Cipro (ciprofloxacin) is a brand-name prescription antibiotic medication. It’s used to treat infections caused by bacteria.

Cipro belongs to a class of antibiotics called fluoroquinolones.

Cipro is effective for treating infections caused by many different types of bacteria. These include bacteria that cause infections in the urinary tract, abdomen, skin, prostate, and bone, as well as other types of infections.

Cipro comes in several forms:

  • tablets (Cipro)
  • extended-release tablets (Cipro XR)
  • powder for oral suspension (Cipro)

Cipro is available as a generic drug. The generic drug name is ciprofloxacin.

Ciprofloxacin (generic Cipro) is available in several forms, including:

  • oral immediate-release tablet
  • oral extended-release tablet
  • ophthalmic solution (eye drops)
  • otic solution (ear drops)
  • oral suspension
  • solution for injection

Cipro can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Cipro. This list does not include all possible side effects.

For more information on the possible side effects of Cipro, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects of Cipro include:

  • nausea
  • diarrhea
  • vomiting
  • stomach upset
  • dizziness
  • rash

Also, results from a liver function test can be higher than normal. This is usually temporary, but can also be a sign of liver damage.

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

This is not common, but in some cases, Cipro can cause more serious side effects. Call your doctor right away if you have any serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Tearing or swelling in a tendon (tissue that connects muscle to bone). Symptoms can include:
    • pain or swelling in the tendon by the heel of the foot, ankle, knee, hand or thumb, shoulder, or elbow
  • Liver damage. Symptoms can include:
    • stomach pain
    • loss of appetite
    • dark-colored urine
    • yellowing of your skin or the whites of your eyes
  • Severe allergic reaction. Symptoms can include:
    • severe rash or hives
    • trouble breathing or swallowing
    • swelling of your lips, tongue, or face
    • rapid heartbeat
  • Mood changes. Symptoms can include:
    • anxiety
    • depression
    • restlessness
    • trouble sleeping
    • hallucinations
    • suicidal thoughts
  • Seizures, tremors, or convulsions
  • Intestinal infection. Symptoms can include:
    • severe diarrhea
    • bloody stool
    • stomach cramps
    • fever
  • Nerve problems in your arms, legs, feet, or hands. Symptoms can include:
    • pain
    • burning
    • tingling
    • numbness
    • weakness
  • Severe sunburn due to skin sensitivity to ultraviolet (UV) light
  • Dangerously low blood sugar. This is more likely to happen in seniors and those with diabetes. Symptoms can include:
    • dizziness
    • confusion
    • shakiness
    • sweating
    • weakness
    • passing out
    • coma

Due to these safety concerns, the FDA has recommended that drugs such as Cipro should not be used as a first-choice antibiotic for sinus infections, bronchitis, or urinary tract infections. For these conditions, the potential risks of treatment with Cipro outweigh the benefits.

Other antibiotics should be used as a first choice.

Long-term side effects

Most Cipro side effects occur soon after the medication is taken. However, taking Cipro long-term may increase the risk of experiencing severe side effects. These long-term side effects can include tendon damage, liver damage, intestinal infection, and nerve problems.

Diarrhea

Diarrhea is a common side effect of antibiotics including Cipro. About 2 to 5 percent of people who take Cipro have diarrhea. Sometimes diarrhea can become severe with loose watery stools, bloody stools, stomach cramps, and fever. This may be due to an intestinal infection.

If you have severe diarrhea while taking Cipro, talk to your doctor. Otherwise, diarrhea typically goes away shortly after the medication is stopped.

Headache

Some people who take Cipro get headaches. In clinical studies, less than 1 percent of people had headaches while taking Cipro. These headaches are usually mild and may go away with continued use of the drug. If you get a headache that doesn't go away while you’re taking Cipro, talk to your doctor.

Yeast infection

Vaginal yeast infections can sometimes occur after treatment with antibiotics, including Cipro. If you’ve never had a yeast infection before and think you might have one, see your doctor for a diagnosis and treatment.

Side effects in children

Cipro use is typically avoided in children because it might cause joint damage in children. Symptoms of joint damage in children can include reduced joint movement and joint pain. If your child is taking Cipro and has these symptoms, call their doctor right away.

Side effects in seniors

Older adults are more likely than younger adults to have side effects from Cipro. However, the types of side effects they have are the same as those in younger adults.

