Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Cipro
Active ingredient: Ciprofloxacin
Available dosage forms: 250, 500, 750, 1000 mg
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Ciprofloxacin general information
The main goal of taking ciprofloxacin is to become cleared of bacterial infection. Amoxicillin is a favorite remedy to take care of bacterial infections related to dogs. Experts warn against usage of ciprofloxacin in dogs who’ven’t crossed 52 weeks old. This infection is well known by diverse names, grounded on the field of infection. Pregnant dogs aren’t appropriate for treatment with ciprofloxacin. Make certain that you administer the perfect dosage, and if you forget to present your pet a dose of cephalexin, don’t double the total amount the following time.
Consequently, medication is usually supplied in the type of combination of a couple of antibiotics, or superior dosage of the sole antibiotic to be able to effectively combat the resistance. Furthermore, penicillin and ciprofloxacin could be prescribed dependent on the bacterial strain. These mechanisms differ based on the sort of antibiotics used. Hence, one has to be vigilant when combining antibiotics and alcohol in just about any form. Therefore, consuming alcohol in the expense of trimming the effectiveness of ciprofloxacin is certainly not advisable. Therefore, a better choice to treat such a prostatitis will be to consider other prescription medicines.
Cephalosporins are assigned to pregnancy category B by the FDA, meaning that there aren’t any known adverse impacts on the fetus. In other words, dogs less than 1-year old shouldn’t be given ciprofloxacin. So far As spectrum and the degree of activity are involved, it really is similar to amoxicillin. Always consult a physician and avoid self-medication.
Just like with any other medication, ciprofloxacin isn’t free from side consequences. In case that one does develop an infection, the therapy would involve the utilization of antibiotics. Doctors prescribe antibiotics on the basis of the sort of infection occurring. Metronidazole dosage, and the length of treatment might vary according to age of the individual, sort of infection, and difficulty of the condition. Another effective solution to fight prostate infection will be to take ciprofloxacin (cipro). Communicate to your vet about any other medication the dog might be taking, like probenecid, or even a loop diuretic for example furosemide or warfarin, because this might interact with cephalexin and induce unwanted effects.
Back pain is a rather common condition connected with pregnancy. The pain related to an infection of the kidney is generally felt in the decrease back region, and in the decrease abdomen. In the event the affliction of the patient will not improve, the physician may recommend a stronger antibiotic and even grow the duration of cure. Nonetheless, certain conditions may necessitate the application of medications while pregnant. The treatment of the condition will be different in line with the causative factor. Treatment will be different agreeing with the sort of infection.
Beta-lactam antibiotics are among the most frequently used set of antibiotics. It kills the bacteria existing in the human body as well as gets rid of the disease. Therefore, it makes sense to utilize antibiotics to remove prostate infection. It can help to flush out the bacteria that results in the infection along with the inflammation. This lowers the danger of infection. Abdominal cramps, an elevated sensitivity of the skin to sunlight, and diarrhea are of a number of the frequent side effects related to tetracyclines.
Buffered Pfizerpen is actually a drug which has to be injected into a patient and may exclusively be used if tests show that the reason for the illness is because of bacterial presence. To sum this up, you can say that alcohol might not reduce the efficacy of antibiotics, but nonetheless, it certainly does aggravate the side effects due to antibiotics. Thus, let’s find out whether this medicine may be taken while pregnant. Alcohol can impact antibiotics in the aforementioned ways. The most ordinary among antibiotics is Ciprofloxacin. Dehydration may be caused by different factors like diarrhea, vomiting, fever or dearth of adequate consumption of fluids.
One ought to consult with a doctor about the iron dosage required to treat anemia. In the event the diarrhea continues, it’s wise to halt the medication and consult a veterinarian. In the event the disease remains in its first stages, then oral consumption of medicines is sufficient to treat it. Every one of these problems related to difficulty in urination may come from several health conditions and illnesses. Regardless, it is best to stop infection in the very first place, as opposed to handling the symptoms and following home remedies. These were some remedies which you can utilize to pick up some respite from the symptoms of the prostate inflammation.
