Ciprofloxacin: Uses, How It Works, Medicines
Ciprofloxacin is a fluoroquinolone antibiotic used to treat certain bacterial infections. These include some urinary, chest, skin, bone and joint and gut infections. It works only against bacteria, so it does not help colds, flu or other viral infections. Because of rare but serious side effects on tendons, nerves and mental health, regulators advise using it only when other commonly recommended antibiotics are not suitable, and in India it is a prescription medicine.
Also known as: Ciprofloxacin tablet, Ciprofloxacin 500 mg, Ciprofloxacin hydrochloride, Ciprofloxacin IP, Fluoroquinolone antibiotic, Quinolone antibiotic
Pharmacist review in progress. This page is based on the sources listed below and is being checked by our registered pharmacist.
How does Ciprofloxacin work?
Ciprofloxacin blocks two bacterial enzymes, DNA gyrase and topoisomerase IV, which bacteria need to copy their DNA, so the bacteria die. It works against bacteria only and has no effect on viruses.
How to take Ciprofloxacin
Take Ciprofloxacin exactly as your doctor has prescribed or as printed on the pack. Your doctor decides the dose and the number of days, which depend on the infection and on how well your kidneys work.
Side effects of Ciprofloxacin
Most people take ciprofloxacin without serious problems; feeling sick and diarrhoea are the most common side effects. Rarely, fluoroquinolone antibiotics cause serious side effects that can be disabling and may last a long time.
Uncommon or mild
- Feeling sick (nausea)
- Diarrhoea
- Being sick (vomiting)
- Rash
- Changes in liver blood tests found on a blood test
Rare but serious: get medical help
- Pain, swelling or inflammation of a tendon, especially the Achilles tendon at the back of the ankle, or a tendon that tears. Stop the medicine and tell your doctor straight away. This can happen within 2 days of starting or months after stopping
- Numbness, tingling, burning pain or weakness in the hands, arms, feet or legs, which can be signs of nerve damage that may last a long time
- Changes in mood or thinking: anxiety, panic attacks, confusion, trouble sleeping, memory problems, depression, or thoughts of harming yourself. Get medical help straight away
- Fits (seizures), or hearing, sight, taste or smell changes
- Signs of low blood sugar, especially in people with diabetes: shaking, sweating, hunger, a fast heartbeat, confusion or drowsiness
- Sudden severe pain in the chest, stomach or back, which can be a sign of a bulge or tear in the aorta, the body's main blood vessel. Call 112 straight away
- A fast or irregular heartbeat, palpitations or fainting
- New or worse muscle weakness or difficulty breathing in people with myasthenia gravis
- Signs of a severe allergic reaction: swelling of the face, lips or throat, difficulty breathing, hives or collapse
- Blood in the diarrhoea, or severe watery diarrhoea lasting more than a few days, which can be a sign of a gut infection called C. difficile, even weeks after the course
- Yellowing of the skin or eyes, dark urine or pain in the upper right side of the tummy, which can be signs of liver problems
- A rash or sunburn-like reaction on skin exposed to sunlight
Who should be careful
Ciprofloxacin is not suitable for everyone, and regulators advise using fluoroquinolones only when other commonly recommended antibiotics are not suitable. Tell your doctor about your health and your other medicines before taking it.
When the label says not to use it
- Allergy to ciprofloxacin, any other quinolone or fluoroquinolone antibiotic, or any ingredient of the tablet
- Taking tizanidine (a muscle relaxant): the combination is not allowed
- Tendon damage during earlier treatment with a fluoroquinolone antibiotic
- Myasthenia gravis
- It treats bacterial infections only. It does not work for colds, flu or other viral infections, and taking it when it is not needed adds to antibiotic resistance
- A past allergy or serious side effect from ciprofloxacin or any other quinolone or fluoroquinolone antibiotic, such as ofloxacin, levofloxacin or norfloxacin: tell your doctor, as it should generally not be used
- Age over 60, kidney disease, a kidney, heart or lung transplant, or taking steroid medicines such as prednisolone: a higher risk of tendon damage
- Myasthenia gravis: ciprofloxacin can make muscle weakness worse, so it is avoided
- Epilepsy, past fits, or other brain or nerve conditions
- A history of mental health problems
- Diabetes, especially if you use insulin or tablets that lower blood sugar: your doctor may ask you to check your sugar more often
- An aortic aneurysm (a bulge in the main blood vessel), or a higher risk of one, such as older age, high blood pressure or hardened arteries
- Heart rhythm problems, a known long QT interval, low potassium, or taking medicines for heart rhythm
- Kidney or liver disease
- Pregnancy: it is usually avoided unless a doctor judges it necessary; tell your doctor if you are pregnant or planning a pregnancy. Breastfeeding: ask your doctor
- Children and teenagers under 18: not a first-choice medicine, because of possible effects on growing joints
- Sunlight: it can make skin more sensitive to the sun
- Dizziness or drowsiness: do not drive or use machines until you know how the medicine affects you
Medicines and things that interact with Ciprofloxacin
Some medicines and supplements change how ciprofloxacin is absorbed or add to its side effects. Tell your doctor or pharmacist about everything you take.