Suicide prevention

  • If you think someone is at immediate risk of self-harm or hurting another person:
  • •  Call 911 or your local emergency number.
  • •  Stay with the person until help arrives.
  • •  Remove any guns, knives, medications, or other things that may cause harm.
  • •  Listen, but don’t judge, argue, threaten, or yell.
  • If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

The Food and Drug Administration (FDA) approves medications, such as Cipro, to treat certain conditions.

Approved uses for Cipro

Cipro is FDA-approved for treating many different types of infections in adults. Examples of these FDA-approved uses include:

Less common FDA-approved uses include:

Cipro XR extended-release tablets are only approved for treating urinary tract infections (UTIs).

Although Cipro is effective, the FDA has recommended that Cipro and other fluoroquinolone antibiotics should not be used as a first-choice antibiotic for certain infections, such as:

  • sinus infections
  • bronchitis
  • urinary tract infections

For these conditions, the risk of serious side effects caused by Cipro outweigh the benefits. Other antibiotics should be used as a first choice.

Uses that are not approved

Cipro is also sometimes used off-label for uses that are not approved by the FDA. Examples of these include:

Uses for ciprofloxacin

The generic version of Cipro is approved to treat all of the conditions that Cipro is approved for. In addition to those conditions, ciprofloxacin is approved to treat ear infections.

Cipro for children

Cipro is FDA-approved for use in children to treat certain infections, such as severe urinary tract infection. However, Cipro is not the first choice for use in children due to concerns that it may cause joint damage in children.

The American Academy of Pediatrics recommends that Cipro and other fluoroquinolone antibiotics only be used in children when there’s no other safe or effective option.

Cipro is an antibiotic in the class of fluoroquinolones. This type of antibiotic is bactericidal. This means that it directly kills bacteria. It does this by blocking enzymes that are needed for bacteria survival.

Cipro is a broad-spectrum antibiotic. This means it works against many different types of bacteria. However, many bacteria have grown to be resistant to Cipro. Resistant bacteria can no longer be treated with a certain drug.

How long does it take to work?

Cipro begins to work against bacterial infections within hours of when you take it. However, you may not notice improvement in your symptoms for a few days.

The Cipro dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Cipro to treat
  • your age
  • the form of Cipro you take
  • other medical conditions you may have, such as kidney disease

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

  • tablets (Cipro): 250 mg, 500 mg, 750 mg
  • extended-release tablets (Cipro XR): 500 mg, 1,000 mg
  • powder for oral suspension (Cipro): 250 mg/5 mL, 500 mg/5 mL

General dosage information

The typical dosage for immediate-release Cipro is 250–750 mg every 12 hours for up to 14 days. Your doctor will determine the best form and dosage of Cipro for your condition.

Dosage for UTI

  • Typical dosage: 250–500 mg every 12 hours for 3 to 14 days.

Dosage for bone and joint infections

  • Typical dosage: 500–750 mg every 12 hours for 4 to 8 weeks.

Dosage for diarrhea caused by infection

  • Typical dosage: 500 mg every 12 hours for 5 to 7 days.

Dosage for respiratory infections

  • Typical dosage: 500–750 mg every 12 hours for 7 to 14 days.

Dosage for sinus infections

  • Typical dosage: 500 mg every 12 hours for 10 days.

Dosage for abdominal infections

  • Typical dosage: 500 mg every 12 hours for 7 to 14 days.

Children’s dosage

  • Typical dosage: For children ages 1–17 years of age, 10–20 mg/kg every 12 hours for 7 to 21 days. The dosage should not be greater than 750 mg every 12 hours.

Dosage for Cipro XR

Cipro XR extended-release tablets are only approved for treating urinary tract infections.

  • Typical dosage: 500 mg once daily for 3 days.
  • Typical dosage for severe urinary tract infections: 1,000 mg once daily for 7 to 14 days.

Special dosage considerations

If you have kidney disease, your doctor may prescribe Cipro at a lower dose or have you take the medication less frequently.

What if I miss a dose?

If you miss a dose, take it as soon as you can. However, if it’s just a few hours until your next dose, skip the missed dose and take the next one on schedule.

Never try to catch up by taking two doses at a time. This can cause dangerous side effects.

Take Cipro exactly according to your doctor’s instructions. You might start to feel better before you finish your entire Cipro treatment. Even if you start to feel better, don’t stop taking Cipro. In many cases, it’s important to finish the entire treatment to make sure the infection doesn’t come back.

