Specific Safety Issues With Ciprofloxacin

Specific Ciprofloxacin Warnings and Precautions

Some warnings and precautions to be aware of prior to taking this drug include the following:
 
  • Antibiotics like ciprofloxacin can disrupt the normal bacteria in the digestive tract, allowing undesirable bacteria to overgrow. A serious problem known as pseudomembranous colitis may result and can occur while you are taking the drug or even for weeks after you stop taking it.
Make sure to watch for signs of this problem, which can become life-threatening, such as bloody or severe diarrhea. Mild, short-term diarrhea is a common side effect of many antibiotics and is usually not a cause for concern.
  • Ciprofloxacin and other fluoroquinolone antibiotics may cause tendon damage, including tendon rupture. People who are over the age of 60; who have had a liver, lung, or heart transplant; or who take corticosteroid drugs are at an increased risk for tendon problems.
Contact your healthcare provider right away if you have any tendon pain, soreness, or swelling, or if you experience weakness or difficulty moving any of your joints. Do not exercise until your healthcare provider makes sure you do not have a ruptured tendon (see Ciprofloxacin Tendonitis for more information).
  • Some people may have severe allergic reactions to ciprofloxacin. Seek immediate medical attention if you develop any signs of an allergic reaction, such as:
     
    • A rash
    • Hives
    • Itching
    • Swelling of the lips or throat
    • Wheezing
    • Difficulty breathing.
 
  • Central nervous system problems and neurological side effects have been reported with ciprofloxacin oral and intravenous (IV) use, sometimes even after just one dose. These problems may include:
 
    • Seizures
    • Tremors
    • Confusion
    • Dizziness
    • Hallucinations
    • Paranoia
    • Anxiety
    • Depression
    • Nervousness
    • Agitation
    • Nightmares
    • Suicidal thoughts or acts.
Certain conditions (including epilepsy, cerebral arteriosclerosis, and kidney disease) can increase the risk of such problems. Let your healthcare provider know if you have any of these conditions.
  • This medication may cause a rare and potentially dangerous heart rhythm problem known as QT prolongation. This problem may be more common in older adults, people with low blood potassium, or those taking certain other medications (see Ciprofloxacin Drug Interactions). It is not likely to occur with ciprofloxacin topical ear and eye use, however.

 

  • Ciprofloxacin (as well as all other fluoroquinolone antibiotics) can cause worsening of myasthenia gravis symptoms, such as muscle weakness and breathing problems. This is a serious occurrence, which can be life-threatening. In severe cases, this can result in the need to be put on a ventilator, or even death. Ciprofloxacin should be avoided in people with a known history of myasthenia gravis

 

  • People taking this drug may be more sensitive to the sun. Try to avoid sun exposure, including natural sun and tanning beds, while using ciprofloxacin oral products. If you do go out in the sun, wear protective clothing and sunscreen. Contact your healthcare provider if you develop a severe sunburn while taking ciprofloxacin.
     
  • Ciprofloxacin oral and IV use has been reported to cause a nerve problem called peripheral neuropathy. If you develop any unusual sensations while taking this medication, such as pain, burning, tingling, prickling, or weakness, contact your healthcare provider right away to reduce the chance of permanent nerve damage.
     
  • You may become dizzy or lightheaded while taking oral ciprofloxacin. Therefore, you should avoid driving or doing anything that requires mental alertness until you know how you will react to this medication.
     
  • Ciprofloxacin oral and IV use has been associated with muscle, joint, or tendon problems in children. Make sure to tell your child's healthcare provider if your child has a history of joint, muscle, or tendon problems.
Also, contact your child's healthcare provider immediately if any muscle, joint, or tendon problems (such as weakness, soreness, or swelling) occur during or after ciprofloxacin use. This drug is believed to be safe for use in children when used topically in the ear or eye.
  • There have been rare reports of liver problems with ciprofloxacin oral and IV use. Contact your healthcare provider immediately if you develop any signs of liver problems, including:
     
    • Dark urine
    • Loss of appetite
    • Fatigue or excessive tiredness
    • Pain in the right upper part of the stomach
    • Yellowing of the whites of the eyes or skin (jaundice).
 
  • Ciprofloxacin ear drops should only be used in the ears. Do not take this form of the medication by mouth, put it in your nose or eyes, or apply it to your skin. Likewise, ciprofloxacin eye products should only be used in the eyes.
     
  • This medication may lead to fungal or yeast infections. Contact your healthcare provider if you experience persistent discomfort or extreme itching in your ears or notice pus coming from your ears while using ciprofloxacin ear drops, or a worsening eye infection while using ciprofloxacin ophthalmic.
Also, contact your healthcare provider if you notice white patches in your mouth or throat, or a thick, white vaginal discharge while using any ciprofloxacin medication.
  • The use of ciprofloxacin eye drops may lead to the formation of a white, crystal-like substance, called a precipitate, in the eye. In clinical trials, this substance occurred in some people using ciprofloxacin ophthalmic drops to treat corneal ulcers. This reaction did not prevent the continued use of the drug, and resolved without any need for treatment in the majority of cases.
     
  • Ciprofloxacin can potentially react with several other medications (see Ciprofloxacin Drug Interactions).
     
  • Ciprofloxacin is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Ciprofloxacin and Pregnancy).
     
  • Most forms of this medication pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to beginning treatment (see Ciprofloxacin and Breastfeeding).
     
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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