Product Details

Ciprotab 500mg Tablets Product Information

What you need to know before you take Ciprofloxacin tablets
Quinolone antibiotics may cause an increase of your blood sugar levels above normal levels (hyperglycaemia), or lowering of your blood sugar levels below normal levels, potentially leading to loss of consciousness (hypoglycaemic coma) in severe cases (see section4). This is important for people who have diabetes. If you suffer from diabetes, your blood sugar should be carefully monitored.
Do not take Ciprofloxacin if you:
 are allergic (hypersensitive) to the Ciprofloxacin, to any other quinolone drugs or to any of the other ingredients of Ciprofloxacin tablets (see section 6).
 are taking tizanidine (see Section 2: Taking other medicines).
Warnings and precautions:
Talk to your doctor, pharmacist or nurse before taking Ciprofloxacin Tablets if:
 you suffer from ‘fits’ or epilepsy or any other neurological conditions.
 you have ever had kidney problems because your treatment may need to be adjusted
 you have a history of tendon problems during previous treatment with antibiotics such as Ciprofloxacin
 you are diabetic because you may experience a risk of hypoglycaemia with ciprofloxacin. you have myasthenia gravis (a type of muscle weakness) because symptoms can be exacerbated.
 you or a member of your family is known to have a deficiency in glucose-6-phosphate dehydrogenase (G6PD), since you may experience a risk of anaemia with ciprofloxacin.
 If your eyesight becomes impaired or if your eyes seem to be otherwise affected, consult an eye specialist immediately
Heart problems
 Caution should be taken when using this kind of medicine, if you were born with or have family history of prolonged QT interval (seen on ECG, electrical recording of the heart), have salt imbalance in the blood (especially low level of potassium or magnesium in the blood), have a very slow heart rhythm (called ‘bradycardia’), have a weak heart (heart failure), have a history of heart attack (myocardial infarction), you are female or elderly or you are taking other medicines that result in abnormal ECG changes (see section Taking other medicines).
For the treatment of some genital tract infections, your doctor can prescribe another antibiotic in addition to ciprofloxacin. If there is no improvement in symptoms after 3 days of treatment, please consult your doctor.
Contact your doctor immediately, if any of the following occurs while taking
Ciprofloxacin. Your doctor will decide whether treatment with Ciprofloxacin needs to be stopped.
 Severe, sudden allergic reaction (an anaphylactic reaction/shock, angio-oedema). Even with the first dose, there is a small chance that you may experience a severe allergic reaction with the following symptoms: tightness in the chest, feeling dizzy, sick or faint, or experiencing dizziness when standing up. If this happens, stop taking Ciprofloxacin tablets and contact your doctor immediately.
 If your eyesight becomes impaired or if your eyes seem to be otherwise affected, consult an eye specialist immediately.
 Pain and swelling in the joints and tendinitis may occur occasionally, particularly if you are elderly and are also being treated with corticosteroids. Inflammation and ruptures of tendons may occur even within the first 48 hours of treatment or up to several months after discontinuation of Ciprofloxacin tablets therapy. At the first sign of any pain or inflammation stop taking Ciprofloxacin tablets and rest the painful area. Avoid any unnecessary exercise, as this might increase the risk of a tendon rupture.
 If you suffer from epilepsy or other neurological conditions such as cerebral ischemia or stroke, you may experience side effects associated with the central nervous system. If this happens, stop taking Ciprofloxacin tablets and contact your doctor immediately.
 You may experience psychiatric reactions the first time you take Ciprofloxacin tablets.
If you suffer from depression or psychosis, your symptoms may become worse under treatment with Ciprofloxacin tablets. In rare cases, depression or psychosis can progress to thoughts of suicide, suicide attempts, or completed suicide. If this happens, stop taking
Ciprofloxacin tablets and contact your doctor immediately.
 You may experience symptoms of neuropathy such as pain, burning, tingling, numbness and/or weakness. If this happens, stop taking Ciprofloxacin tablets and contact your doctor immediately.
 Hypoglycemia has been reported most often in diabetic patients, predominantly in elderly population. If this happens, contact your doctor immediately.
 Diarrhoea may develop while you are taking antibiotics, including Ciprofloxacin tablets, or even several weeks after you have stopped taking them. If it becomes severe or persistent or you notice that your stool contains blood or mucus, stop taking Ciprofloxacin tablets immediately, as this can be life-threatening. Do not take medicines that stop or slow down bowel movements and contact your doctor.