If you’re feeling better and want to stop Cipro early, be sure to talk with your doctor first to make sure it’s safe to do so.

Timing

Cipro tablets and suspension should be taken at about the same time each day in the morning and the evening.

Cipro XR extended-release tablets should be taken once daily at about the same time each day.

Taking Cipro with food

Cipro can be taken with or without food. Either way you take it, be sure to consume plenty of fluids while taking Cipro.

Cipro shouldn’t be taken along with dairy products or calcium-fortified juices. It should be taken at least two hours before or after consuming these products. However, Cipro can be taken along with a meal that contains dairy products or calcium-fortified foods or drinks.

Can Cipro be crushed?

Cipro tablets and Cipro XR extended-release tablets should not be crushed, split, or chewed. They should be swallowed whole.

Cipro suspension should be shaken well before you take it.

Cipro can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Cipro and other medications

Below is a list of medications that can interact with Cipro. This list does not contain all drugs that may interact with Cipro.

Before taking Cipro, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Antacids

Many antacids (such as Tums, Gaviscon, and Maalox) contain calcium carbonate, magnesium hydroxide, and aluminum hydroxide. These ingredients can bind to Cipro and prevent your body from absorbing it. This can decrease how well Cipro works.

To avoid this interaction, take Cipro at least two hours before taking an antacid, or six hours afterward.

Anticoagulant drugs

Taking Cipro with oral anticoagulant drugs such as warfarin (Coumadin, Jantoven) might increase the anticoagulant effects. This might result in increased bleeding. If you take an anticoagulant, your doctor may need to monitor your bleeding risk more frequently if you take Cipro.

Drugs that prolong the QT interval

Certain medications prolong your QT interval, which means they might affect the rhythm of your heartbeat. Taking Cipro with these drugs can increase the risk of having a dangerous irregular heartbeat. Cipro should be avoided or used very carefully with these medications.

Examples of these medications include:

Clozapine

Taking Cipro with clozapine (Versacloz, Fazaclo ODT) can increase the levels of clozapine in the body and increase the risk of clozapine side effects.

Diabetes drugs

Cipro can increase the blood sugar-lowering effects of certain diabetes drugs, such as glyburide (Diabeta, Glynase PresTabs) and glimepiride (Amaryl). This might cause blood sugar levels to become too low.

Methotrexate

Taking Cipro with methotrexate (Rasuvo, Otrexup) can increase the levels of methotrexate in your body and increase the risk of methotrexate side effects.

Probenecid

Probenecid can increase Cipro levels in the body and increase the risk of Cipro side effects.

Ropinirole

Taking Cipro with ropinirole (Requip, Requip XL) can increase the levels of ropinirole in the body and increase the risk of ropinirole side effects.

Phenytoin

Taking Cipro with the seizure drug phenytoin (Dilantin, Dilantin-125, Phenytek) can cause phenytoin levels in the body to become too low. This can result in uncontrolled seizures in people taking phenytoin for epilepsy.

Sildenafil

Taking Cipro with sildenafil (Viagra, Revatio) can increase the levels of sildenafil in your body and increase the risk of sildenafil side effects.

Theophylline

Taking Cipro with theophylline can increase levels of theophylline in your body. This can cause serious theophylline side effects. These include nausea, vomiting, jitters, irritability, abnormal heartbeat, heart attack, seizures, and breathing failure. Cipro and theophylline should not be taken together if possible.

Tizanidine

Cipro can increase the sedative and blood pressure effects of tizanidine (Zanaflex). Cipro and tizanidine shouldn’t be taken together.

Zolpidem

Cipro can increase the levels of zolpidem (Ambien, Ambien CR, Edluar, Intermezzo) in the body. This might result in excessive sedation from zolpidem.

Metronidazole

Cipro can prolong your QT interval, which means it might affect the rhythm of your heartbeat. In rare cases, metronidazole (Flagyl, Flagyl ER) might also cause QT interval prolongation. Using these drugs together might increase the risk of a dangerous irregular heartbeat.

Talk to your doctor before using these drugs together.

Tylenol

There are no known interactions between Cipro and Tylenol (acetaminophen).

Tinidazole

There are no known interactions between Cipro and tinidazole.

