INDICATION
CiprocinTM is used in adults for the treatment of urinary tract infections, lower respiratory tract infections, skin and soft tissue infections, bone and joint
infections and G.I. infections, caused by susceptible gram-negative and gram-positive aerobic bacteria. It is also used for the treatment of uncomplicated
gonorrhoea caused by penicillinase producing Neisseria gonorrhoeae. CiprocinTM 750 tablet is specially indicated for the treatment of pseudomonal infections
of lower respiratory tract; severe infections particularly due to pseudomonas, staphylococcus and streptococci. CiprocinTM 750 is also indicated in surgical
prophylaxis.
DOSAGE AND ADMINISTRATION
CiprocinTM may be given orally without regard to meals. Patients receiving CiprocinTM should be well hydrated and should be instructed to drink fluids liberally.
Because of the risk of crystalluria, it is recommended that the usual dosage of the drug should not be exceeded. For the treatment of urinary tract infections,
the usual adult oral dosage of CiprocinTM for mild to moderate infections is 250 mg every 12 hours and the usual adult dosage for complicated infections,
caused by organisms not highly susceptible to drug is 500 mg every 12 hours. The usual adult oral dosage of CiprocinTM for infectious diarrhoea is 500 mg every
12 hours. The usual adult dosage for mild to moderate lower respiratory tract, skin and soft tissue, or bone and joint infections is 500 mg every 12 hours; a
dosage of 750 mg every 12 hours may be needed, especially in bone and joint infections or when infections are severe or complicated. In severe infections,
particularly due to pseudomonas, staphylococcus and streptococci, the higher dosage of CiprocinTM 750 tablet twice daily should be used. For surgical
prophylaxis, a single dose of CiprocinTM 750 is given 60-90 minutes before the procedure. For the treatment of uncomplicated urethral, endocervical or rectal
gonorrhoea caused by penicillinase producing strains of Neisseria gonorrhoeae (PPNG) or non-penicillinase producing strains of the organism, adults should
receive a single 500 mg oral dose of CiprocinTM followed by oral doxycycline therapy for possible coexisting chlamydia infection. In the treatment of chancroid,
500 mg orally twice daily for 3 days is required. The duration of therapy depends on the type and severity of infection and should be determined by the clinical
and bacteriologic response of the patients. For most infections, therapy should be continued for at least 48 hours after the patients become asymptomatic. The
usual duration is 1-2 weeks but severe or complicated infections may require more prolonged therapy. CiprocinTM therapy may need to be continued for 4-6
weeks or longer for the treatment of bone and joint infections. Infectious diarrhoea generally is treated for 3-7 days, although less prolonged therapy may be
adequate. Modification of the usual dosage of CiprocinTM generally is unnecessary in patients with creatinine clearance greater than 50 ml/minute. In patients
with creatinine clearance of 50 ml /minute or less, doses and/or frequency of administration of CiprocinTM should be modified in response to the degree of
renal impairment and the site and severity of infection. Adults with creatinine clearance of 30-50 ml/minute can receive 250-500 mg of CiprocinTM every 12
hours and adults with creatinine clearance of 5-29 ml/minute can receive 250-500 mg every 18 hours. Patients with severe infections and severe renal
impairment may be given 750 mg of CiprocinTM every 12 or 18 hours. However, these patients should be monitored carefully and serum Ciprofloxacin
concentrations determined periodically.
PRECAUTION AND WARNING
It should be used with caution in patients with suspected or known CNS disorders such as arteriosclerosis or epilepsy or other factors which predispose to
seizures and convulsion.
INFORMATION FOR PATIENTS
Ciprofloxacin may be taken with or without meals and to drink fluids liberally.
Concurrent administration of ciprofloxacin should be avoided with magnesium /
aluminium antacids, or sucralfate or with other products containing calcium, iron or zinc. These products may be taken two hours after or six hours before
ciprofloxacin.
Ciprofloxacin should not be taken concurrently with milk or yogurt alone, since absorption of ciprofloxacin may be significantly reduced. Dietary calcium is a
part of a meal, however, does not significantly affect the ciprofloxacin absorption.
PREGNANCY, LACTATION AND CHILDREN
Not to be used in pregnancy and nursing stage. Though not recommended for the children where benefit out – weighs risk, a dosage of 7.5 – 15 mg/kg/day in two divided
doses can be given.
CONTRAINDICATION
Patients with a history of hypersensitivity to Ciprofloxacin or to other quinolones
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