Ciprofloxacin
Fluoroquinolone antibiotic (Bayer Cipro). UTI, GI + complex Gram-negative infections. FDA boxed warning: tendon rupture + peripheral neuropathy.
Related comparisons
Amoxicillin vs Ciprofloxacin vs DoxycyclineWHAT IS CIPROFLOXACIN?
Detailed overview
Ciprofloxacin is the fluoroquinolone class prototype (Bayer Cipro, FDA 1987). Bactericidal via DNA gyrase and topoisomerase IV inhibition. Strong Gram-negative (E. coli, Pseudomonas, Klebsiella), moderate Gram-positive activity. FDA 2016/2018 BOXED WARNING is significant: tendon rupture, peripheral neuropathy, mental side effects (confusion, delirium), aortic aneurysm. Due to antibiotic stewardship, NOT first-line for mild UTI – typical indications: complicated UTI, prostatitis, non-severe acute sinusitis, GI infections (Salmonella, Shigella). FDA + EMA 2019 reassessment strictly limits fluoroquinolone use.
ATC code
J01MA02
Prescription
Prescription only (Rx), stewardship protocol
Mechanism
DNA gyrase and topoisomerase IV inhibitor (fluoroquinolone)
Half-life
~4 h (twice-daily dosing)
Onset
24–48 h (clinical response)
Data console
Lab data
Safety
Side effects, stop signs, contraindications
Side effects · 8
- FDA boxed warning – tendon rupture and tendinitis (especially the Achilles tendon), risk increased in patients over 60, with concurrent corticosteroids, and in organ-transplant recipients; stop immediately if tendon pain occurs.
- FDA boxed warning – peripheral neuropathy that can be rapid in onset and potentially irreversible (numbness, burning pain, weakness).
- CNS and psychiatric effects: dizziness, headache, insomnia, confusion, delirium, hallucinations, rarely seizures; lowers the seizure threshold.
- QT interval prolongation and risk of ventricular arrhythmia (torsades de pointes), especially with hypokalemia, other QT-prolonging drugs, or pre-existing arrhythmia.
- Increased risk of aortic aneurysm and dissection, particularly in the elderly and in patients with hypertension, vascular disease, or known aneurysm.
- Gastrointestinal effects: nausea, diarrhea, abdominal discomfort; Clostridioides difficile-associated colitis (even weeks after treatment).
- Phototoxicity (increased sun sensitivity, exaggerated sunburn) and severe skin reactions (Stevens–Johnson syndrome, TEN); avoid sun exposure and tanning beds.
- Blood-glucose disturbances (hypo- and hyperglycemia, especially in diabetics), plus elevated liver enzymes and rarely hepatotoxicity.
Contraindications · 3
- Fluoroquinolone hypersensitivity
- Children/adolescent (bone growth risk, except specific indications)
- Myasthenia gravis (relative contraindication)
Related Pharmaceuticals
Same therapeutic category
Studies
Related research and clinical findings
Fluoroquinolones and the risk of aortic aneurysm or aortic dissection
Pasternak B, Inghammar M, Svanström H.
Fluoroquinolone-Associated Tendinopathy: Does Levofloxacin Pose the Greatest Risk?
Bidell MR, Lodise TP
Antimicrobial resistance in complicated urinary tract infections: A retrospective study from a rehabilitation centre.
Do DV, Tran TTH, Tran TL
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Educational drug info from official sources (PubMed, FDA, EMA). Does NOT replace medical consultation or the SmPC. Talk to your doctor!
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The information here is for educational and scientific purposes only. Medication use requires medical consultation and a prescription. The indications, dose ranges, and side effects listed here do NOT replace the official Summary of Product Characteristics (SmPC) or consultation with a physician. Do not start or stop any medication on your own. In an emergency, call your local emergency number.