Cipro and herbs and supplements

Some vitamin and supplement products can bind to Cipro and prevent your body from absorbing it. This can decrease how well Cipro works. These supplements include:

  • multivitamins
  • calcium
  • iron
  • zinc

To avoid this interaction, you should take Cipro at least two hours before you take these supplements, or at least six hours afterward.

Cipro and foods

Cipro can interact with certain foods.

Cipro and dairy / milk

Dairy foods or calcium-fortified juice can bind to Cipro and prevent your body from absorbing it. This can decrease how well Cipro works. To avoid this interaction, you should take Cipro at least two hours before you consume these foods, or at least two hours afterward.

Cipro and caffeine

Cipro can increase the effects of caffeine consumed from coffee, tea, chocolate, and other sources. This might increase the risk of caffeine-related side effects such as nervousness, jitteriness, and trouble sleeping.

Cipro and alcohol

Taking Cipro with alcohol will not make the antibiotic less effective, but the combination might increase the risk of certain side effects or make side effects worse. Examples of side effects that might be more likely to occur, or worsened by alcohol use, include:

  • nausea
  • vomiting
  • dizziness
  • stomach upset
  • liver problems

Cipro is FDA-approved for use in children to treat certain infections, such as severe urinary tract infection. The typical dosage for children ages 1–17 years is 10–20 mg/kg every 12 hours for 7 to 21 days. The dosage should not be more than 750 mg every 12 hours.

Even though Cipro is FDA-approved for use in children, it’s not the first choice. In fact, it’s usually avoided in children due to concerns that it may damage joints in children.

The American Academy of Pediatrics recommends that Cipro and other fluoroquinolone antibiotics only be used in children when there’s no other safe or effective alternative.

There haven’t been enough studies done in pregnant humans to be sure how this drug might affect a fetus. Some research suggests that taking Cipro early in pregnancy might increase the risk of spontaneous abortion. Other studies have not found this effect on pregnancy.

Talk to your doctor if you’re pregnant or planning to become pregnant. This medication should be used during pregnancy only if the benefit justifies the potential risk.

You should not breastfeed while taking this medication. Cipro can pass through breast milk and cause side effects in a child who is breastfed.

Tell your doctor if you’re breastfeeding. You may need to decide whether to stop breastfeeding or stop taking this medication.

There are many different antibiotics that are used as alternatives to Cipro. The most appropriate antibiotic to use can depend on your age, site of the infection, the type of bacteria causing the infection, drug allergies you may have, and the geographic region you live in.

If you’re interested in alternatives to Cipro, talk with your doctor about other antibiotic options that might be appropriate for you.

Note: Some of the drugs listed here are used off-label to treat these specific infections.

Alternatives for abdominal infections

Examples of other drugs that may be used to treat abdominal infections include:

Alternatives for bone and joint infections

Examples of other drugs that may be used to treat bone and joint infections include:

  • aztreonam (Azactam)
  • ceftriaxone
  • ertapenem (Invanz)
  • levofloxacin (Levaquin)
  • metronidazole (Flagyl, Flagyl ER)
  • piperacillin-tazobactam
  • vancomycin

Alternatives for diarrhea caused by infection

Examples of other drugs that may be used to treat diarrhea caused by infection include:

Alternatives for respiratory infections

Examples of other drugs that may be used to treat respiratory infections include:

Alternatives for sinus infection

Examples of other drugs that may be used to treat sinus infection include:

Alternatives for skin infections

Examples of other drugs that may be used to treat skin infections include:

  • amoxicillin
  • cephalexin
  • clindamycin
  • doxycycline (Acticlate, Doryx, Doryx MPC)
  • trimethoprim-sulfamethoxazole (Bactrim)

Alternatives for urinary tract infection

Examples of other drugs that may be used to treat urinary tract infections include:

  • cefpodoxime
  • cephalexin (Keflex)
  • levofloxacin (Levaquin)
  • nitrofurantoin (Macrobid, Macrodantin)
  • trimethoprim-sulfamethoxazole (Bactrim)

You may wonder how other antibiotics compare to Cipro.

Cipro vs Bactrim

Cipro and Bactrim are both antibiotic drugs, but they belong to different drug classes. Cipro is a fluoroquinolone antibiotic. Bactrim is a sulfonamide antibiotic. Bactrim contains two drugs in one pill, trimethoprim and sulfamethoxazole.

