Call you doctor right away if you are not able to move or bear weight on a joint or if you hear or feel a snap or pop. Call your doctor right away if you have signs of nerve problems. These may include not being able to handle heat or cold; change in sense of touch; or burning, numbness , tingling, pain, or weakness in the arms, hands, legs, or feet. Call your doctor right away if you have signs of nervous system problems. These may include anxiety , bad dreams, trouble sleeping, change in eyesight, dizziness , feeling confused, feeling nervous or agitated, feeling restless, hallucinations seeing or hearing things that are not there , new or worse behavior or mood changes like depression or thoughts of killing yourself, seizures , or very bad headaches.

Do not take if you have myasthenia gravis. Very bad and sometimes deadly breathing problems have happened with Cipro ciprofloxacin oral suspension in people who have myasthenia gravis. For some health problems, Cipro ciprofloxacin oral suspension is only for use when other drugs cannot be used or have not worked. Talk with the doctor to be sure that the benefits of Cipro ciprofloxacin oral suspension are more than the risks. It is used to treat or prevent bacterial infections. If you have an allergy to ciprofloxacin or any other part of Cipro ciprofloxacin oral suspension.

If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives ; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

If you have any of these health problems: Long QTc on ECG or other heartbeat that is not normal, slow heartbeat , or low potassium or magnesium levels.

If you have kidney problems. If you have heart failure weak heart. If you have had a recent heart attack. If you have ever had any of these health problems: Nerve problems or tendon problems.

If you have had tendons get irritated or torn when taking Cipro ciprofloxacin oral suspension or an alike drug in the past. If you have been taking any drugs to treat a heartbeat that is not normal.

If you are taking any drugs that can cause a certain type of heartbeat that is not normal prolonged QT interval. There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure. If you are taking any of these drugs: Duloxetine , theophylline , tizanidine , or zolpidem.

If you are breast-feeding or plan to breast-feed. This is not a list of all drugs or health problems that interact with Cipro ciprofloxacin oral suspension. Tell your doctor and pharmacist about all of your drugs prescription or OTC, natural products, vitamins and health problems. You must check to make sure that it is safe for you to take Cipro ciprofloxacin oral suspension with all of your drugs and health problems.

Do not start, stop, or change the dose of any drug without checking with your doctor. Tell all of your health care providers that you take Cipro ciprofloxacin oral suspension. Moderate Clinical monitoring for adverse effects, such as cardiotoxic effects, hypotension, or CNS toxicity, is recommended during coadministration as plasma concentrations of bupivacaine may be elevated when administered concurrently with ciprofloxacin.

Moderate Concomitant use of systemic lidocaine and ciprofloxacin may increase lidocaine plasma concentrations by decreasing lidocaine clearance and therefore prolonging the elimination half-life. Monitor for lidocaine toxicity if used together. Major Buprenorphine should be used cautiously and with close monitoring with ciprofloxacin. Rare cases of QT prolongation and torsade de pointe TdP have been reported with ciprofloxacin during post-marketing surveillance.

Buprenorphine has also been associated with QT prolongation and has a possible risk of torsade de pointes TdP.

FDA-approved labeling for some buprenorphine products recommend avoiding use with Class 1A and Class III antiarrhythmic medications while other labels recommend avoiding use with any drug that has the potential to prolong the QT interval.

Additionally, the plasma concentrations of buprenorphine and its metabolite, norbuprenorphine, may be elevated when administered concurrently ciprofloxacin. Dose adjustments are not required; however clinical monitoring for adverse effects, such as CNS side effects or respiratory depression, is recommended during coadministration.

Moderate Close clinical monitoring is recommended if buspirone is administered with ciprofloxacin; buspirone dose reductions may be required. The plasma concentrations of buspirone may be elevated when administered concurrently with ciprofloxacin. Predictions regarding this interaction can be made based on the metabolic pathways of these drugs. Ciprofloxacin is an inhibitor of CYP3A4, an isoenzyme responsible for the metabolism of buspirone.

These drugs used in combination may result in elevated buspirone plasma concentrations, causing an increased risk for buspirone-related adverse events. Major Administer oral ciprofloxacin at least 2 hours before or 6 hours after oral products that contain calcium. Examples of compounds that may interfere with quinolone bioavailability include antacids and multivitamins that contain calcium.

Calcium Carbonate; Magnesium Hydroxide: Major Serum carbamazepine concentrations should be monitored closely during coadministration with ciprofloxacin; reduced carbamazepine doses may be necessary. Carbamazepine is metabolized by the hepatic isoenzyme CYP3A4. Drugs known to inhibit CYP3A4, such as ciprofloxacin, may decrease carbamazepine metabolism and increase carbamazepine plasma concentrations.

Moderate Monitor for adverse effects, such as CNS effects and extrapyramidal symptoms, during coadministration of cariprazine and ciprofloxacin. Cariprazine and its active metabolites are extensively metabolized by CYP3A4.