Ciprofloxacin (Ciprofloxacin): instruction, and the use of a formula
Ciprofloxacinum ( genus. Ciprofloxacini)
1 – Cyclopropyl – 6 – fluoro – 1,4 – dihydro – 4 – oxo – 7 – (1 – piperazinyl) – 3 – quinolinecarboxylic acid (and as hydrochloride)
Gross – formula
Therapeutic agents Ciprofloxacin
The nosological classification (ICD – 10)
Feature substance Ciprofloxacin
Antibacterial fluoroquinolones II generation. Pale to slightly yellowish crystalline powder, soluble in 0.1N. hydrochloric acid, practically insoluble in water and ethanol.
Mode of action – antibacterial broad-spectrum bactericidal.
It inhibits DNA – gyrase (topoisomerase II and IV, the process responsible for placing the chromosomal DNA superspiral around nuclear RNA), violates the biosynthesis of DNA. bacteria growth and division; It is expressed morphological changes (including cell walls and membranes) and rapid cell death. It acts on the microorganisms in the period of growth and rest.
It has a wide spectrum of antimicrobial action, is active against most Gram-negative bacteria, is less pronounced impact on the anaerobes. It has effects on the Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Campylobacter jejuni, Citrobacter diversus, Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Morganella morganii, Neisseria gonorrhoeae, Proteus mirabilis, Proteus vulgaris , Providencia rettgeri, Providencia stuartii, Pseudomonas aeruginosa, Salmonella typhi, Serratia marcescens, Shigella flexneri, Shigella sonnei, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus saprophyticus, Acinetobacter spp. Acinetobacter calcoaceticus, Aeromonas caviae, Aeromonas hydrophila, Brucella melitensis, Campylobacter coli, Edwardsiella tarda, Enterobacter aerogenes, Haemophilus ducreyi, Klebsiella oxytoca, Legionella pneumophila, Moraxella (Branhamella) catarrhalis, Neisseria meningitidis, Pasteurella multocida, Salmonella enteritidis, Vibrio cholerae, Vibrio parahaemolyticus , Vibrio vulnificus, Yersinia enterocolitica, Chlamydia trachomatis, Mycobacterium tuberculosis. in an acidic medium activity decreases.
Most of staphylococcus, methicillin-resistant, resistant to ciprofloxacin. Moderately sensitive to ciprofloxacin Streptococcus pneumoniae . Enterococcus faecalis . Mycobacterium avium (located intracellularly).
By the ciprofloxacin resistant against most strains of Burkholderia cepacia and some strains of Stenotrophomonas maltophilia . and Bacteroides fragilis . Pseudomonas cepacia . Pseudomonas maltophilia . Ureaplasma urealyticum . Clostridium difficile . Nocardia asteroides . Ineffective against Treponema pallidum .
Resistance develops slowly and gradually ( “multi-stage” type). No cross-resistance with penicillins, cephalosporins, aminoglycosides.
carcinogenicity, mutagenicity, effects on fertility
The two-year carcinogenicity studies with ciprofloxacin administered orally (rats and mice) oncogenic actions have been identified.
The study mutagenic action of ciprofloxacin in vitro received both positive and negative results.
In the experiments on rats and mice treated with ciprofloxacin at doses up to 6 times higher than the usual daily dose for humans, adverse effects were found.