 Tell the doctor or laboratory staff that you are taking Ciprofloxacin tablets if you have to provide a blood or urine sample.
 If you suffer from kidney problems, tell the doctor because your dose may need to be adjusted.
 Ciprofloxacin tablets may cause liver damage. If you notice any symptoms such as loss of appetite, jaundice (yellowing of the skin), dark urine, itching, or tenderness of the stomach, stop taking Ciprofloxacin tablets and contact your doctor immediately.
 Ciprofloxacin tablets may cause a reduction in the number of white blood cells and your resistance to infection may be decreased. If you experience an infection with symptoms such as fever and serious deterioration of your general condition, or fever with local infection symptoms such as sore throat/pharynx/mouth or urinary problems you should see your doctor immediately. A blood test will be taken to check possible reduction of white blood cells (agranulocytosis). It is important to inform your doctor about your medicine.
 Your skin becomes more sensitive to sunlight or ultraviolet (UV) light when taking Ciprofloxacin tablets. Avoid exposure to strong sunlight, or artificial UV light such as sunbeds.
Other medicines and Ciprofloxacin:
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including those medicines obtained without a prescription.
Ciprofloxacin can increase the level of the following substances in the blood:
 Agomelatine,
 Zolpidem
Do not take Ciprofloxacin together with tizanidine, because this may cause side effects such as low blood pressure and sleepiness (see Section 2: “Do not take Ciprofloxacin”).
The following medicines are known to interact with Ciprofloxacin in your body. Taking
Ciprofloxacin together with these medicines can influence the therapeutic effect of those
medicines. It can also increase the probability of experiencing side effects.
Tell your doctor if you are taking:
 Vitamin K antagonists (e.g. warfarin, acenocoumarol, phenprocoumon or fluindione) or
other oral anti-coagulants (to thin the blood)
 theophylline (for breathing problems)
 phenytoin (used to treat epilepsy)
 ropinirole (for Parkinson’s disease)
 phenytoin (for epilepsy)
 cyclosporin (used to treat psoriasis, dermatitis, rheumatoid arthritis and in organ
transplantation)
 probenecid (used to prevent gout)
 metoclopramide (used to treat nausea and vomiting (feeling/being sick) and migraine)
 ropinirole (used to treat Parkinson’s disease)
 methotrexate (for certain types of cancer, psoriasis, rheumatoid arthritis)
 tizanidine (for muscle spasticity in multiple sclerosis)
 clozapine (an antipsychotic)
 olanzapine (an antipsychotic)
 other medicines that can alter your heart rhythm: medicines that belong to the group of anti-arrhythmics (e.g. quinidine, hydroquinidine, disopyramide, amiodarone, sotalol, dofetilide, ibutilide), tricyclic antidepressants, some antimicrobials (that belong to the group of macrolides), some antipsychotics.
Ciprofloxacin may increase the levels of the following medicines in your blood:
 pentoxifylline (for circulatory disorders)
 caffeine
 duloxetine (for depression, diabetic nerve damage or incontinence)
 lidocaine (for heart conditions or anesthetic use)
 sildenafil (e.g. for erectile dysfunction)
Some medicines reduce the effect of Ciprofloxacin. Tell your doctor if you take or wish to take:
 antacids
 omeprazole
 mineral supplements
 sucralfate
 a polymeric phosphate binder (e.g. sevelamer or lanthanum carbonate)
 medicines or supplements containing calcium, magnesium, aluminium or iron
If these preparations are essential, take Ciprofloxacin about two hours before or no sooner than four hours after them.
Taking Ciprofloxacin with food and drink
Unless you take Ciprofloxacin during meals, do not eat or drink any dairy products (such as milk or yogurt) or drinks with added calcium when you take the tablets. These can affect the absorption of ciprofloxacin and so you should take your tablets either 1 to 2 hours before or at least 4 hours after you have such products.
Pregnancy and breast-feeding
It is preferable to avoid the use of Ciprofloxacin during pregnancy. Tell your doctor if you are pregnant or planning to become pregnant.
Do not take Ciprofloxacin tablets during breast feeding because ciprofloxacin is excreted in breast milk and can be harmful for your child.
Ask your doctor or pharmacist for advice before taking any other medicine.
Driving and using machines
Ciprofloxacin may make you feel less alert. Some neurological adverse events can occur.
Therefore, make sure you know how you react to ciprofloxacin before driving a vehicle or operating machinery. If in doubt, talk to your doctor.
Important information about some of the ingredients of Ciprofloxacin tablets:
Lactose monohydrate – If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.