Moderate The concomitant administration of quinolones and nonsteroidal antiinflammatory drugs has been reported to increase the risk of CNS stimulation and convulsive seizures. Patients with CNS disorders or other risk factors that may predispose them to seizure development or patients taking drugs that lower the seizure threshold may not be appropriate candidates for NSAID usage if they are also taking a quinolone.

Major Periodically monitor electrolytes and ECGs in patients receiving concomitant treatment with ceritinib and ciprofloxacin; an interruption of ceritinib therapy, dose reduction, or discontinuation of therapy may be necessary if QT prolongation occurs. Ceritinib causes concentration-dependent prolongation of the QT interval. Rare cases of QT prolongation and torsade de pointes TdP have been reported with ciprofloxacin during postmarketing surveillance.

Moderate Clinical monitoring for adverse effects, such as GI or cardiac side effects, is recommended during coadministration of cevimeline and ciprofloxacin as the plasma concentrations of cevimeline may be elevated when administered concurrently with ciprofloxacin. Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering chloroquine with ciprofloxacin.

Chloroquine administration is associated with an increased risk of QT prolongation and TdP. The need to coadminister chloroquine with other drugs associated with QT prolongation and TdP, such as ciprofloxacin, should be done with a careful assessment of risks versus benefits and should be avoided when possible.

Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine: Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering chlorpromazine with ciprofloxacin. This risk is generally higher at elevated drugs concentrations of phenothiazines.

Chlorpromazine is specifically associated with an established risk of QT prolongation and TdP; case reports have included patients receiving therapeutic doses of chlorpromazine. Administration of chlorpromazine with ciprofloxacin may cause additive QT prolongation and could lead to TdP, and therefore concurrent use is generally not recommended.

Choline Salicylate; Magnesium Salicylate: Major Reduce cilostazol dose to 50 mg PO twice daily when administered with ciprofloxacin. Severe QT prolongation and ventricular arrhythmias, including torsade de pointes TdP and death, have been reported with cisapride. Because of the potential for TdP, use of ciprofloxacin is contraindicated with cisapride.

Major Concurrent use of citalopram and ciprofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes TdP. If concurrent therapy is considered essential, ECG monitoring is recommended. Citalopram causes dose-dependent QT interval prolongation. Ciprofloxacin is associated with a possible risk for QT prolongation and TdP. Moderate Concomitant use of clindamycin and ciprofloxacin may decrease clindamycin clearance and increase the risk of adverse reactions.

Caution and close monitoring are advised if these drugs are used together. Moderate Use tretinoin with caution in patients who are also taking drugs known to be photosensitizers, such as ciprofloxacin, as concomitant use may augment phototoxicity.

Patients should take care and use proper techniques to limit sunlight and UV exposure of treated areas. Moderate Ciprofloxacin is a CYP3A4 inhibitor and may reduce the metabolism of clonazepam and increase the potential for benzodiazepine toxicity. Minor The therapeutic effectiveness of clopidogrel should be monitored during coadministration with ciprofloxacin. Clopidogrel requires hepatic biotransformation to an active metabolite; the activation is thought to be mediated by the CYP3A4 isoenzyme.

Ciprofloxacin is an inhibitor of CYP3A4 and may decrease the hepatic metabolism of clopidogrel to its active metabolite. Moderate Ciprofloxacin is a CYP3A4 inhibitor and may reduce the metabolism of clorazepate and increase the potential for benzodiazepine toxicity. Major If co-administration of clozapine and a potent inhibitor of CYP1A2 such as ciprofloxacin is necessary, the manufacturer of clozapine recommends using one-third of the usual clozapine dose.

If the inhibitor is discontinued, increase the clozapine dose based on clinical response. In addition, rare cases of QT prolongation and torsade de pointes TdP have been reported with both ciprofloxacin and clozapine.

Elevated plasma concentrations of clozapine occurring through inhibition of CYP1A2, CYP3A4, or CYP2D6 may potentially increase the risk of life-threatening arrhythmias, sedation, anticholinergic effects, seizures, orthostasis, or other adverse effects. Major Avoid the concurrent use of cobimetinib with chronic ciprofloxacin therapy due to the risk of cobimetinib toxicity.

If concurrent short-term 14 days or less use of ciprofloxacin is unavoidable, reduce the dose of cobimetinib to 20 mg once daily for patients normally taking 60 mg daily; after discontinuation of ciprofloxacin, resume cobimetinib at the previous dose. Use an alternative to ciprofloxacin in patients who are already taking a reduced dose of cobimetinib 40 or 20 mg daily.

Moderate Promethazine carries a possible risk of QT prolongation. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously with promethazine include ciprofloxacin.

Major Due to the risk for serious colchicine toxicity including multi-organ failure and death, avoid coadministration of colchicine and ciprofloxacin unless the use of both agents is imperative. Ciprofloxacin can inhibit colchicine's metabolism via CYP3A4, resulting in increased colchicine exposure. If coadministration cannot be avoided, adjust the dose of colchicine by either reducing the daily dose or the dosage frequency, and carefully monitor for colchicine toxicity.