When ingestion rapidly and adequately absorbed from the gastrointestinal tract. Absorption is carried out mainly in the duodenum and jejunum. The absolute bioavailability of ; 60 – 80%. C max is achieved through the 1 – 1,5 hours, and at doses of 250, 500 and 750 mg was 0.1; 0.2 and 0.4 ug / ml, respectively. Food intake delays absorption, but does not change the C max and bioavailability. After 60 minutes of intravenouslyfusion at doses of 200 and 400 mg of C max ; 2.1 and 4.6 ug / ml, the plasma concentration after 12 hours was 0.1 and 0.2 ug / ml, respectively. Plasma protein binding is 20 – 40%. It penetrates the tissues, fluids and cells, creating high concentrations in the kidneys, gall bladder, liver, lung, bronchial mucosa and sinuses, female genital mutilation, phagocytic cells (polynuclears, macrophages), urine, sputum, bile, skin blister fluid; is found in the prostate gland, spinal cord – cerebrospinal fluid (less than 10% of plasma levels in meningitis ; up to 45% or more), saliva, skin, adipose tissue, muscle, bone, cartilage, passes through the placenta. T 1/2 at intake ; 3,5 – 5 h, on / in ; 5 & ndash; 6 hours total Cl .; about 35 l / h. Biotransformiroetsa in the liver (15 – 30%) with the formation of inactive metabolites (deetiltsiprofloksatsin, sulfotsiprofloksatsin, oksotsiprofloksatsin, formiltsiprofloksatsin). Write mainly kidneys (by glomerular filtration and tubular secretion) in unchanged form (with ingestion ; 40 – 50% after the on / in ; 50 – 70%) and in the form of metabolites (ingestion ; 15% at / in the introduction ; 10%), the rest of ; through the gastrointestinal tract (bile and feces); a small amount excreted in lactating mammary glands. The concentrations in urine is significantly superior to the IPC for the majority of agents of urinary tract infections. There were no accumulation after oral administration at a dose of 500 mg 2 times a day for 5 days or on / in the 100, 150 and 200 mg 2 times a day for 7 days. In chronic cirrhosis of the liver does not change the pharmacokinetics in patients with renal insufficiency lengthened T 1/2 .
When using eye drops containing ciprofloxacin hydrochloride, in each eye every 2 hours for 2 days and then every 4 hours for 5 days C max in plasma ; less than 5 ng / ml, the average concentration of ; below 2.5 ng / ml.
Application of the substance Ciprofloxacin
for systemic use: bacterial infections caused by susceptible microorganisms: infections of ENT – organs (otitis media, sinusitis, frontal sinusitis, sinusitis, mastoiditis, tonsillitis, pharyngitis), lower respiratory tract infections (bronchitis and acute exacerbation chronic pneumonia, bronchiectasis, cystic fibrosis), pelvic organs (cystitis, pyelonephritis, prostatitis, adnexitis, salpingitis, oophoritis, endometritis, tubular abscess pelvioperitonit), skin and soft tissue (infected ulcers, wounds, burns, abscess, cellulitis) , bones and joints (osteomyelitis, septic arthritis); sexually transmitted diseases (gonorrhea, chancroid, chlamydia), abdominal infections (bacterial gastrointestinal infection. gallbladder and biliary tract, intra-abdominal abscesses, peritonitis, salmonella, typhoid fever, campylobacteriosis, yersiniosis, shigellosis, cholera), bacteremia, septicemia, severe infections due to immune deficiency and neutropenia, prevention of infections in surgical interventions.
In ophthalmology: infectious – inflammatory diseases of the eye (acute and subacute conjunctivitis, blepharitis, Blepharoconjunctivitis, keratitis, keratoconjunctivitis, bacterial corneal ulcer, chronic dacryocystitis, meybomit, infections of the eye after the injury or the ingress of foreign bodies ), pre – and post-operative prophylaxis of infectious complications in ophthalmic surgery.
in otorhinolaryngology: external otitis, treatment of postoperative infectious complications.
Hypersensitivity (including to other fluoroquinolones), glucose deficiency – 6 – phosphate dehydrogenase, childhood and adolescence (18, end of the period of intensive growth ; for systemic use); in ophthalmology: viral keratitis, children’s age (up to 1 year ; for eye drops to 2 years ; for ophthalmic ointment).
Restrictions on the use
Severe cerebral atherosclerosis, stroke, mental illness, epilepsy, epileptic syndrome, severe renal and / or hepatic impairment.
Application of pregnancy and breastfeeding
is contraindicated in pregnancy (safety and efficacy in women during pregnancy has not been established). Ciprofloxacin passes through the placenta. It has been shown that ciprofloxacin induced arthropathy in young animals. In experiments on rats and mice treated with ciprofloxacin at doses exceeding the usual daily dose for a person up to 6 times, the adverse effects on the fetus have been identified. In experiments on rabbits treated with ciprofloxacin oral dose of 30 and 100 mg / kg, showing that the drug disturbs gastrointestinal functions. leading to weight loss in females and increases the number of abortions; however teratogenic effects have been detected. The on / in the introduction of doses up to 20 mg / kg ciprofloxacin do not have toxic effects on the mother and fetus, did not show teratogenic effects.