- Tizanidine (a muscle relaxant): must not be taken together
- Antacids with aluminium, magnesium or calcium, sucralfate, iron, zinc, calcium or multivitamins with minerals: take ciprofloxacin at least 2 hours before or 6 hours after them
- Theophylline (an asthma medicine): its levels may rise and cause fits, so the combination is avoided or monitored
- Warfarin: its blood-thinning effect may increase, so your doctor may check your clotting more often
- Insulin and diabetes tablets such as glibenclamide: blood sugar may go too low
- NSAID painkillers such as ibuprofen: may increase the risk of fits
- Steroid medicines such as prednisolone: higher risk of tendon damage
- Caffeine in large amounts: ciprofloxacin slows its clearance and can cause jitteriness
- Medicines that affect heart rhythm: higher risk of an irregular heartbeat
If someone takes too much
There is no specific antidote for a ciprofloxacin overdose; hospital care keeps the person well hydrated and watched. If someone has taken more than prescribed, especially if they are confused, dizzy or having fits, call 112 or go to the nearest hospital and take the medicine pack with you.
Regulatory status in India
Approved for sale in India as a prescription medicine. Single-ingredient ciprofloxacin is not on the CDSCO list of medicines banned under section 26A of the Drugs and Cosmetics Act. Several fixed-dose combinations that pair ciprofloxacin with other ingredients are prohibited (for example with phenazopyridine, and the multi-ingredient skin or ear combinations with clotrimazole and neomycin), so check the ingredient list on the pack.
Type of medicine
Ciprofloxacin belongs to this type of medicine.
Medicines that contain Ciprofloxacin
These medicines sold in India contain Ciprofloxacin. They are listed A to Z, not ranked.
- Cifran 500 · 500 mg film-coated tablet
What is Ciprofloxacin used for?
Medicines that contain Ciprofloxacin are used for these conditions.
Other medicines of the same type
These active ingredients are of the same type as Ciprofloxacin.
Common questions
Is Ciprofloxacin a prescription medicine?
Yes. Ciprofloxacin is a prescription-only antibiotic in India. It should be taken only if a doctor has prescribed it, and it should not be started, stopped or changed without the doctor's advice. Regulators advise using fluoroquinolones only when other commonly recommended antibiotics are not suitable.
What side effects of Ciprofloxacin need urgent attention?
Stop taking it and contact your doctor straight away if you get tendon pain or swelling, numbness, tingling or burning pain, changes in mood or thinking, signs of low blood sugar, a fast or irregular heartbeat, or sudden severe chest, stomach or back pain. These side effects are rare but can be serious and long-lasting.
How is Ciprofloxacin usually taken?
Ciprofloxacin tablets are usually taken twice a day, about 12 hours apart, with or without food but not with dairy products alone. Keep them at least 2 hours before or 6 hours after antacids, iron, zinc or calcium. Your doctor decides the dose and number of days; follow the label or your doctor's advice.
Is Ciprofloxacin an antibiotic for cold, flu or viral fever?
No. Ciprofloxacin acts only on bacteria, and colds, flu and many fevers are caused by viruses. Taking it for them does not speed recovery, adds side effects and adds to antibiotic resistance. A doctor decides whether an infection is bacterial and needs an antibiotic.
Can I take Ciprofloxacin with milk, curd or an antacid?
Do not take it with milk, curd or other dairy products alone, because calcium can reduce how much medicine is absorbed. A meal that includes dairy is fine. Take it at least 2 hours before or 6 hours after antacids, iron, zinc or calcium supplements.
Can I drink alcohol while taking Ciprofloxacin?
Alcohol does not stop ciprofloxacin from working, but both can cause dizziness and affect alertness, so it is best avoided during the course. Do not drive or use machines if you feel dizzy or drowsy, and ask your doctor if you are unsure.
Can Ciprofloxacin be taken in pregnancy or while breastfeeding?
It is usually avoided in pregnancy unless a doctor decides it is needed, and ciprofloxacin passes into breast milk. If you are pregnant, planning a pregnancy or breastfeeding, tell your doctor. Do not start or stop it without your doctor's advice.
Should I finish the whole course of Ciprofloxacin?
Take the full course your doctor prescribed, even if you feel better sooner, because stopping early can let the infection come back. The exception is a serious side effect or allergic reaction: stop and contact your doctor straight away. Never keep leftover tablets or share them.
Sources
- Ciprofloxacin tablets: prescribing information (Yiling Pharmaceutical, label revised 9/2020). DailyMed, US National Library of Medicine
- Side effects of ciprofloxacin. NHS (UK)
- Quinolone- and fluoroquinolone-containing medicinal products (referral). European Medicines Agency
- Fluoroquinolone antibiotics: must now only be prescribed when other commonly recommended antibiotics are inappropriate (Drug Safety Update, 22 January 2024). Medicines and Healthcare products Regulatory Agency (MHRA), UK
- List of drugs prohibited for manufacture and sale through gazette notifications under section 26A of the Drugs & Cosmetics Act 1940. Central Drugs Standard Control Organisation (CDSCO)
- The Drugs Rules, 1945 (consolidated, September 2024 edition), Schedule H: prescription drugs. Central Drugs Standard Control Organisation (CDSCO)