Specific dosage adjustment recommendations are available for the Colcrys product for patients who have taken a moderate inhibitor like ciprofloxacin in the past 14 days or require concurrent use: Moderate Coadministration of conivaptan with CYP3A4 inhibitors, such as ciprofloxacin, could lead to an increase in conivaptan serum concentrations.

Conivaptan is a substrate of CYP3A4. According to the manufacturer, coadministration of conivaptan with strong CYP3A4 inhibitors is contraindicated. Until further data are available, it is prudent to coadminister conivaptan with caution or to avoid coadministering conivaptan with other drugs known to be significant inhibitors of CYP3A4 isoenzymes, such as ciprofloxacin.

Major Monitor ECGs for QT prolongation, monitor electrolytes, and watch for an increase in crizotinib-related adverse reactions e. An interruption of therapy, dose reduction, or discontinuation of therapy may be necessary for crizotinib patients if QT prolongation occurs.

Ciprofloxacin is a moderate CYP3A4 inhibitor; rare cases of QT prolongation and torsade de pointes TdP have been reported with ciprofloxacin during postmarketing surveillance.

Moderate Coadministration of ciprofloxacin with drugs known to prolong the QT interval could increase the risk of developing torsade de pointes TdP in predisposed patients. Cyclobenzaprine is associated with a possible risk of QT prolongation and TdP, particularly in the event of acute overdose. Moderate Use caution if cyclophosphamide is used concomitantly with ciprofloxacin, and monitor for possible changes in the efficacy or toxicity profile of cyclophosphamide.

The clinical significance of this interaction is unknown. Cyclophosphamide is a prodrug that is hydroxylated and activated primarily by CYP2B6; the contribution of CYP3A4 to the activation of cyclophosphamide is variable. N-dechloroethylation to therapeutically inactive but neurotoxic metabolites occurs primarily via CYP3A4.

In vitro, coadministration with a CYP3A4 inhibitor had little-to-no effect on cyclophosphamide metabolism. Moderate Monitor renal function during concomitant therapy. Cyclosporine serum concentrations should be monitored and suitable dosage adjustments made.

Coadministration of ciprofloxacin and cyclosporine may result in elevated plasma cyclosporine concentrations. Additionally, some quinolones, including ciprofloxacin, have been associated with transient elevations in serum creatinine in patients receiving concomitant cyclosporine and ciprofloxacin therapy and may potentiate renal dysfunction. Cases of nephrotoxicity with and without increases in cyclosporine concentrations during concurrent cyclosporine and ciprofloxacin treatment have been reported.

Moderate According to the manufacturer, concurrent administration of daclatasvir, a CYP3A4 substrate, with ciprofloxacin, a moderate CYP3A4 inhibitor, may increase daclatasvir serum concentrations. If these drugs are administered together, monitor patients for daclatasvir-related adverse effects, such as headache, fatigue, nausea, and diarrhea.

The manufacturer does not recommend daclatasvir dose reduction for adverse reactions. Moderate Careful monitoring of blood glucose is recommended when quinolones and antidiabetic agents, including saxagliptin, are coadministered. Moderate Clinical monitoring for adverse effects, such as hemolytic anemia, methemoglobinemia, or peripheral neuropathy, is recommended during coadministration of dapsone and ciprofloxacin. Plasma concentrations of dapsone may be elevated when administered concurrently with ciprofloxacin.

Moderate Clinical monitoring for adverse effects, such as anticholinergic effects, is recommended during coadministration of darifenacin and ciprofloxacin. The plasma concentrations of darifenacin may be elevated when administered concurrently with ciprofloxacin. Moderate Caution is warranted when darunavir is administered with ciprofloxacin as there is a potential for elevated concentrations of darunavir.

Clinical monitoring for adverse effects is recommended during coadministration. Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide: Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir: Major Ritonavir has been associated with dose-related QT prolongation in other trials.

Ciprofloxacin should be used cautiously and with close monitoring with ritonavir. Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering dasatinib with ciprofloxacin. In vitro studies have shown that dasatinib has the potential to prolong cardiac ventricular repolarization prolong QT interval. Ciprofloxacin also has a possible risk for QT prolongation and TdP and should be used cautiously with dasatinib.

Major Ciprofloxacin has been reported to cause QT prolongation and torsade de pointes. Use ciprofloxacin with caution with daunorubicin or doxorubicin as acute cardiotoxicity can occur during administration; cumulative, dose-dependent cardiomyopathy may also occur.

Sinus tachycardia is the most common arrhythmia, but other arrhythmias such as supraventricular tachycardia SVT , ventricular tachycardia, heart block, and premature ventricular contractions PVCs have been reported during anthracycline therapy. Major Decrease deflazacort dose to one third of the recommended dosage when coadministered with ciprofloxacin.