Use

Cipro and Bactrim are commonly used for treating urinary tract infections (UTIs).

Dosage and forms

Cipro is available as an oral tablet and oral suspension that are taken twice daily. Cipro XR extended-release tablets are taken once daily. Bactrim is available as oral tablets and an oral suspension that are also taken twice daily.

Effectiveness

Both Cipro and Bactrim are effective for treating UTIs. However, Cipro is not a first-choice medication for this condition, due to the risk of serious side effects. Cipro should only be used for UTIs when first-choice medications cannot be used.

According to the Infectious Diseases Society of America, Bactrim is usually a first-choice antibiotic for treating UTIs.

When comparing drugs, keep in mind that your doctor will make treatment recommendations based on your individual needs. They’ll consider several factors, such as the location of your infection, bacteria that might be causing your infection, and bacterial resistance rates in your geographic area.

They’ll also consider your age, gender, childbearing potential, other conditions you may have, your risk of side effects, and how severe your condition is.

Side effects and risks

Cipro and Bactrim cause similar common side effects such as:

  • nausea
  • diarrhea
  • vomiting
  • stomach upset
  • dizziness
  • rash

People with a sulfa allergy should not take Bactrim.

Cipro is not a first-choice antibiotic for urinary tract infections due to the potential for serious side effects. These include tendon, joint, and nerve damage, and central nervous system side effects.

Costs

Cipro and Bactrim are both brand-name drugs. They’re both also available in generic forms. Generic drugs usually cost less than brand-name drugs. The generic name of Bactrim is trimethoprim-sulfamethoxazole.

Brand-name Cipro is usually more expensive than brand-name Bactrim. The generic forms of these medications cost about the same. The actual amount you pay will depend on your insurance.

Cipro vs. Macrobid

Cipro and Macrobid (nitrofurantoin) are both antibiotic drugs, but they belong to different drug classes. Cipro is a fluoroquinolone antibiotic. Macrobid is a nitrofuran antibiotic.

Use

Cipro and Macrobid are commonly used to treat urinary tract infections (UTI). However, Macrobid is only for mild or uncomplicated UTIs. It should not be used for more severe UTIs or kidney infections.

Cipro is sometimes used for more severe UTIs or kidney infections, but it’s not a first-choice antibiotic due to the risk of serious side effects.

Dosage and forms

Cipro is available as an oral tablet and oral suspension that are taken twice daily. Cipro XR extended-release tablets are taken once daily. Macrobid is available as an oral capsule that’s taken twice daily.

Effectiveness

Both Cipro and Macrobid are effective for treating mild or uncomplicated urinary tract infections. However, according to the Infectious Diseases Society of America, Macrobid is usually a first-choice antibiotic for treating urinary tract infections.

Cipro should only be used for urinary tract infections when first-choice medications cannot be used. Cipro is not a first-choice medication for urinary tract infections due to the risk of serious side effects.

When comparing drugs, keep in mind that your doctor will make treatment recommendations based on your individual needs. They’ll consider several factors, such as the location of your infection, bacteria that might be causing your infection, and bacterial resistance rates in your area.

They’ll also consider your age, gender, childbearing potential, other conditions you may have, your risk of side effects, and how severe your condition is.

Side effects and risks

Cipro and Macrobid have some similar side effects, and some that differ. Below are examples of these side effects.

Both Cipro and MacrobidCiproMacrobid
More common side effects• nausea
• headache
• flatulence
• rash
• upset stomach
• dizziness
(no unique common side effects)
Serious side effects• nerve damage• tendon damage
• joint damage
• central nervous system side effects
• liver damage
• lung damage

Costs

Cipro and Macrobid are both brand-name drugs. They’re both also available in generic forms. Generic drugs usually cost less than brand-name drugs. The generic name of Macrobid is nitrofurantoin.

Brand-name Cipro is usually more expensive than brand-name Macrobid. The generic form of Macrobid is usually more expensive than generic Cipro. The actual amount you pay will depend on your insurance.

Cipro vs. Levaquin

Cipro and Levaquin (levofloxacin) are both fluoroquinolone antibiotics.

Use

Cipro and Levaquin are FDA-approved for many similar uses. Examples of these include:

  • urinary tract infection
  • pneumonia
  • skin infections
  • sinus infection
  • prostate infection

Cipro is also FDA-approved to treat abdominal and bone and joint infections.

