A synthetic broad-spectrum antibacterial drug from the group of fluoroquinolones inhibits bacterial DNA gyrase (topoisomerases II and IV, responsible for the process of superspiralization of chromosomal DNA around nuclear RNA, which is necessary for reading genetic information), disrupts DNA synthesis, growth and division of bacteria; causes pronounced morphological changes (including cell walls and membranes) and rapid death of the bacterial cell.
Indications for use of the drug
Treatment of complications caused by Pseudomonas aeruginosa in children from 5 to 17 years with cystic fibrosis of the lungs; prevention and treatment of the pulmonary form of anthrax (infection with Bacillus anthracis).
In connection with possible adverse events from the joints and/or surrounding tissues, treatment should be initiated by a doctor with experience in the treatment of severe infections in children and adolescents and after a careful assessment of the benefit-risk ratio.
The drug is prescribed for the treatment of corneal ulcers and infections of the anterior segment of the eyeball and its appendages caused by bacteria sensitive to ciprofloxacin in adults, newborns (from 0 to 27 days), infants and infants (from 28 days to 23 months), children (from 2 to 11 years) and adolescents (from 12 to 18 years).
Ciprofloxacin is contraindicated during pregnancy and breastfeeding.
If it is necessary to use ciprofloxacin in the mother during breastfeeding, breast-feeding should be stopped before treatment begins.
Contraindications to the use of the drug and side effects
Marked atherosclerosis of cerebral vessels, ischemic stroke, increased risk of QT prolongation or development of arrhythmias type “pirouette” (e.g. the syndrome of congenital elongation QT interval, heart disease (heart failure, myocardial infarction, bradycardia), electrolyte imbalance (e.g. hypokalemia, hypomagnesemia), the deficit glukozo-6-fosfatdegidrogenaza; the simultaneous use of drugs, extension QT interval (including antiarrhythmic drugs of class IA and III, tricyclic antidepressants, macrolides, neuroleptics), simultaneous use with inhibitors of the isoenzyme sur1a2, including methylxanthines, including theophylline, caffeine, DULOXETINE, clozapine, ropinirole, olanzapine (see “precautions”); patients with a history of indication of tendon damage associated with the use of quinolones; mental illness (depression, psychosis); CNS DISEASES (epilepsy, decreased threshold of convulsive readiness (or a history of convulsive seizures), organic brain damage or STROKE; myasthenia gravis; severe renal and / or liver failure; elderly.
On the part of the visual organ: rarely-visual disorders; very rarely-violation of color perception, diplopia.
From the hearing organ and labyrinth disorders: rarely-tinnitus, temporary hearing loss; very rarely-hearing disorders.
From the CCC: often — feeling of serdzebienie; rare — tachycardia, vasodilation, decreased blood pressure, fainting, feeling of rush of blood to the face; very rarely — vasculitis; frequency is unknown — prolonged QT interval (most often in patients who have a predisposition to the development of QT prolongation, see “precautions”), ventricular arrhythmias (including type “pirouette”).
From the respiratory system, chest and mediastinal organs: rarely-dyspnoea, laryngeal edema, pulmonary edema, respiratory disorders (including bronchospasm).
From the gastrointestinal tract: often-nausea, diarrhea; infrequently-vomiting, abdominal pain, dyspepsia, flatulence; rarely-oral candidiasis; very rarely-pancreatitis.
From the liver and biliary tract: infrequently-increased activity of hepatic transaminases, bilirubin concentrations; rarely-impaired liver function, cholestatic jaundice, hepatitis (non-infectious); very rarely — necrosis of liver tissue (in extremely rare cases, progressing to life-threatening liver failure).
From the skin and subcutaneous tissues: infrequently — rash, itching, urticaria, spot-nodular rash; rarely — photosensitization, blistering; very rarely — petechiae, small-form erythema multiforme, nodular erythema, Stevens — Johnson syndrome (malignant exudative erythema), including potentially life-threatening, Lyell’s syndrome (toxic epidermal necrolysis, including potentially life-threatening, spot skin hemorrhages; frequency unknown-acute generalized pustular exanthema.
From the musculoskeletal system and connective tissue: infrequently-arthralgia, musculoskeletal pain (including pain in the extremities, back, chest); rarely-myalgia, joint edema, arthritis, increased muscle tone, muscle cramps; very rarely-muscle weakness, tendinitis, tendon rupture (mainly Achilles), exacerbation of symptoms of myasthenia gravis.
From the kidneys and urinary tract: infrequently-impaired renal function; rarely-renal failure, hematuria, crystalluria, tubulointerstitial nephritis.
General disorders and disorders at the site of administration: often-reactions at the site of administration (pain, burning, redness, phlebitis); infrequently — pain syndrome of non — specific etiology, General malaise, fever; rarely — edema, sweating (hyperhidrosis); very rarely-gait disorders.
Laboratory parameters: infrequently-increased activity of schp in the blood, urea concentration in the blood, ALT and AST activity, hyperbilirubinemia; rarely-changes in prothrombin concentration, increased amylase activity; frequency unknown-increased INR (in patients receiving vitamin K antagonists).
In clinical studies, the most common adverse events were eye discomfort, dysgeusia, and corneal precipitates.
The frequency of violations by the organ of sight (decreasing their occurrence): often-corneal precipitates, eye discomfort, conjunctival hyperemia; infrequently-keratopathy, spot keratitis, corneal infiltrates, photophobia, decreased visual acuity, eyelid edema, blurred vision, eye pain, dry eye, conjunctival and eyelid edema, itching in the eye, lacrimation, eye discharge, crusting at the edges of the eyelids, peeling of the eyelid skin, eyelid hyperemia; rarely-toxic phenomena from the visual organ, keratitis, conjunctivitis, corneal epithelial defect, diplopia, decreased corneal sensitivity, asthenopia, barley.
No effect of ciprofloxacin instillations on the state of the musculoskeletal system and connective tissue was observed in clinical studies and post-marketing surveillance.
Symptoms in case of drug overdose are: nausea, vomiting, confusion, mental agitation.
Treatment: the specific antidote is unknown. It is necessary to carefully monitor the patient’s condition, conduct symptomatic therapy, and ensure sufficient fluid intake. In order to prevent the development of crystalluria, it is recommended to monitor kidney function, including the acidity (pH) of urine.
There may also be:
dizziness, tremor, headache, fatigue, convulsive seizures, hallucinations, prolongation of the QT interval, gastrointestinal disorders, impaired liver and kidney function, crystalluria, hematuria.
Treatment: the specific antidote is unknown. Gastric lavage, taking activated carbon, antacids containing calcium and magnesium to reduce the absorption of ciprofloxacin. To prevent the development of crystalluria, monitoring of kidney function, including pH and urine acidity, is recommended. Symptomatic therapy. Careful monitoring of the patient’s condition, ensuring sufficient fluid intake.
With the help of hemo – or peritoneal dialysis, only a small (less than 10%) amount of ciprofloxacin can be removed.
If you experience unpleasant sensations in the eye area, it is recommended to wash your eyes with warm water.
Possibility to purchase the drug online
You can forget about the noisy jostling in pharmacies and the time spent searching for the necessary medical product while running through city pharmacies. Now the drug Ciprofloxacin can be selected from a variety of pharmaceutical catalogs of online pharmacies, at an optimal price and with convenient delivery conditions.
The convenience of online purchase of the drug is that simultaneously with the search for the necessary means, it is possible to study all customer reviews in the product description. This certainly helps you make the right choice.