Concurrent use may significantly increase concentrations of desDFZ, the active metabolite of deflazacort, resulting in an increased risk of toxicity. Additionally, coadministration of deflazacort and ciprofloxacin may increase the risk of tendon rupture that has been associated with quinolone antibiotics.

Discontinue quinolone therapy at the first sign of tendon inflammation or tendon pain as these are symptoms that may precede rupture of the tendon. Major Since degarelix can cause QT prolongation, degarelix should be used cautiously with other drugs that are associated with QT prolongation, such as ciprofloxacin. Prescribers need to weigh the potential benefits and risks of degarelix use in patients with prolonged QT syndrome or receiving treatment with ciprofloxacin.

Moderate The plasma concentrations of delavirdine may be elevated when administered concurrently with ciprofloxacin. Major Halogenated anesthetics should be used cautiously and with close monitoring with ciprofloxacin.

Halogenated anesthetics can prolong the QT interval. Ciprofloxacin should be used with caution in patients receiving other drugs that prolong the QT interval. Clinically relevant QTc prolongation may occur with deutetrabenazine. Minor The plasma concentrations of dexlansoprazole may be elevated when administered concurrently with ciprofloxacin. Clinical monitoring for adverse effects, such as GI effects, is recommended during coadministration.

Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate: Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering quinidine with ciprofloxacin. Quinidine is associated with QT prolongation and TdP. The manufacturer of dextromethorphan; quinidine recommends an ECG in patients taking it in combination with other drugs known to prolong the QTc, such as ciprofloxacin. Moderate Ciprofloxacin is a CYP3A4 inhibitor and may reduce the metabolism of diazepam and increase the potential for benzodiazepine toxicity.

Ciprofloxacin has been shown to decrease the clearance and increase the half-life of diazepam. However, no significant changes were observed in digit symbol substitution psychometric tests, tapping rate and short memory, or concentration, vigilance, and tension. Major Administer oral ciprofloxacin at least 2 hours before or 6 hours after didanosine tablets or powder for oral solution.

Ciprofloxacin absorption may be reduced as it can chelate with the buffering agents contained in didanosine tablets and powder. The delayed-release didanosine capsules do not contain a buffering agent and would not be expected to interact with ciprofloxacin. Moderate Caution and monitoring is warranted with the use of ciprofloxacin and diltiazem. Monitor for adverse events such as a decrease in blood pressure or heart rate.

Major Both disopyramide and ciprofloxacin are associated with a possible risk for QT prolongation and torsade de pointes TdP ; therefore, caution is advised when administering these medications concurrently. Moderate The plasma concentrations of disulfiram may be elevated when administered concurrently with ciprofloxacin.

Moderate The plasma concentrations of docetaxel may be elevated when administered concurrently with ciprofloxacin. Clinical monitoring for adverse effects, such as myelosuppression and neurologic toxicity, is recommended during coadministration. Severe Because of the potential for torsade de pointes TdP , use of dofetilide with ciprofloxacin is contraindicated.

Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering dolasetron with ciprofloxacin. Ciprofloxacin has been associated with a possible risk for QT prolongation and TdP based on varying levels of documentation. Dolasetron injection is contraindicated for use for the prevention of chemotherapy-induced nausea and vomiting because the risk of QT prolongation is higher with the doses used for this indication; when the injection is used at lower doses i.

Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering rilpivirine with ciprofloxacin. Major Case reports indicate that QT prolongation and torsade de pointes TdP can occur during donepezil therapy.

Donepezil is considered a drug with a known risk of TdP. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with donepezil include ciprofloxacin.

Major Avoid coadministration of escitalopram and doxorubicin if possible. If not possible, closely monitor for increased side effects of doxorubicin including myelosuppression and cardiotoxicity. Clinically significant interactions have been reported when doxorubicin was coadministered with inhibitors of CYP3A4, resulting in increased concentration and clinical effect of doxorubicin.

Additionally, acute cardiotoxicity can occur during the administration of doxorubicin; although, the incidence is rare. Moderate Use caution if coadministration of dronabinol with ciprofloxacin is necessary, and closely monitor for an increase in dronabinol-related adverse reactions e. Concomitant use may result in elevated plasma concentrations of dronabinol.

Severe Concurrent use of dronedarone and ciprofloxacin is contraindicated. Dronedarone administration is associated with a dose-related increase in the QTc interval. The increase in QTc is approximately 10 milliseconds at doses of mg twice daily the FDA-approved dose and up to 25 milliseconds at doses of mg twice daily.

Although there are no studies examining the effects of dronedarone in patients receiving other QT prolonging drugs, coadministration of such drugs may result in additive QT prolongation. The concomitant use of dronedarone with other drugs that prolong the QTc, such as ciprofloxacin, may induce Torsade de Pointes TdP and is contraindicated. Major Droperidol should not be used in combination with any drug known to have potential to prolong the QT interval, such as ciprofloxacin.