The use of local forms of ciprofloxacin during pregnancy is possible if the expected benefit outweighs the potential risk to the fetus.
Category effects on the fetus by FDA ; C.
Ciprofloxacin is excreted in breast milk, so during lactation should decide to stop taking ciprofloxacin or breastfeeding, based on the degree of importance of the use of drugs for the mother.
With careful use of local forms of ciprofloxacin during lactation (known whether ciprofloxacin is excreted in breast milk when applied topically).
Side effects of substance Ciprofloxacin
In the systemic application
From the digestive tract: nausea, vomiting, disturbance of appetite, diarrhea, constipation, pseudomembranous colitis, epigastric and abdominal pain, abdominal discomfort, hiccups, ulcers, dryness and soreness of oral mucosa, bloating, bleeding in the gastrointestinal tract. pancreatitis, cholestatic jaundice, hepatitis, liver cell necrosis.
From the nervous system and sensory organs: headache, dizziness, excitement, a sense of anxiety, insomnia, nightmares, confusion, depression, phobias, fatigue, visual disturbances (changes in color vision, diplopia, nystagmus, eye pain), the taste, smell, tinnitus, transient hearing loss, mood changes, gait disturbance, increased intracranial pressure, paraesthesia, sweating, ataxia, tremors, convulsions, toxic psychosis, paranoia, hallucinations, headache .
From the cardio – vascular system and blood (blood, hemostasis): decrease in blood pressure. cardiovascular collapse, arrhythmias, cerebral thrombosis, paroxysmal tachycardia, leukopenia, leukocytosis, anemia, thrombocytopenia, thrombocytosis, changes in prothrombin level.
From the respiratory system: pulmonary embolism, dyspnoea, respiratory distress, bronchospasm, pleural effusion.
From the musculo – skeletal system: arthralgia, myalgia, tendonitis.
With the genitourinary system: frequent urination, crystalluria, hematuria, cylindruria, polyuria, proteinuria, acidosis, urinary retention, hemorrhagic cystitis, nephritis, vaginitis, gynecomastia.
Allergic reactions: rash, petechiae, blisters, papules, cutaneous vasculitis, Stevens – Johnson syndrome, Lyell’s syndrome, exudative erythema multiforme, exfoliative dermatitis, itching, swelling of the lips, face, neck, conjunctiva , limbs, angioedema, urticaria, anaphylactic shock.
Other: hyperpigmentation, eosinophilia, fever, photosensitivity, transient elevation of liver transaminases, alkaline phosphatase. creatinine, urea, serum triglycerides, glucose, potassium, bilirubin; goiter, candidiasis; on-site / in ; pain, burning sensation, phlebitis.
The local application: allergic reactions, itching, burning, mild soreness and redness of the conjunctiva or in the eardrum; rare ; swelling of the eyelids, photophobia, tearing, foreign body sensation in the eye, an unpleasant taste in the mouth immediately after instillation, decreased visual acuity, appearance of a white crystalline precipitate in patients with corneal ulcer, keratitis, keratopathy, stains or infiltration of the cornea, superinfection development.
The activity increases when combined with the beta – lactam antibiotics, aminoglycosides, vancomycin, clindamycin, metronidazole. Sucralfate, Bismuth preparations, antacids that contain aluminum ions, magnesium or calcium, cimetidine, ranitidine, vitamins, micronutrient, ferrous sulfate, zinc, didanosine (recommended for 2 hours before or 4 hours after these drugs) reduce the absorption. Probenecid, azlocillin increase the concentration in the blood. Decreases clearance and increases in plasma caffeine, aminophylline and theophylline (increased chance of side effects of development). It enhances the effect of warfarin and other oral anticoagulants (prolongs bleeding time). Increases cyclosporine nephrotoxicity, the risk of increased excitability of the central nervous system and convulsive reactions to NSAIDs background. Formulations urine alkalizing (citrate, sodium bicarbonate, carbonic anhydrase inhibitors), decrease the solubility (increased probability of crystalluria). Infusion solutions of ciprofloxacin, ready to use, can be combined with infusion solutions: 0.9% sodium chloride solution, Ringer’s solution, Ringer – lactate, 5 and 10% dextrose, 10% fructose solution, and a solution containing 5% dextrose with 0,225 or 0.45% sodium chloride. Incompatible with solutions having a pH greater than 7.
