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Cipromycin

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Indications:

Lower Respiratory Tract Infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Pseudomonas aeruginosa, Haemophilus influenzae, Haemophilus parainfluenzae, or Streptococcus pneumoniae. Also, Moraxella catarrhalis for the treatment of acute exacerbations of chronic bronchitis. Bone and Joint Infections caused by Enterobacter cloacae, Serratia marcescens, or Pseudomonas aeruginosa. Skin and Skin Structure Infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Proteus vulgaris, Providencia stuartii, Morganella morganii, Citrobacter freundii, Pseudomonas aeruginosa, Staphylococcus aureus (methicillin-susceptible), Staphylococcus epidermidis, or Streptococcus pyogenes. Typhoid Fever (Enteric Fever) caused by Salmonella typhi. Urinary Tract Infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens, Proteus mirabilis, Providencia rettgeri, Morganella morganii, Citrobacter diversus, Citrobacter freundii, Pseudomonas aeruginosa, Staphylococcus epidermidis, Staphylococcus saprophyticus, or Enterococcus faecalis. Acute Uncomplicated Cystitis in females caused by Escherichia coli or Staphylococcus saprophyticus. Chronic Bacterial Prostatitis caused by Escherichia coli or Proteus mirabilis. Acute Sinusitis caused by Haemophilus influenzae, Streptococcus pneumoniae, or Moraxella catarrhalis. Complicated Intra-Abdominal Infections (used in combination with metronidazole) caused by Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae, or Bacteroides fragilis. Infectious Diarrhoea caused by Escherichia coli (enterotoxigenic strains), Campylobacter jejuni, Shigella boydii, Shigella dysenteriae, Shigella flexneri or Shigella sonnei when antibacterial therapy is indicated. Uncomplicated cervical and urethral gonorrhoea due to Neisseria gonorrhoeae.

Contraindications:

It is contraindicated in-patients who are hypersensitive to Ciprofloxacin or other drugs from the same class of quinolones or gyrase inhibitors. Also in-patients who are suffering from seizures (epileptics) and patients with other existing damage to the central nervous system.

Adverse reactions:

Nausea, vomiting, dyspepsia, abdominal pain, diarrhoea, headache, dizziness, sleep disorders, rash (rarely Stevens-Johnson syndrome and toxic epidermal necrolysis), pruritus, flatulence, dysphagia, tremor, hyperglycaemia, altered prothrombin concentration, casualties, petechiae, haemorrhagic bullae, tinnitus, tenosynovitis, tachycardia, oedema, syncope, hot flushes and sweating. Less frequent adverse reactions include anorexia, increase in blood urea and creatinine, drowsiness, restlessness, asthenia, depression, confusion, hallucinations, convulsions, paraesthesia, photosensitivity, hypersensitivity reactions including fever, urticaria, angioedema, arthralgia, myalgia, and anaphylaxis; blood disorders (including eosinophilia, leucopenia, thrombocytopenia); disturbances in vision, hearing, taste and smell. Also isolated reports of tendon inflammation and damage especially in the elderly and in those taking corticosteroids. Other adverse reactions that have been reported include haemolytic anaemia, renal failure, interstitial nephritis and hepatic dysfunction including hepatitis and cholestatic jaundice. USE DURING PREGNANCY AND LACTATION: Ciprofloxacin must not be prescribed to pregnant women or to nursing mothers, since there is no experience with the drug safety in these patients groups and since animal studies indicate that damage to articular cartilage in the immature organism can not be fully excluded. Animal studies have not yielded any evidence of teratogenic effects (malformations).

Interactions:

Concomitant administration of Ciprofloxacin and iron, sucralfate, or antacid containing magnesium, aluminum or calcium reduces the absorption of Ciprofloxacin. Therefore, Ciprofloxacin should be taken 1 hr. before or 4 hrs. after taking these products. Concomitant administration of Ciprofloxacin and theophylline can cause an undesirable rise in the serum theophylline concentration which may lead to theophylline-determined side effects. Animal studies show that the combination of very high doses of quinolones (gyrase inhibitors) and certain anti-inflammatory drugs (nonsteroidal anti-inflammatories) can provoke convulsions. This is not, however, the case with drugs containing acetylsalicylic acid. Concomitant administration of Ciprofloxacin and warfarin can intensify the action of the warfarin. After concomitant administration of Ciprofloxacin and glibenclamide, the action of the glibenclamide can be intensified in isolated cases lowering of blood glucose (hypoglycaemia). Probenecid influences the excretion of Ciprofloxacin in the urine. After concomitant administration of Ciprofloxacin and probenecid, the concentration of Ciprofloxacin in the blood (serum) rises. Metoclopramide reduces the uptake of Ciprofloxacin into circulation, leading to maximum concentrations in the blood (serum) within a short time.

Warnings:

Ciprofloxacin should be discontinued at the first appearance of a skin rash or any other sign o hypersensitivity reaction. Avoid excessive alkalinity of urine and ensure adequate fluid intake (risk of crystaluria). Ciprofloxacin may impair performance of skilled tasks and effects enhanced by alcohol, caution should be exercised while driving or operating machinery. It is not recommended to give the drug for children less than 12 years.

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