Droperidol administration is associated with an established risk for QT prolongation and torsade de pointes TdP. Some cases have occurred in patients with no known risk factors for QT prolongation and some cases have been fatal. If coadministration cannot be avoided, use extreme caution; initiate droperidol at a low dose and increase the dose as needed to achieve the desired effect.

Major Coadministration of duloxetine and potent inhibitors of CYP1A2, such as ciprofloxacin, should be avoided. Duloxetine is partially metabolized by CYP1A2. One study involving a potent CYP1A2 inhibitor in concomitant use with duloxetine showed that duloxetine exposure was significantly increased. Major Coadministration of efavirenz and ciprofloxacin may increase the risk for QT prolongation and torsades de pointes TdP. QT prolongation has been observed with use of efavirenz.

Although data are limited, the manufacturer of efavirenz recommends an alternative antiretroviral be considered for patients receiving medications with a known risk for TdP. Rare cases of QT prolongation and TdP have been reported with ciprofloxacin during post-marketing surveillance.

Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate: Moderate Administering elbasvir; grazoprevir with ciprofloxacin may cause the plasma concentrations of elbasvir and grazoprevir to increase; thereby increasing the potential for adverse effects i. If these drugs are used together, closely monitor for signs of hepatotoxicity. Moderate Monitor for increased eletriptan-related adverse effects if coadministered with ciprofloxacin.

Systemic concentrations of eletriptan may be increased. The coadministration of eliglustat with ciprofloxacin and a moderate or strong CYP2D6 inhibitor is contraindicated in all patients. Coadministration of eliglustat with moderate CYP3A inhibitors, such as ciprofloxacin, increases eliglustat exposure and the risk of serious adverse events e.

Both eliglustat and ciprofloxacin can independently prolong the QT interval, and coadministration increases this risk. The significance of administering inhibitors of CYP1A2, such as ciprofloxacin, on the systemic exposure of eltrombopag has not been established.

Monitor patients for signs of eltrombopag toxicity if these drugs are coadministered. Moderate Careful monitoring of blood glucose is recommended when quinolones and antidiabetic agents, including linagliptin, are coadministered. Emtricitabine; Rilpivirine; Tenofovir alafenamide: Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate: Moderate Concurrent administration of felodipine with ciprofloxacin may result in elevated felodipine plasma concentrations.

This increase in felodipine concentration may lead to increased therapeutic and adverse effects, such as lower blood pressure, dizziness, and headache. Felodipine is metabolized by the hepatic isoenzyme CYP3A4; ciprofloxacin is an inhibitor of this enzyme. If coadministration of these drugs is warranted, do so with caution and careful monitoring.

Major Avoid coadministration of encorafenib and ciprofloxacin due to increased encorafenib exposure and QT prolongation.

If concurrent use cannot be avoided, reduce the encorafenib dose to one-half of the dose used prior to the addition of ciprofloxacin. If ciprofloxacin is discontinued, the original encorafenib dose may be resumed after 3 to 5 elimination half-lives of ciprofloxacin. Encorafenib is a CYP3A4 substrate that has been associated with dose-dependent QT prolongation; ciprofloxacin is a moderate CYP3A4 inhibitor that has been associated with rare cases of QT prolongation and torsade de pointes TdP during postmarketing surveillance.

Coadministration of a moderate CYP3A4 inhibitor with a single 50 mg dose of encorafenib 0. Major Enteral feedings may decrease the serum concentrations of quinolone antimicrobials. Administration of ciprofloxacin and enteral feedings together through a nasogastric NG tube decreased the gastrointestinal absorption of ciprofloxacin minimally; MIC values remained high for many pathogenic bacteria.

Ciprofloxacin should be taken either 2 hours before or 6 hours after enteral feedings. Moderate Due to the potential for QT prolongation and torsade de pointes TdP , caution is advised when administering ciprofloxacin with epirubicin.

Ciprofloxacin has been reported to cause QT prolongation and TdP. Acute cardiotoxicity can also occur during administration of epirubicin; although, the incidence is rare. Sinus tachycardia is the most common arrhythmia, but other arrhythmias such as supraventricular tachycardia SVT , ventricular tachycardia, heart block, and premature ventricular contractions PVCs have been reported.

Major Do not exceed an eplerenone dose of 25 mg PO once daily if given concurrently with a CYP3A4 inhibitor in a post-myocardial infarction patient with heart failure.

In patients with hypertension receiving a concurrent CYP3A4 inhibitor, initiate eplerenone at 25 mg PO once daily; the dose may be increased to a maximum of 25 mg PO twice daily for inadequate blood pressure response.

In addition, measure serum creatinine and serum potassium within 3 to 7 days of initiating a CYP3A4 inhibitor and periodically thereafter. Eplerenone is a CYP3A4 substrate.

Ciprofloxacin is a CYP3A4 inhibitor. Increased eplerenone concentrations may lead to a risk of developing hyperkalemia and hypotension. Major Concurrent use of eribulin and ciprofloxacin should be avoided due to an increased risk for QT prolongation and torsade de pointes TdP. If these drugs must be coadministered, ECG monitoring is recommended; closely monitor the patient for QT interval prolongation. Eribulin has been associated with QT prolongation, and ciprofloxacin is associated with a posssible risk for QT prolongation and TdP.