Dosage and forms

Cipro is available as an oral tablet and oral suspension that are taken twice daily. Cipro XR extended-release tablets are taken once daily.

Levaquin is available as an oral tablet that’s taken once daily.

Effectiveness

Both Cipro and Levaquin are effective for their FDA-approved uses. However, the FDA has recommended that Cipro and other fluoroquinolone antibiotics, including Levaquin, not be used as a first-choice antibiotic for certain infections. These include:

  • sinus infections
  • bronchitis
  • urinary tract infections

For these conditions, the risk of serious side effects caused by Cipro and Levaquin outweigh their benefits. Other antibiotics should be used as a first choice.

When comparing drugs, keep in mind that your doctor will make treatment recommendations based on your individual needs. They’ll consider several factors, such as the location of your infection, bacteria that might be causing your infection, and bacterial resistance rates in your area.

They’ll also consider your age, gender, childbearing potential, other conditions you may have, your risk of side effects, and how severe your condition is.

Side effects and risks

Cipro and Levaquin have similar common and serious side effects.

The more common side effects of Cipro and Levaquin include:

  • nausea
  • diarrhea
  • vomiting
  • stomach upset
  • dizziness
  • rash

Cipro and Levaquin can also cause similar serious side effects including:

  • tendon tearing or swelling
  • liver damage
  • severe allergic reaction
  • mood changes
  • seizures, tremors, or convulsions
  • intestinal infection
  • nerve problems

Because of these serious side effects, Cipro and Levaquin are often not considered first-choice antibiotics.

Costs

Cipro and Levaquin are both brand-name drugs. They’re both also available in generic forms. Generic drugs usually cost less than brand-name drugs. The generic name of Levaquin is levofloxacin.

Brand-name Levaquin is usually more expensive than brand-name Cipro. The generic forms of Cipro and Levaquin cost about the same. The actual amount you pay will depend on your insurance.

Cipro vs. Keflex

Cipro and Keflex (cephalexin) are both antibiotics, but they belong to different drug classes. Cipro is a fluoroquinolone antibiotic. Keflex is a cephalosporin antibiotic.

Use

Cipro and Keflex are both FDA-approved to treat some similar infections. Examples of these include:

  • urinary tract infection
  • pneumonia
  • skin infections
  • prostate infection
  • bone and joint infections

Cipro is also FDA-approved for abdominal infections.

Drug forms

Cipro is available as an oral tablet and oral suspension that are taken twice daily. Cipro XR extended-release tablets are taken once daily.

Keflex is available as an oral capsule that’s taken two to four times daily.

Effectiveness

Cipro and Keflex are both effective for their FDA-approved uses. However, they’re not always considered a first-choice antibiotic. This may be because they’re less studied than other medications, or it may be due to the risk of side effects.

The FDA has recommended that Cipro and other fluoroquinolone antibiotics not be used as a first-choice antibiotic for certain infections. These include:

  • sinus infections
  • bronchitis
  • urinary tract infections

For these conditions, the risk of serious side effects caused by Cipro outweigh its benefits. Other antibiotics should be used as a first choice.

When comparing drugs, keep in mind that your doctor will make treatment recommendations based on your individual needs. They’ll consider several factors, such as the location of your infection, bacteria that might be causing your infection, and bacterial resistance rates in your area.

They’ll also consider your age, gender, childbearing potential, other conditions you may have, your risk of side effects, and how severe your condition is.

Side effects and risks

Cipro and Keflex have some similar common and serious side effects. Examples of these side effects are included below.

Both Cipro and KeflexCiproKeflex
More common side effects• nausea
• diarrhea
• vomiting
• stomach upset or pain
• dizziness
• rash
• headache
(no unique common side effects)(no unique common side effects)
Serious side effects• liver damage
• severe allergic reaction
• seizures, tremors, or convulsions
• intestinal infections
• tendon damage
• mood changes
• nerve problems
(no unique serious side effects)

Costs

Cipro and Keflex are both brand-name drugs. They’re both also available in generic forms. Generic drugs usually cost less than brand-name drugs. The generic name of Keflex is cephalexin.

Brand-name Keflex is usually more expensive than brand-name Cipro. The generic forms of Cipro and Keflex cost about the same. The actual amount you pay will depend on your insurance.

Here are answers to some common questions about Cipro.

