 hours (combination therapy for active infection) | Up to 60 days |
| Plague | 500–750 mg orally every 12 hours, or 400 mg IV every 12 hours | 14 days |
*Where used for typhoid fever, treatment should be guided by local antimicrobial susceptibility patterns and physician judgment, as resistance is increasingly reported.
Renal Impairment (Adult)
| Creatinine Clearance | Dose Adjustment |
|---|---|
| >50 mL/min | No adjustment needed |
| 30–50 mL/min | 250–500 mg every 12 hours |
| 5–29 mL/min | 250–500 mg every 18 hours |
| Hemodialysis/peritoneal dialysis | 250–500 mg every 24 hours, after dialysis on dialysis days |
Ciprofloxacin tablets may be taken with or without food, but should not be taken with dairy products or calcium-fortified juices alone, as this reduces absorption. Antacids, sucralfate, and multivitamins/minerals containing iron, zinc, or calcium should be avoided within 2 hours before or 6 hours after a dose of Ciprofloxacin (see Interactions). Patients should drink plenty of fluids while taking Ciprofloxacin.
Antibiotic stewardship: Take Ciprofloxacin exactly as prescribed by your physician; do not stop, extend, skip doses, or share this medicine with others without medical advice, even if symptoms improve before the course is completed.
Side Effects of Ciprofloxacin
Most adverse effects associated with Ciprofloxacin are mild to moderate, but the drug carries a boxed warning for certain serious, potentially irreversible reactions (see Precautions and Warnings).
Common
- Nausea
- Diarrhea
- Headache
- Dizziness
- Abdominal pain/discomfort
- Rash
- Elevated liver enzymes (transient)
Less Common / Serious (see Precautions and Warnings for detail)
- Tendinitis and tendon rupture
- Peripheral neuropathy
- Central nervous system effects (seizures, confusion, hallucinations, increased intracranial pressure)
- QT prolongation and cardiac arrhythmia
- Aortic aneurysm and aortic dissection
- Clostridioides difficile-associated diarrhea/colitis
- Hypersensitivity reactions, including anaphylaxis and severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
- Photosensitivity/phototoxicity reactions
- Hemolytic anemia (particularly in patients with G6PD deficiency)
- Blood glucose disturbances (hypoglycemia or hyperglycemia)
Contraindications of Ciprofloxacin
Ciprofloxacin is contraindicated in:
- Patients with known hypersensitivity to Ciprofloxacin, other fluoroquinolone antibiotics, or any component of the formulation.
- Patients receiving concurrent tizanidine therapy, due to the risk of significant hypotension and sedation.
- Patients with myasthenia gravis, as fluoroquinolones may exacerbate muscle weakness and precipitate respiratory failure.
Frequently Asked Questions about Ciprofloxacin
What is Ciprofloxacin used for?
Ciprofloxacin is a fluoroquinolone antibiotic used to treat bacterial infections of the urinary tract, respiratory tract, skin, bones and joints, gastrointestinal tract, and certain serious infections such as typhoid fever, anthrax, and plague, as directed by a physician.
How should I take Ciprofloxacin?
Ciprofloxacin should be taken exactly as prescribed, at evenly spaced times each day, with plenty of fluids. Avoid taking it at the same time as dairy products, calcium-fortified juices, antacids, or iron/zinc supplements — separate these by at least 2 hours before or 6 hours after your dose. Complete the full course even if you feel better before finishing it.
Can I take Ciprofloxacin during pregnancy?
Ciprofloxacin should generally be avoided during pregnancy because of potential effects on fetal cartilage development, and used only if no safer alternative antibiotic is suitable and a physician determines the benefit outweighs the risk. Always consult your physician before use during pregnancy.
What are the common side effects of Ciprofloxacin?
The most common side effects of Ciprofloxacin include nausea, diarrhea, headache, dizziness, and abdominal discomfort. However, Ciprofloxacin also carries a boxed warning for rare but serious effects including tendon rupture, nerve damage (peripheral neuropathy), and central nervous system effects — contact your physician immediately if you notice tendon pain, tingling/numbness, or confusion.
Who should not take Ciprofloxacin?
Ciprofloxacin should not be taken by anyone with a known allergy to it or other fluoroquinolone antibiotics, anyone taking tizanidine, or anyone with myasthenia gravis, since it may worsen muscle weakness in this condition.
Can children take Ciprofloxacin?
Ciprofloxacin is generally avoided in children due to a potential risk to developing joints and cartilage, but it may be used in specific situations such as complicated urinary tract infections or anthrax/plague exposure, only under close physician supervision with weight-based dosing.
What should I do if I miss a dose or take too much Ciprofloxacin?
If you miss a dose of Ciprofloxacin, take it as soon as you remember unless it is almost time for the next dose — do not double the dose. If you suspect an overdose of Ciprofloxacin, seek immediate medical attention or contact a poison control center right away.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.