Cipro is a synthetic antibiotic of the second-generation fluoroquinolone drug class. It is used to treat patients suffering from different infectious diseases such as respiratory tract infections (e.g. malignant otitis externa, sinusitis, tonsillitis, bronchitis, pneumonia), bone and joint infections (arthritis, poliomyelitis), endocarditis, gastroenteritis, infectious diarrhea of different causes, skin infections (infected wounds, burns, cellulitis, abscess, phlegmon), urinary tract infections (e.g. cystitis, pielonephritis, prostatitis, adnexitis, endometritis), infectious eye diseases (conjunctivitis, blepharitis, keratitis etc), anthrax, bacteriemia, septicemia. This antibiotic can also be used for prophylaxis of infectious complications after surgery.
Although Cipro is usually well tolerated by the body, up to 15% of patients who use it experience some side effects. The most common side effects are dizziness, headache, drowsiness, weakness, mouth dryness, loss of appetite, bad taste in the mouth, painful oral mucosa, nausea, vomiting, heartburn, dysphagia, dyspepsia, stomach upset, flatulence, aggravated irritable bowel syndrome, diarrhea, constipation, nervousness, anxiety, agitation, mood changes, insomnia, nightmares, tremor, anosmia, yellowing of the skin or eyes (jaundice), vision changes (blurred vision, decreased visual acuity, flashing lights, change in color perception, diplopia), cataracts, nystagmus, photosensitivity (increased sensitivity of the skin to sunlight), flu-like symptoms (fever, chills, sore throat or unusual cough), suprapubic pain, vaginal itching and/or discharge, vaginal candidiasis.
Also Cipro may cause:
Musculo-sceletal side effects: myalgia, myasthenia, myoclonus, night muscle cramps, neck, back pain, arthralgia, joint stiffness, joint swelling, inability to move, redness and pain in joints, tendinitis, extremity pain.
Neurological side effects: hyperesthesia, peripheral neuropathy, polyneuropathy, flushing, increased perspiration (sweating).
Skin side effects: hyperpigmentation, erythema multiforme, exfoliative dermatitis.
Like any other drug, Cipro can cause allergic reactions such as rash, urticaria, itching, swallowing or breathing difficulty, tightness in the chest, swelling of the mouth, hands, eyes, conjunctivae, face, lips, tongue and throat, unusual hoarseness, angioedema, anaphylaxis, anaphylactic shock and anaphylactoid reactions, allergic interstitial nephritis. These reactions are serious and require urgent medical attention.
In some cases, Cipro can cause toxic reactions such as bullous pemphigoid, purpura, erythema multiforme, serum sickness-like reaction, Stevens-Johnson syndrome, exfoliative dermatitis, fixed eruption, toxic epidermal necrolysis (Lyell’s syndrome), necrotizing and cutaneous vasculitis, interstitial nephritis.
Rare side effects
In some rare cases, Cipro intake can lead to disturbance in attention, migraine, tinnitus, hearing loss, loss of taste, hiccough, injection site reaction, erythema nodosum, lymphadenopathy, allodynia, hypesthesia, dyskinesia, temperature sensitivity, cystic fibrosis arthropathy, foot pain, tendon rupture, (including Achilles tendon rupture), knee inflammation, abnormal gait, Clostridium difficile-associated diarrhea, tachycardia, hypotension, renal calculi, phlebitis, gout flare up, polyuria, urinary retention, vaginitis.
Changes in laboratory tests
People who use Cipro should keep in mind that this medicine can cause changes in laboratory tests results. Therefore, you should know that Cipro can cause such abnormalities as anemia, methemoglobinemia, decreased hematocrit, eosinophilia, leukopenia or leukocytosis, increased atypical lymphocyte count, monocytosis, immature white blood cells, neutropenia, agranulocytosis, thrombocytopenia or throbocytosis, pancytopenia (life-threatening condition), bone marrow depression signs, elevated sedimentation rate, prolongation or decrease in prothrombin time, hepatic enzyme elevations (alanine aminotransferase, aspartate aminotransferase, lactat dehydrogenase, gammaglutamyl transferase, bilirubin, alkaline phosphatase), elevation of lipase levels, cholesterol, triglycerides, blood urea nitrogen, uric acid, serum creatinine, creatine phosphokinase, serum amylase, serum calcium, potassium, blood glucose (or hypoglycemia), acidosis signs, decrease in total serum protein, serum albumin. There can also be some changes in urine tests: abnormal odor, color, polyuria, crystalluria, albuminuria, candiduria, hematuria, eosinophiluria. Presence of blood or mucus in your stool.
Serious side effects
Cipro can cause some serious side effects that require urgent medical attention.
Neurological: seizures or convulsions, loss of consciousness, hallucinations, depression, lethargy, catatonia, ataxia, dysphasia, dysesthesia, paresis, delirium, paranoia, suicidal thoughts, toxic psychosis, benign intracranial hypertension.
Pulmonary: epistaxis, hemoptysis, dyspnea, bronchospasm, pleural effusion, respiratory arrest, respiratory distress.
Cardiovascular: pulmonary edema, cerebral thrombosis, pulmonary embolism, angina pectoris, myocardial infarction, cardiac murmur, abdominal aortic bruit, cardiopulmonary arrest, cardiovascular collapse, arrhythmia (fast, slow or irregular heartbeat, atrial flutter, palpitations, ventricular bigeminy), postural hypotension, hypertension, QT prolongation on ECG, torsade de pointes, vasculitis, easy bruising and bleeding.
Gastro-intestinal: oral ulceration, oral thrush infection, gastrointestinal moniliasis, hepatic necrosis with hepatic failure (fatal sometimes), gastrointestinal bleeding, intestinal perforation, watery or bloody diarrhea, pancreatitis, pseudomembranous colitis.
Urogenital: feeling an urgent need to urinate, urethral bleeding, urine retention, micturition, renal failure, vaginal infection (including yeast infection).
Other: cutaneous candidiasis, tingling in arms and legs, myasthenia gravis exacerbation, myoclonus.
Side effects in pregnant women
Cipro seems to be sufficiently safe during pregnancy. However, it should be used only when the benefit outweighs the risk and it is not advisable to take it during breastfeeding due to risks for the baby.
Side effects in children
The most common side effects in children are joint problems: arthralgia, arthrosis, joint sprains, limited movement in affected joints (shoulder, elbow, wrist, hip, knee, ankle). In addition, Cipro can cause such adverse reactions as nausea, vomiting, abdominal pain, dyspepsia, diarrhea, fever, myalgia, asthma, rash, dizziness, insomnia or somnolence. There are also reported cases of Jarisch-Herxheimer reaction (hypotension, tachycardia, and disseminated intravascular coagulation).
You may never experience any of the side effects listed above. Your doctor cannot predict your body’s reaction to Cipro until you have tried it. That is why you should immediately inform your doctor of any changes in your health condition after taking Cipro. Therefore, when you feel something is wrong, ask your doctor for advice and he or she will diagnose if your problem is connected with the medicine intake. You should also be careful because some of the side effects of Cipro require urgent medical attention.