Will I need to use Cipro long-term?

In most cases, Cipro treatment is short term, from 3 to 14 days. But for some infections, such as certain bone or joint infections, treatment may last several weeks.

Does Cipro make you tired?

Cipro does not usually cause you to feel tired, but in some cases, people report feeling tired while taking it. It’s common for people who have infections to feel fatigued or more tired than usual. Feeling more tired than usual may be due to your condition rather than the medication.

Is Cipro an antibiotic?

Yes, Cipro is an antibiotic.

Is Cipro a type of penicillin?

No, Cipro is not a penicillin. Cipro is a fluoroquinolone antibiotic.

Taking too much Cipro can increase your risk of harmful or serious side effects.

Overdose symptoms

Symptoms of an overdose of Cipro can include:

  • nausea
  • diarrhea
  • vomiting
  • stomach upset
  • dizziness
  • anxiety
  • liver damage
  • kidney damage
  • nerve damage
  • tendon damage

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Cipro is sometimes prescribed by veterinarians to treat infections in dogs and cats. It’s commonly used for urinary tract infections, and may also be used for other kinds of infections.

If you think your dog or cat has an infection, see your veterinarian for an evaluation and treatment. Different doses are used for animals than humans, so don’t try to treat your pet with a Cipro prescription intended for humans.

If you think your pet has eaten your prescription of Cipro, call your veterinarian right away.

Cipro and other fluoroquinolone antibiotics can cause a falsely positive result for opioids on urine drug screenings. If you’re taking Cipro, consider disclosing this information before completing a drug screening.

How long Cipro stays in your system varies from person to person, but it’s usually one to two days.

Before taking Cipro, talk with your doctor about your health history. Cipro may not be appropriate for you if you have certain medical conditions.

For people with diabetes: Cipro and other fluoroquinolones can sometimes cause severe low blood sugar. This is more likely to happen in those with diabetes who are taking hypoglycemic drugs. You may need to monitor your blood sugar levels more closely if you take Cipro.

If your blood sugar gets too low, call your doctor. You may need to stop taking Cipro.

For people with myasthenia gravis: Cipro and other fluoroquinolone antibiotics can worsen muscle weakness in people with this condition. If you have myasthenia gravis, you should not take Cipro.

For people with QT interval prolongation: People with QT interval prolongation have a higher risk of having a potentially serious irregular heartbeat. Taking Cipro might worsen this condition, resulting in a life-threatening arrhythmia.

Sun exposure: Cipro can make your skin more sensitive to sunlight. You may be more likely to get a severe sunburn while taking Cipro.

When Cipro is dispensed from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically one year from the date the medication was dispensed. Oral suspensions often have a much earlier expiration date.

The purpose of such expiration dates is to guarantee the effectiveness of the medication during this time.

The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. However, an FDA study showed that many medications may still be good beyond the expiration date listed on the bottle.

How long a medication remains good can depend on many factors, including how and where the medication is stored. Cipro should be stored at room temperature in its original container.

If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

The following information is provided for clinicians and other healthcare professionals.

Mechanism of action

Cipro is a fluoroquinolone antibiotic that has bactericidal effects through inhibition of bacteria DNA gyrase and topoisomerase IV. These enzymes are required for bacterial DNA replication, transcription, repair, and recombination.

Pharmacokinetics and metabolism

The bioavailability of Cipro is about 70 percent when taken orally. Maximum blood concentrations occur within one to two hours.

Food delays Cipro tablet absorption, resulting in peak levels occurring closer to two hours, but does not delay absorption of Cipro suspension. However, food does not change overall absorption and peak levels of Cipro tablet or suspension.

About 40 percent to 50 percent of Cipro is excreted in the urine unchanged. Urinary excretion of Cipro is complete within about 24 hours after dosing.

The half-life of Cipro about four to five hours for adults and children. In people with reduced kidney function, it may increase to six to nine hours.

Contraindications

Cipro is contraindicated in people with a history of hypersensitivity to Cipro or to any other fluoroquinolone antibiotic.

Concomitant administration with tizanidine is also contraindicated due to potentiation of sedative and hypotensive effects of tizanidine.

Storage

Cipro tablets should be stored at room temperature between 68°F and 77°F (20°C and 25°C).

Reconstituted Cipro suspension should also be stored at room temperature for up to 14 days. The suspension should not be frozen.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.