Drug Notebook

FDA Alerts

Special Alerts:

[Posted 07/08/2008] FDA notified healthcare professionals that a BOXED WARNING and Medication Guide are to be added to the prescribing information to strengthen existing warnings about the increased risk of developing tendinitis and tendon rupture in patients taking fluoroquinolones for systemic use.

Fluoroquinolones are associated with an increased risk of tendinitis and tendon rupture. This risk is further increased in those over age 60, in kidney, heart, and lung transplant recipients, and with use of concomitant steroid therapy. Physicians should advise patients, at the first sign of tendon pain, swelling, or inflammation, to stop taking the fluoroquinolone, to avoid exercise and use of the affected area, and to promptly contact their doctor about changing to a non-fluoroquinolone antimicrobial drug. Selection of a fluoroquinolone for the treatment or prevention of an infection should be limited to those conditions that are proven or strongly suspected to be caused by bacteria. For more information visit the FDA website at: http://www.fda.gov/medwatch/safety/2008/safety08.htm#Fluoroquinolone, http://www.fda.gov/cder/drug/infopage/fluoroquinolones/default.htm, http://www.fda.gov/cder/drug/InfoSheets/HCP/fluoroquinolonesHCP.htm and http://www.fda.gov/bbs/topics/NEWS/2008/NEW01858.html.

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What is the most important information I should know about ciprofloxacin?

Do not take ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified juice. You may eat or drink dairy products or calcium-fortified juice with a regular meal, but do not use them alone when taking ciprofloxacin. They could make the medication less effective. Take all of the ciprofloxacin that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated. Certain medicines should be taken at least 2 hours after or 6 hours before you take ciprofloxacin. This includes didanosine (Videx) chewable/buffered tablets or powder; sucralfate (Carafate); antacids that contain calcium, magnesium or aluminum (such as Tums or Rolaids); or vitamin or mineral supplements that contain calcium, iron, or zinc.

Taking ciprofloxacin can make your skin more sensitive to sunlight. Avoid exposure to sunlight, sun lamps, or tanning beds.

What is ciprofloxacin?

Ciprofloxacin is an antibiotic in a group of drugs called fluoroquinolones. Ciprofloxacin fights bacteria in the body.

Ciprofloxacin is used to treat different types of bacterial infections.

Ciprofloxacin may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking ciprofloxacin?

Before taking ciprofloxacin, tell your doctor if you have:

If you have any of these conditions, you may not be able to use ciprofloxacin or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C: This medication may be harmful to an unborn baby. Do not use ciprofloxacin without telling your doctor if you are pregnant. Tell your doctor if you become pregnant during treatment. Ciprofloxacin passes into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take ciprofloxacin?

Take ciprofloxacin exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor.

Take each dose with a full glass of water (8 ounces). Drink several extra glasses of fluid each day while you are taking ciprofloxacin. Shake the oral suspension (liquid) for at least 15 seconds just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

When taking the oral liquid, swallow it without chewing the medicine beads you may notice in the liquid.

Do not crush, chew or break the extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

Ciprofloxacin may be taken with or without food, but take it at the same time each day.

Do not take ciprofloxacin with dairy products such as milk or yogurt, or with calcium-fortified juice. You may eat or drink these products as part of a regular meal, but do not use them alone when taking ciprofloxacin. They could make the medication less effective. Take this medication for as many days as it has been prescribed for you even if you begin to feel better. Your symptoms may get better before the infection is completely treated. Ciprofloxacin will not treat a viral infection such as the common cold or flu. Store ciprofloxacin at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze.
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