Ciprofloxacin is an antibiotic that is commonly used for the following infections caused by certain bacteria.

• Urinary tract infections (UTIs) and bladder infections
• Prostate infections
• Lung infections (e.g., bronchitis, pneumonia)
• Sinus infections
• Skin infections
• Bone and joint infections
• Abdominal infections
• Infectious diarrhea
• Typhoid fever
• Certain gonorrhea infections
• Certain anthrax infections
• An infection called plague

Ciprofloxacin may not be appropriate for some of the infections listed above, depending on which germs are causing the infection. Bacteria in some locations may have developed resistance to ciprofloxacin, which will make it less effective.

Ciprofloxacin may also be used for other conditions as determined by your healthcare provider.

How does ciprofloxacin work?

Ciprofloxacin kills certain types of bacteria by disrupting their ability to create and repair their DNA.

Dosage

Ciprofloxacin is available as Cipro, Cipro XR, and generic ciprofloxacin in the following dosage forms that are taken by mouth.

• 100 mg oral tablet
• 250 mg oral tablet
• 500 mg oral tablet
• 750 mg oral tablet
• 500 mg extended-release oral tablet
• 1000 mg extended-release oral tablet
• 250 mg oral suspension
• 500 mg oral suspension

The Proquin XR brand of ciprofloxacin is no longer available.

Ciprofloxacin is also available in injectable forms.

How should ciprofloxacin be stored?

Oral Tablets. Most ciprofloxacin oral tablets should be stored at room temperature, which is generally between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Medicine should generally be stored in a cool, dry place, in a tightly closed container.

Oral Liquid. Cipro oral liquid should be stored at room temperature, which is generally between 68 F to 77 F (20 C to 25 C) for 14 days. It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. You should not freeze it. Safely throw away any unused portion after the full treatment is finished.

Side Effects

Common Side Effects

The most common side effects of ciprofloxacin are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Nausea and vomiting
• Diarrhea
• Changes in liver function tests
• Skin rash
• Yeast infection (extended-release tablets)
• Swollen nose and throat (extended-release tablets)
• Headache (extended-release tablets)
• Feeling an urgent need to urinate (extended-release tablets)

There may be other side effects of ciprofloxacin that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine.

Serious Side Effects

While less common, the most serious side effects of ciprofloxacin are described below, along with what to do if they happen.

Tendon Problems. Tendons are the connectors between your bones and muscles. Problems with tendons can happen in people who are taking ciprofloxacin or who have taken it in the past several months. This can possibly lead to tendon swelling, also called tendonitis, or tearing of the tendon. It is most common with then tendon on the back of your ankle, called the Achilles tendon, but can also happen with other tendons.

Stop using ciprofloxacin and get medical help right away if you develop any tendon pain or swelling.

Nerve Problems. Nerves are the fibers that carry sensations from your body to the brain. Damage to these nerves, called peripheral neuropathy, can happen in people who are taking ciprofloxacin. Stop taking ciprofloxacin and call your healthcare provider if you develop pain, burning, tingling, numbness, or weakness in your arms, hands, legs, or feet.

Mental Effects. Stop taking ciprofloxacin and call your healthcare provider if you develop any signs of mental effects while taking ciprofloxacin, such as the following.

• Hearing, seeing, or sensing things that are not there (hallucinations)
• Feeling unusually suspicious (paranoia)
• Having false or strange thoughts or beliefs (delusions)
• Feeling restless, agitated, anxious, or nervous
• Having memory trouble, feeling confused, or feeling less aware of your surroundings
• Feeling depressed or having suicidal thoughts or actions
• Having trouble sleeping or nightmares

Seizures. Some people who have taken ciprofloxacin have reporting having seizures. There are many different types of seizures and some of them are not easy to recognize. Stop taking ciprofloxacin and call your healthcare provider if you experience any of the following signs that a seizure is happening or could happen.

• Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
• Stiffening of your arms and legs
• Feeling anxious, nervous, confused, or a sense of dread
• Feeling dizzy or lightheaded
• Falling or losing consciousness

Severe Allergic Reactions. Ciprofloxacin can cause allergic reactions, which can be serious. Stop using ciprofloxacin and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking ciprofloxacin. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

• Nausea or vomiting
• Stomach or belly pain
• Fever
• Weakness or unusual tiredness
• Itching
• Loss of appetite
• Light colored poop
• Dark colored urine
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Aortic Aneurysm and Dissection. Tell your healthcare provider if you have ever had swelling or a tear in the large artery that carries blood from the heart, called the aorta. Get emergency help right away if you have sudden symptoms related to this condition, such as chest pain, stomach pain, or back pain.

Antibiotic-associated Diarrhea. An overgrowth of germs called Clostridioides difficile, or “C. diff,” can happen in your gut with many types of antibiotics, including ciprofloxacin. This can cause a condition known as antibiotic-associated diarrhea and can happen even up to 2 months after stopping the antibiotic. Call your healthcare provider right away if you have any of the following symptoms of this condition.

• Watery diarrhea
• Diarrhea that does not go away
• Blood in your poop
• Severe stomach cramps
• Fever that starts after you start or finish the medicine

Heart Rhythm Changes. Ciprofloxacin may cause a rare dangerous heart rhythm problems called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium, or who take some medicines for other heart rhythm problems. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as fast or skipping heartbeat.

Joint Problems. Children under 18 years old can develop problems with their joints during and after treatment with ciprofloxacin. Tell your child’s healthcare provider if they develop any joint problems.

