Cifran OD 1g

Drug name: Cifran

Therapeutic actions: Ciprofloxacin is a synthetic broad spectrum antibacterial agent. Ciprofloxacin is effective in vitro against virtually all gram-negative pathogens, including Pseudomonas aeruginosa. It is also effective against gram-positive pathogen such as staphylococci and streptococci. Anaerobes are generally less susceptible.

Ciprofloxacin has a rapid bactericidal action, both in the proliferation phase and in the resting phase.

Indications: Adults: Uncomplicated and complicated infections caused by ciprofloxacin sensitive pathogens:

• Infections of the lower respiratory tract. In the treatment of outpatients with pneumonia due to Pneumococcus ciprofloxacin should not be used as the drug of first choice. Ciprofloxacin can be regarded as a suitable treatment for pneumonias caused by Klebsiella, Enterobacter, Proteus, E. coli, Pseudomonas, Haemophilus, Branhamella, Legionella, and Staphylococcus.
• Infections of the kidneys and/or the efferent urinary tract.
• Infections of the genital organs, including adnexitis, gonorrhoea, prostatitis.
• Infections of the abdominal cavity (e.g. infections of the gastrointestinal tract or of the biliary tract, peritonitis).
• Infections of the skin and soft tissue.
• Infections of the bones and joints.
• Sepsis.
• Inhalation anthrax (post exposure): To reduce the incidence or progression of disease following exposure to aerolized Bacillus anthracis. Ciprofloxacin serum concentrations achieved in humans serve as a surrogate endpoint reasonably likely to predict clinical benefit and provide the basis for this indication.

Children: For the treatment of acute pulmonary exacerbation of cystic fibrosis associated with P. aeruginosa infection in paediatric patients aged 5-17 years. For the indication of inhalational anthrax (post-exposure), the risk-benefit assessment indicates that administration of ciprofloxacin to paediatric patients is appropriate. The use of ciprofloxacin for indications other than this is not recommended in children.

Contraindications and cautions: Ciprofloxacin must not be used in cases of hypersensitivity to ciprofloxacin or other quinolone chemotherapeutics.

Ciprofloxacin must not be prescribed for pregnant women or nursing mothers as there is no experience regarding safety in these patient groups and since, on the basis of animal studies, it is possible that the drug could cause damage to articular cartilage in the foetus or infant. Animal studies have not shown any evidence of teratogenic effects. When considering treatment for inhalational anthrax (post-exposure), the risks and benefits of ciprofloxacin and alternative antibiotic therapies must be carefully considered, and explained to the patient.

Adverse effects: Some side affects that may appear are presented as follows:

• nausea, diarrhoea;
• rush;
• abdominal pain;
• moniliasis, asthenia (general feeling of weakness, tiredness);
• (thrombo)-phlebitis;
• vomiting, dyspepsia, abnormal liver function test, alkaline phosphatase increased, anorexia, flatulence, bilirubinemia;
• injection site reaction;
• arthralgia (joint pain);
• headache, dizziness, insomnia, agitation, confusion;
• pruritus, maculopapular rash, urticaria;
• taste perversion.

Interactions: The simultaneous administration of ciprofloxacin (oral) and iron, sucralfate or antacids and highly buffered drugs (e.g. antiretrovirals), containing magnesium, aluminium, or calcium reduce the absorption of ciprofloxacin. Consequently, ciprofloxacin should be administered either 1-2 hours before, or at least 4 hours after these preparations. This restriction does not apply to antacids belonging to the class of H2 receptor blockers.

The concurrent administration of dairy products or mineral fortified drinks alone (eg. Milk, yoghurt, calcium fortified orange juice) and ciprofloxacin should be avoided because absorption of ciprofloxacin may be reduced. Dietary calcium as part of a meal, however, does not significantly affect absorption.

Concurrent administration of ciprofloxacin and theophylline can cause an undesirable increase in the serum theophylline concentration. This can lead to theophylline-induced side effects; in very rare cases these side effects can be life threatening or fatal. If concurrent use of the two products is unavoidable, the serum theophylline concentration should therefore be checked and the theophylline dose appropriately reduced.

Additional Information: DO NOT SHARE THIS MEDICINE with others. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS PRODUCT, as well as syringes and needles, if needed during treatment, out of the reach of children. Do not reuse needles, syringes, or other materials.