Ciplox: Potent Fluoroquinolone for Bacterial Infection Resolution
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Ciplox (ciprofloxacin) is a broad-spectrum fluoroquinolone antibiotic indicated for the treatment of serious bacterial infections in adults. It demonstrates potent bactericidal activity against a wide range of Gram-positive and Gram-negative aerobic pathogens through inhibition of bacterial DNA gyrase and topoisomerase IV. This agent is particularly valuable in managing complicated urinary tract infections, respiratory tract infections, skin and soft tissue infections, and bone/joint infections where first-line therapies have failed or are contraindicated. Proper diagnosis and susceptibility testing should guide therapy to ensure appropriate use and minimize resistance development.
Features
- Contains ciprofloxacin hydrochloride as the active pharmaceutical ingredient
- Available in 250mg, 500mg, and 750mg film-coated tablet formulations
- Exhibits concentration-dependent bactericidal activity
- Demonstrates excellent tissue penetration (serum, urine, prostate, lung, bone)
- Oral bioavailability of approximately 70% (not significantly affected by food)
- Elimination half-life of approximately 4 hours in patients with normal renal function
Benefits
- Rapid bactericidal action against susceptible pathogens reduces microbial load quickly
- Broad spectrum coverage addresses both Gram-negative and Gram-positive organisms
- High tissue penetration ensures therapeutic concentrations at infection sites
- Convenient twice-daily dosing supports patient adherence to treatment regimens
- Effective against many multidrug-resistant pathogens, including Pseudomonas aeruginosa
- Well-established safety profile with extensive clinical experience spanning decades
Common use
Ciplox is indicated for the treatment of adults with the following bacterial infections caused by susceptible strains of designated microorganisms:
Urinary Tract Infections: Complicated and uncomplicated urinary tract infections, including pyelonephritis caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens, Proteus mirabilis, Providencia rettgeri, Morganella morganii, Citrobacter diversus, Citrobacter freundii, Pseudomonas aeruginosa, Staphylococcus epidermidis, and Enterococcus faecalis.
Lower Respiratory Tract Infections: Acute bacterial exacerbations of chronic bronchitis and community-acquired pneumonia caused by Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydia pneumoniae.
Skin and Skin Structure Infections: Complicated infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Proteus vulgaris, Providencia stuartii, Morganella morganii, Citrobacter freundii, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pyogenes.
Bone and Joint Infections: Osteomyelitis and septic arthritis caused by susceptible organisms including Enterobacter species, Pseudomonas aeruginosa, Serratia marcescens, and Staphylococcus aureus.
Infectious Diarrhea: Caused by Campylobacter jejuni, Shigella species, Salmonella species, and enterotoxigenic Escherichia coli.
Dosage and direction
Dosage should be adjusted based on the type and severity of infection, renal function, and susceptibility of the causative organism. The usual adult dosage is 250-750 mg orally every 12 hours. Treatment duration typically ranges from 7 to 14 days depending on infection type and clinical response.
Renal Impairment Adjustment: For patients with creatinine clearance less than 30 mL/min, the dosage should be reduced by 50% (e.g., 250-500 mg every 12 hours becomes 250-500 mg every 18 hours).
Administration Instructions: Tablets should be swallowed whole with a full glass of water. May be taken with or without food, though taking with food may minimize gastrointestinal upset. Patients should maintain adequate hydration during therapy. Avoid concomitant administration with dairy products, calcium-fortified juices, or antacids containing magnesium, aluminum, or calcium, as these may significantly reduce absorption (separate by at least 2 hours before or 4 hours after dosing).
