From the Guidelines
When taking ciprofloxacin, watch out for tendon pain or rupture, particularly in the Achilles tendon, as this antibiotic can increase the risk of tendon damage, especially in older adults, those taking steroids, or with kidney disease. Stop the medication and contact your doctor immediately if you experience tendon pain, swelling, or rupture. Be aware of potential central nervous system effects including dizziness, confusion, hallucinations, or seizures 1. Ciprofloxacin can cause photosensitivity, so avoid excessive sun exposure and use sunscreen. The medication may lower blood sugar, particularly in diabetic patients taking insulin or oral diabetes medications. Drink plenty of fluids while taking ciprofloxacin to prevent crystal formation in the kidneys. Take the medication at least 2 hours before or 6 hours after products containing calcium, aluminum, magnesium, iron, or zinc (including antacids, dairy products, and multivitamins) as these can reduce ciprofloxacin's effectiveness 1. Complete the full course of treatment even if symptoms improve before finishing to prevent antibiotic resistance and ensure complete eradication of infection.
Some key points to consider when taking ciprofloxacin include:
- The risk of tendon damage is increased, especially in older adults, those taking steroids, or with kidney disease 1
- Central nervous system effects, such as dizziness, confusion, hallucinations, or seizures, can occur 1
- Photosensitivity can occur, so avoid excessive sun exposure and use sunscreen
- The medication may lower blood sugar, particularly in diabetic patients taking insulin or oral diabetes medications
- Drink plenty of fluids to prevent crystal formation in the kidneys
- Take the medication at least 2 hours before or 6 hours after products containing calcium, aluminum, magnesium, iron, or zinc to ensure effectiveness 1
It is essential to follow the recommended dosage and treatment duration to minimize the risk of adverse effects and ensure the effectiveness of the medication. If you experience any symptoms or have concerns, consult your doctor promptly. The most recent and highest quality study 1 supports these recommendations, prioritizing morbidity, mortality, and quality of life as the outcome.
From the FDA Drug Label
WARNINGS Tendinopathy and Tendon Rupture: Fluoroquinolones, including Ciprofloxacin Tablets USP, 250 mg, 500 mg and 750 mg, are associated with an increased risk of tendinitis and tendon rupture in all ages.
Central Nervous System Disorders: Convulsions, increased intracranial pressure, and toxic psychosis have been reported in patients receiving quinolones, including ciprofloxacin
Ciprofloxacin Tablets USP can make you feel dizzy and lightheaded
Avoid sunlamps, tanning beds, and try to limit your time in the sun. Ciprofloxacin Tablets USP can make your skin sensitive to the sun (photosensitivity) and the light from sunlamps and tanning beds
Other serious side effects of Ciprofloxacin Tablets USP include:
- Central Nervous System effects: Seizures have been reported in people who take fluoroquinolone antibiotics including Ciprofloxacin Tablets USP.
- Serious allergic reactions: Allergic reactions can happen in people taking fluoroquinolones, including Ciprofloxacin Tablets USP, even after only one dose
- Skin rash
- Serious heart rhythm changes (QT prolongation and torsade de pointes)
- Intestine infection (Pseudomembranous colitis)
- Changes in sensation and possible nerve damage (Peripheral Neuropathy)
- Low blood sugar (hypoglycemia)
Key things to watch out for when taking ciprofloxacin include:
- Tendinopathy and tendon rupture: increased risk of tendinitis and tendon rupture in all ages
- Central Nervous System effects: seizures, convulsions, increased intracranial pressure, and toxic psychosis
- Dizziness and lightheadedness: avoid driving, operating machinery, or doing other activities that require mental alertness or coordination
- Photosensitivity: avoid sunlamps, tanning beds, and limit time in the sun
- Allergic reactions: stop taking Ciprofloxacin Tablets USP and get emergency medical help right away if you get any symptoms of a severe allergic reaction
- Skin rash: stop taking Ciprofloxacin Tablets USP at the first sign of a skin rash and call your healthcare provider
- Heart rhythm changes: tell your healthcare provider right away if you have a change in your heart beat or if you faint
- Intestine infection: call your healthcare provider right away if you get watery diarrhea, diarrhea that does not go away, or bloody stools
- Peripheral neuropathy: talk with your healthcare provider right away if you get any symptoms of peripheral neuropathy
- Low blood sugar: tell your healthcare provider if you get low blood sugar with CIPRO 2, 2, 2
From the Research
Ciprofloxacin Side Effects
- The most common side effects of ciprofloxacin include digestive issues (4.9%), metabolic-nutritional issues (4.4%), and central nervous system issues (1.5%) 3
- Other less common side effects include skin issues (1.1%), hemic and lymphatic issues (0.9%), urogenital issues (0.8%), and body as a whole issues (0.5%) 3
- Serious side effects are rare, but can include acute peripheral neuropathy 4, tendinopathy 5, and acute severe myalgia 6
Rare but Serious Side Effects
- Acute peripheral neuropathy has been reported in patients taking ciprofloxacin, particularly those with lupus nephritis 4
- Tendinopathy, including tendonitis and tendon rupture, is a rare but serious side effect of ciprofloxacin, particularly in patients over 60 years old or those taking concomitant corticosteroid therapy 5
- Acute severe myalgia, or muscle pain, has been reported in patients taking ciprofloxacin, although this is a rare side effect 6