Major Avoid coadministration of erlotinib with ciprofloxacin if possible due to the increased risk of erlotinib-related adverse reactions. If concomitant use is unavoidable and severe reactions occur, reduce the dose of erlotinib by 50 mg decrements.

Moderate Careful monitoring of blood glucose is recommended when quinolones and antidiabetic agents, including sitagliptin, are coadministered. Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering erythromycin with ciprofloxacin.

Erythromycin is associated with QT prolongation and TdP. Ciprofloxacin is associated with a possible risk for QT prolongation and TdP and should be used cautiously with erythromycin. Moderate Escitalopram has been associated with QT prolongation.

Coadministration with other drugs that have a possible risk for QT prolongation and torsade de pointes TdP , such as ciprofloxacin, should be done with caution and close monitoring. Minor Use caution when administering ciprofloxacin and esomeprazole concurrently.

Coadministration of ciprofloxacin with CYP3A substrates, such as esomeprazole, can theoretically increase esomeprazole exposure leading to increased or prolonged therapeutic effects and adverse events; however, the clinical impact of this has not yet been determined. Moderate Ciprofloxacin is a CYP3A4 inhibitor and may reduce the metabolism of estazolam and increase the potential for benzodiazepine toxicity.

Major "Quinolones have been associated with QT prolongation and in rare cases, torsades de pointes TdP. Of the quinolones, ciprofloxacin has the least potential for causing QT prolongation at usual dosages.

Rare cases of TdP have been reported with ciprofloxacin during post-marketing surveillance. Although less likely than with most quinolones, coadministration of ciprofloxacin with drugs known to prolong the QT interval could increase the risk of developing TdP in predisposed patients.

Other drugs with potential to prolong the QT interval may include local anesthetics. CYP3A4 is a primary metabolic pathway for eszopiclone, and increased systemic exposure to eszopiclone increases the risk of next-day impairment, which may decrease the ability to perform tasks requiring full mental alertness such as driving. Minor Coadministration of etonogestrel and moderate CYP3A4 inhibitors such as ciprofloxacin may increase the serum concentration of etonogestrel.

Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate: Major Administer oral ciprofloxacin at least 2 hours before or 6 hours after oral products that contain iron. Examples of compounds that may interfere with quinolone bioavailability include multivitamins that contain iron. Ethinyl Estradiol; Norethindrone; Ferrous fumarate: Moderate Close clinical monitoring is advised when administering ethosuximide with ciprofloxacin due to an increased potential for ethosuximide-related adverse events.

If ethosuximide dose adjustments are made, re-adjust the dose upon completion of ciprofloxacin treatment. Although this interaction has not been studied, predictions about the interaction can be made based on the metabolic pathway of ethosuximide. Ethosuximide is metabolized by the hepatic isoenzyme CYP3A4; ciprofloxacin inhibits this isoenzyme. Coadministration may result in elevated ethosuximide plasma concentrations. Major The plasma concentrations of etoposide may be elevated when administered concurrently with ciprofloxacin.

Clinical monitoring for adverse effects, such as myelosuppression and GI effects, is recommended during coadministration. Major A dose adjustment of everolimus is necessary when prescribed with ciprofloxacin due to increased plasma concentrations of everolimus.

For patients with breast cancer, neuroendocrine tumors, renal cell carcinoma, and renal angiolipoma with tubular sclerosis complex TSC , reduce the dose of Afinitor to 2. If ciprofloxacin is discontinued, increase everolimus to its original dose after 3 days. Change to every other day dosing if the reduced dose is lower than the lowest available strength.

Zortress dosing for prophylaxis of organ rejection should be guided by TDM. Moderate Monitor for evidence of myopathy, including rhabdomyolysis, during coadministration of ciprofloxacin and simvastatin.

There are case reports of rhabdomyolysis in patients stabilized on a simvastatin regimen after the addition of ciprofloxacin. Ciprofloxacin may increase simvastatin exposure. Major Ezogabine has been associated with QT prolongation. The manufacturer of ezogabine recommends caution during concurrent use of medications known to increase the QT interval, such as ciprofloxacin. Moderate The plasma concentrations of fentanyl may be elevated when administered concurrently with ciprofloxacin.

Clinical monitoring for adverse effects, such as oversedation, respiratory depression, and hypotension, is recommended during coadministration. Major Cautious use of fingolimod with ciprofloxacin is advised, as ciprofloxacin is associated with a possible risk for QT prolongation and torsade de pointes.

Fingolimod initiation results in decreased heart rate and may prolong QT interval. After the first fingolimod dose, overnight monitoring with continuous ECG in a medical facility is advised for patients taking QT prolonging drugs with a known risk of TdP. Fingolimod has not been studied in patients treated with drugs that prolong the QT interval, but drugs that prolong the QT interval have been associated with cases of TdP in patients with bradycardia.