Precautions
- Tendon inflammation and rupture may occur during or after therapy, particularly in elderly patients, those receiving corticosteroid therapy, and solid organ transplant recipients
- May exacerbate muscle weakness in patients with myasthenia gravis
- Use with caution in patients with known or suspected central nervous system disorders that may predispose to seizures
- Photosensitivity reactions may occur; patients should avoid excessive sunlight and artificial UV light
- Periodic assessment of organ system functions is recommended during prolonged therapy
- Clostridium difficile-associated diarrhea may occur during or months after antibiotic treatment
- Peripheral neuropathy may occur and can be irreversible
- Serious and occasionally fatal hypersensitivity reactions may occur
Contraindications
- Known hypersensitivity to ciprofloxacin or other quinolone antibiotics
- Concurrent administration with tizanidine due to potentiated hypotensive and sedative effects
- History of tendon disorders related to fluoroquinolone administration
- Pediatric patients (except for specific indications where benefit outweighs risk) and growing adolescents due to arthropathy risk in juvenile animals
- Pregnancy (Category C) unless potential benefit justifies potential risk to fetus
- Nursing mothers due to secretion in human milk and potential for serious adverse reactions in nursing infants
Possible side effect
Common (≥1%):
- Nausea, diarrhea, vomiting, abdominal pain/discomfort
- Headache, restlessness, dizziness
- Rash, photosensitivity
- Transient elevations in liver enzymes
Less Common (0.1-1%):
- Tendinitis, tendon rupture
- Peripheral neuropathy
- CNS effects (insomnia, nightmares, anxiety, confusion)
- Candidiasis (oral, vaginal)
- Prolongation of QT interval
Rare (<0.1%):
- Stevens-Johnson syndrome, toxic epidermal necrolysis
- Hepatotoxicity (including fatal cases)
- Blood dyscrasias (leukopenia, neutropenia, thrombocytopenia)
- Interstitial nephritis
- Pseudomembranous colitis
- Severe hypersensitivity reactions (anaphylaxis, angioedema)
Drug interaction
- Antacids, sucralfate, multivitamins, dairy products: Significantly reduce absorption (separate administration by 2-4 hours)
- Warfarin: Potentiates anticoagulant effect; monitor prothrombin time closely
- Theophylline: Increases theophylline levels and risk of toxicity; monitor levels and reduce dose as needed
- Cyclosporine: May increase nephrotoxic potential; monitor renal function
- Probenecid: Decreases renal clearance of ciprofloxacin, increasing serum levels
- NSAIDs: May increase risk of CNS stimulation and seizures
- Oral hypoglycemic agents: May enhance hypoglycemic effect
- Methotrexate: May increase methotrexate serum concentrations
- QT-prolonging agents: Additive effect on QT interval prolongation
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed dose. Maintaining consistent antibiotic levels is important for efficacy, so patients should try to adhere strictly to the prescribed dosing schedule.
Overdose
Symptoms may include nausea, vomiting, diarrhea, CNS excitation (tremors, restlessness, confusion, hallucinations, convulsions), and renal impairment. Management is primarily supportive with ECG monitoring for QT prolongation. Adequate hydration should be maintained. Hemodialysis or peritoneal dialysis removes only small amounts (less than 10%) of ciprofloxacin. Specific antidote is not available. In cases of recent ingestion (within 2 hours), gastric lavage may be considered.
Storage
Store at room temperature (15-30°C or 59-86°F) in a dry place protected from light and moisture. Keep in the original container with the lid tightly closed. Do not store in bathroom cabinets where humidity levels may fluctuate. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly discard any unused medication after completion of therapy.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Ciplox is a prescription medication that should only be used under the supervision of a qualified healthcare professional. The prescribing physician should be consulted for diagnosis and treatment decisions. Dosage and administration should be individualized based on the specific infection, pathogen susceptibility, patient factors, and clinical response. Serious adverse reactions may occur, and patients should report any unusual symptoms to their healthcare provider immediately. Antibiotic resistance is a significant public health concern, and this medication should be used judiciously.
Reviews
“Clinical experience with ciprofloxacin spans over three decades, establishing it as a reliable option for complicated bacterial infections. Its broad spectrum and excellent tissue penetration make it particularly valuable for difficult-to-treat cases. However, the recent FDA warnings regarding disabling side effects have necessitated more careful patient selection and monitoring.” - Infectious Disease Specialist, 15 years experience
“In our hospital formulary, we reserve ciprofloxacin for specific indications where its unique properties are most beneficial. The rising resistance patterns, particularly in urinary pathogens, require us to use it judiciously. When appropriately prescribed, it remains highly effective for targeted infections.” - Hospital Pharmacist, 10 years experience
“Patient education is crucial when prescribing ciprofloxacin. I emphasize the importance of completing the full course, reporting any tendon pain immediately, and avoiding interactions with calcium-containing products. Most patients tolerate it well when properly instructed.” - Primary Care Physician, 8 years experience