Symptoms: do not have specific symptoms.
Treatment: gastric lavage, the use of emetic drugs, the introduction of large amounts of fluid, creating an acidic urine reaction, further ; hemodialysis and peritoneal dialysis (can be displayed only 10% of the drug); All activities are carried out against the background of maintaining vital functions. A specific antidote is not known.
Dosing and Administration
Inside, intravenously. locally. The mode set individually, depending on the location and severity of the infection, body condition, age, body weight, renal function. Inside (not liquid, and drinking plenty of fluids), 250 mg (in severe infections ; 500 – 750 mg) of 2 – 3 times a day; Prolonged forms take 1 time a day. For infections of the urinary tract ; 500 mg per day in 2 divided doses, in acute gonorrheal urethritis ; 0.5 g once. B / drip in ; 200 mg (in severe infections ; 400 mg) 2 times a day; infusion time is 30 minutes at a dose of 200 mg and 60 min ; at a dose of 400 mg.
Patients with severe renal function the daily dose reduced by half, elderly patients ; 30%.
In severe infections and / or the impossibility of taking the pills inside the treatment begins with a / infusion. The duration of treatment depends on the severity of the disease. The average duration of treatment: 1 day ; in acute uncomplicated gonorrhea and cystitis; up to 7 days ; for infections of the kidneys, urinary tract and abdominal organs; during the entire period of neutropenia phase ; in patients with weakened protective forces of the organism, but not more than 2 months ; osteomyelitis and 7 – 14 days ; at all other infections. In streptococcal infections because of the risk of late complications, as well as chlamydial infections, treatment should continue for at least 10 days. In patients with immune deficiency treatment is carried out during the entire period of neutropenia.
The treatment should be carried out for at least 3 days after normalization of body temperature or the disappearance of clinical symptoms.
Local: for mild to moderate infections instill eye drops 1 – 2 drops into the conjunctival sac of the affected eye every 4 hours for severe infections ; 2 drops every hour. After improving the dose and frequency of instillations reduced.
Eye ointment for a lower eyelid of the affected eye.
Ear drops: 5 drops instilled in the affected ear 3 times a day. After the disappearance of symptoms should be continued during the next 48 hours.
Precautions substance Ciprofloxacin
Due to the threat of adverse reactions from the CNS ciprofloxacin should be used only for health of CNS pathology in history: organic brain lesions, epilepsy, lowered seizure threshold, severe atherosclerosis of vessels of the brain (risk of circulatory disorders, stroke) in an elderly age, with severe renal and hepatic function (requires monitoring of plasma concentrations).
In patients with allergic reactions to fluoroquinolone derivatives in history may develop reactions to ciprofloxacin. During treatment should avoid sunlight and UV radiation, intense exercise, control the drinking regime, pH urine.
crystalluria reported cases, particularly in patients with alkaline urine (pH 7 or above). In order to avoid the development of crystalluria is unacceptable excess of the recommended daily intake, you also need a sufficient fluid intake and maintain acidic urine.
If you have pain in the tendons, or the first signs of tenosynovitis treatment should be discontinued (described in some cases of inflammation or tendon rupture during treatment with fluoroquinolones).
It may reduce the speed of psychomotor reactions, especially against the background of alcohol that should be considered for patients who work with potentially dangerous machinery or drive a vehicle. If you develop severe diarrhea, pseudomembranous colitis should be excluded (for which ciprofloxacin is contraindicated). Simultaneous in / with the introduction of barbiturates requires monitoring functions of cardio – vascular system (heart rate blood pressure ECG..). Teenagers of 18 years is prescribed only in the case of pathogen resistance to other chemotherapy drugs.
The solution in the form of eye drops not intended for intraocular injection. When using other ophthalmic means the interval between doses should be at least 5 minutes.
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