Moderate Due to the potential for QT prolongation and torsade de pointes TdP , caution is advised when administering ciprofloxacin with flecainide. Although causality for TdP has not been established for flecainide, patients receiving concurrent drugs which have the potential for QT prolongation, such as ciprofloxacin, may have an increased risk of developing proarrhythmias.

Severe The concomitant use of flibanserin and moderate CYP3A4 inhibitors, such as ciprofloxacin, is contraindicated.

Moderate CYP3A4 inhibitors can increase flibanserin concentrations, which can cause severe hypotension and syncope. If initiating flibanserin following use of a moderate CYP3A4 inhibitor, start flibanserin at least 2 weeks after the last dose of the CYP3A4 inhibitor.

If initiating a moderate CYP3A4 inhibitor following flibanserin use, start the moderate CYP3A4 inhibitor at least 2 days after the last dose of flibanserin. Major Due to an increased risk for QT prolongation and torsade de pointes TdP , caution is advised when administering fluconazole with ciprofloxacin.

Fluconazole has been associated with QT prolongation and rare cases of TdP. Ciprofloxacin also has a possible risk for QT prolongation and TdP and should be used cautiously with fluconazole. Major Because QT prolongation and torsade de pointes TdP have been reported in patients treated with fluoxetine, the manufacturer recommends caution when using fluoxetine with other drugs that prolong the QT interval.

Drugs with a possible risk for QT prolongation and TdP include ciprofloxacin. Major Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances.

Therefore, caution is advised when administering olanzapine with drugs having an established causal association with QT prolongation and torsade de pointes TdP including ciprofloxacin. Additionally, ciprofloxacin inhibits the activity of CYP1A2.

Inhibitors of CYP1A2 could potentially reduce the elimination of olanzapine. However, since multiple enzyme pathways metabolize olanzapine, inhibition of only one isoenzyme may not appreciably decrease olanzapine clearance.

One case study reported elevated olanzapine plasma concentrations during ciprofloxacin coadministration, possibly due to CYP1A2 inhibition of olanzapine metabolism. Ciprofloxacin inhibits the activity of CYP1A2. Parents should inform their child's physician if the child has a history of joint-related problems before taking this drug. Parents of pediatric patients should also notify their child's physician of any joint-related problems that occur during or following ciprofloxacin therapy.

In a pharmacokinetic study, tizanidine serum concentrations were significantly increased Cmax 7-fold, AUC fold when the drug was given concomitantly with ciprofloxacin. Potentiated hypotensive and sedative effects were observed. Coadministration of tizanidine and ciprofloxacin must be avoided. As with some other quinolones, concurrent administration of ciprofloxacin with theophylline may lead to elevated serum concentrations of theophylline and prolongation of its elimination half-life.

This may result in increased risk of theophylline-related adverse reactions. Some quinolones, including ciprofloxacin, have also been shown to interfere with the metabolism of caffeine. This may lead to reduced clearance of caffeine and a prolongation of its serum half-life.

Histamine H 2 -receptor antagonists appear to have no significant effect on the bioavailability of ciprofloxacin. Altered serum levels of phenytoin increased and decreased have been reported in patients receiving concomitant ciprofloxacin.

The concomitant administration of ciprofloxacin with the sulfonylurea glyburide has, on rare occasions, resulted in severe hypoglycemia. Some quinolones, including ciprofloxacin, have been associated with transient elevations in serum creatinine in patients receiving cyclosporine concomitantly. Quinolones, including ciprofloxacin, have been reported to enhance the effects of the oral anticoagulant warfarin or its derivatives.

When these products are administered concomitantly, prothrombin time or other suitable coagulation tests should be closely monitored.

Probenecid interferes with renal tubular secretion of ciprofloxacin and produces an increase in the level of ciprofloxacin in the serum. This should be considered if patients are receiving both drugs concomitantly.

Renal tubular transport of methotrexate may be inhibited by concomitant administration of ciprofloxacin potentially leading to increased plasma levels of methotrexate. This might increase the risk of methotrexate associated toxic reactions. Therefore, patients under methotrexate therapy should be carefully monitored when concomitant ciprofloxacin therapy is indicated.

Metoclopramide significantly accelerates the absorption of oral ciprofloxacin resulting in shorter time to reach maximum plasma concentrations. No significant effect was observed on the bioavailability of ciprofloxacin.

Non-steroidal anti-inflammatory drugs but not acetyl salicylic acid in combination of very high doses of quinolones have been shown to provoke convulsions in pre-clinical studies.

Carcinogenesis, Mutagenesis, Impairment of Fertility: Eight in vitro mutagenicity tests have been conducted with ciprofloxacin, and the test results are listed below: Results from photo co-carcinogenicity testing indicate that ciprofloxacin does not reduce the time to appearance of UV-induced skin tumors as compared to vehicle control.