Sensitivity to Sunlight. Your skin may be very sensitive to light from the sun and devices that give off similar light, such as sunlamps and tanning beds, while you are taking certain drugs, including ciprofloxacin. This is called photosensitivity. Use sunscreen and wear a hat and clothes that cover your skin if you need to be in the sunlight. Exposing your skin to this kind of light, even for a short time, can cause your skin to be severely sunburned, blistered, or swollen. Tell your healthcare provider right away if any of these happen.

Warnings & Precautions

Allergies to Ingredients. People who are allergic to any of the following should not use ciprofloxacin products.

• Cipro or Cipro XR
• Proquin XR
• Ciprofloxacin
• Any other medicine known as a fluoroquinolone
• Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific ciprofloxacin products they stock.

Drug Interactions. Ciprofloxacin should not be taken while you are using certain other medicines. Before using ciprofloxacin, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.  See the Interactions section below for more details.

Myasthenia Gravis. Myasthenia gravis (MG) is a condition that can cause muscle weakness. Ciprofloxacin can make this condition worse. It should not be used in people who have a history of this condition.

Peripheral Neuropathy. Peripheral neuropathy (PN) is a condition in which damage to your nerves causes pain, burning, tingling, numbness, or weakness in your arms, hands, legs, or feet. Ciprofloxacin can make this condition worse. It should not be used in people who have a history of this condition.

What should I know about ciprofloxacin before using it?

Do not take ciprofloxacin unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share ciprofloxacin with other people, even if they have the same condition as you. It may harm them.

Keep ciprofloxacin out of the reach of children.

Ciprofloxacin can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how ciprofloxacin affects you.

Ciprofloxacin can make your skin more sensitive to light from the sun, sunlamps, and tanning beds. This is called photosensitivity. Exposure to this light can cause severe sunburns, blisters, and swelling. If you need to be in sunlight, wear sunscreen, a hat, and clothing that covers your skin.

People who are under 18 or over 60 years old can be at greater risk for some side effects from ciprofloxacin. Talk to your healthcare provider about your risks if you are in one of these age groups.

What should I tell my healthcare provider before using ciprofloxacin?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if ciprofloxacin is right for you.

In particular, make sure that you discuss any of the following before using ciprofloxacin.

Heart Problems. Tell your healthcare provider if you or anyone in your family has a history of heart attack or an irregular heartbeat (arrhythmia), especially a condition called “QT prolongation” or “long QT syndrome.”

Other Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

• Kidney, heart, or lung transplant
• Kidney or liver problems
• Past tendon or joint problems
• History of seizures or epilepsy
• History of myasthenia gravis
• Low blood potassium (hypokalemia) or magnesium (hypomagnesemia)
• Diabetes

Other Medicines and Supplements. Ciprofloxacin may interact with other medicines and supplements. Before using ciprofloxacin, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.  See the Interactions section below for more details.

Pregnancy. It is not known if or how ciprofloxacin could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. Ciprofloxacin passes into breast milk. You should not breastfeed while using ciprofloxacin or for two days after you finish using it. You may pump and throw away your breast milk during this time. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.

Interactions

Foods and drinks that are high in calcium may decrease the amount of ciprofloxacin that your body absorbs. You should not take eat or drink dairy products like milk and yogurt or calcium-fortified products alone near the time that you take ciprofloxacin by mouth. However, you can eat and drink these types of products with normal meals.

Proquin XR (ciprofloxacin extended-release tablets) should be taken with your main meal of the day, preferably the evening meal.

It is unknown if drinking alcohol will affect ciprofloxacin.

Ciprofloxacin can increase the effects of caffeine. You should limit the amount of caffeine-containing drinks you consume while taking ciprofloxacin.

Interaction with other medecine

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using ciprofloxacin.

• A corticosteroid, which is a medicine for certain inflammatory conditions
• A non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
• Tizanidine (Zanaflex), which is a muscle relaxant
• Probenecid, which is a medicine commonly used for gout
• An antipsychotic, which is a medicine for certain mental health conditions
• A tricyclic antidepressant or duloxetine, even if it is not used for depression
• Theophylline, which is a medicine for certain breathing conditions
• An antiarrhythmic, which is a medicine to control your heart rate or rhythm
• A blood thinner, such as warfarin (Coumadin and others)
• A medicine for diabetes
• Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
• Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine to suppress your immune system
• Methotrexate (Trexall and others)
• Ropinirole (Requip), which is a medicine used for Parkinson disease, restless legs syndrome, and other conditions
• A type of medicine called a phosphodiesterase-5 (PDE-5) inhibitor, such as avanafil (Stendra), sildenafil (Viagra, Revatio, and others), tadalafil (Cialis and others), or vardenafil (Levitra, Staxyn), which are used for erectile dysfunction and pulmonary arterial hypertension (PAH)
• A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
• Products that contain caffeine, which is often found in medicines for reducing water weight (diuretics), staying awake, headaches, and hangover relief

This may not be a complete list of medicines that can interact with ciprofloxacin. Always check with your healthcare provider.

Overdose

If you or someone else has taken too much ciprofloxacin, get medical help right away.

Miss dose

It is important to complete your prescribed course of ciprofloxacin, even if your symptoms get better or go away. This will reduce the risk that future infections are not resistant to ciprofloxacin or other similar medicines.

Never take two doses of ciprofloxacin at the same time.

If you miss a dose of ciprofloxacin or Cipro tablets or liquid and it is still more than 6 hours until your next scheduled dose, take your missed dose right away.  Then take your next dose at the regular time.

If you miss a dose of ciprofloxacin or Cipro tablets or liquid and it is less than 6 hours until your scheduled next dose, do not take your missed dose.  Just take your next dose at the regular time. After that, you should still finish all of your prescribed doses.

If you miss a dose of Proquin XR tablets, take it as soon as you remember, but do not take more than one dose per day.