Hairless Skh-1 mice were exposed to UVA light for 3. The times to development of skin tumors ranged from weeks in mice treated concomitantly with UVA and other quinolones.

The clinical significance of these findings to humans is unknown. There are no adequate and well-controlled studies in pregnant women.

The reported rates of major congenital malformations were 2. Rates of spontaneous abortions, prematurity and low birth weight did not differ between the groups and there were no clinically significant musculoskeletal dysfunctions up to one year of age in the ciprofloxacin exposed children.

The malformation rates among live-born babies exposed to ciprofloxacin and to fluoroquinolones overall were both within background incidence ranges. No specific patterns of congenital abnormalities were found. The study did not reveal any clear adverse reactions due to in utero exposure to ciprofloxacin. No differences in the rates of prematurity, spontaneous abortions, or birth weight were seen in women exposed to ciprofloxacin during pregnancy.

Ciprofloxacin is excreted in human milk. The amount of ciprofloxacin absorbed by the nursing infant is unknown. Because of the potential for serious adverse reactions in infants nursing from mothers taking ciprofloxacin, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Ciprofloxacin, like other quinolones, causes arthropathy and histological changes in weight-bearing joints of juvenile animals resulting in lameness.

Inhalational Anthrax Post-Exposure Ciprofloxacin is indicated in pediatric patients for inhalational anthrax post-exposure. The risk-benefit assessment indicates that administration of ciprofloxacin to pediatric patients is appropriate.

Complicated Urinary Tract Infection and Pyelonephritis Ciprofloxacin is indicated for the treatment of complicated urinary tract infections and pyelonephritis due to Escherichia coli. The rates of these events in pediatric patients with complicated urinary tract infection and pyelonephritis within six weeks of follow-up were 9. The rates of these events occurring at any time up to the one year follow-up were Cystic Fibrosis Short-term safety data from a single trial in pediatric cystic fibrosis patients are available.

In a randomized, double-blind clinical trial for the treatment of acute pulmonary exacerbations in cystic fibrosis patients ages years , 67 patients received ciprofloxacin I. Patients less than 5 years of age were not studied.

Safety monitoring in the study included periodic range of motion examinations and gait assessments by treatment-blinded examiners. Patients were followed for an average of 23 days after completing treatment range days.

This study was not designed to determine long term effects and the safety of repeated exposure to ciprofloxacin. Other adverse events were similar in nature and frequency between treatment arms.

One of sixty-seven patients developed arthritis of the knee nine days after a ten day course of treatment with ciprofloxacin.

Clinical symptoms resolved, but an MRI showed knee effusion without other abnormalities eight months after treatment.

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However, cipro suspension schering, coadministration of a single mg oral dose of Proquin XR given 2 hours after the third dose of omeprazole 40 mg once daily for 3 days to 27 healthy volunteers resulted in no changes in the ciprofloxacin AUC and Cmax. Moderate Schering may be an cipro risk for QT suspension and torsade de pointes TdP during concurrent use of fluvoxamine and ciprofloxacin. The exposure to lomitapide was increased fold in the presence of ketoconazole, a strong CYP3A4 suspension. If co-administration is necessary, suspension for an increase in ado-trastuzumab emtansine-related adverse cipro. If possible, avoid misoprostol 400 mg. Discontinue quinolone therapy at the first sign of tendon inflammation or tendon pain, as these are symptoms that may precede rupture of the tendon, cipro suspension schering. This is not a list of all drugs or schering problems that interact with Cipro ciprofloxacin oral suspension. Post-marketing surveillance for ofloxacin has identified very rare cases of TdP. In addition, rare cases of QT prolongation and TdP schering been reported with cipro during post-marketing surveillance.

Specific recommendations for immediate-release IR guanfacine are not available. Major Avoid coadministration of ribociclib with ciprofloxacin schering to an increased risk for QT prolongation and schering de pointes TdP. The likelihood of QT prolongation may increase with increasing concentrations of moxifloxacin, therefore the recommended dose or infusion rate should not be exceeded. Moderate Coadministration of conivaptan with CYP3A4 inhibitors, such as ciprofloxacin, could cipro to an cipro in conivaptan serum concentrations. Ciprofloxacin may be taken two suspensions before or six hours after taking these products. Predictions regarding this suspension can be made based on the metabolic pathways of these drugs. Major Monitor ECGs for QT prolongation, monitor electrolytes, and watch for an increase in crizotinib-related adverse reactions e. Other adverse events were similar in nature and frequency between treatment arms. Avoid alkalinity of the urine in patients receiving ciprofloxacin when possible, cipro suspension schering. Histopathological examination of the weight-bearing joints schering these dogs revealed permanent lesions of the cartilage. Moderate Administering elbasvir; grazoprevir with ciprofloxacin may cause the plasma concentrations of elbasvir and grazoprevir to suspension thereby increasing the potential for adverse cipro i. Notes Do not share this medication with others. The exposure to lomitapide was increased fold in the presence of ketoconazole, a strong CYP3A4 inhibitor, cipro suspension schering.

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