| Dosage | : | Tablet |
| Contains | : | Ciprofloxacin |
| Category | : | Antibiotic (2nd generation fluoroquinolone) |
| Uses | : | Bacterial infections |
| Price | : |
Cifran contains Ciprofloxacin. Ciprofloxacin is a drug used to treat bacterial infections. It is a second generation fluoroquinolone antibacterial. It kills bacteria by interfering with the enzymes that cause DNA to rewind after being copied, which stops DNA and protein synthesis.
Cifran is a product from Sun Pharmaceutical Industries Limited. Sunpharma is an Indian multinational pharmaceutical company headquartered in Mumbai, Maharashtra that manufactures and sells pharmaceutical formulations and active pharmaceutical ingredients (APIs) primarily in India and the United States. The company offers formulations in various therapeutic areas, such as cardiology, psychiatry, neurology, gastroenterology and diabetology. It also provides APIs such as warfarin, carbamazepine, etodolac, and clorazepate, as well as anti-cancers, steroids, peptides, sex hormones, and controlled substances.
This antibiotic is used for a variety of severe bacterial infections. Some of them are explained below.
Pneumonia
Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing
Hospital-acquired pneumonia: Some people catch pneumonia during a hospital stay for another illness. Hospital-acquired pneumonia can be serious because the bacteria causing it may be more resistant to antibiotics and because the people who get it are already sick. People who are on breathing machines (ventilators), often used in intensive care units, are at higher risk of this type of pneumonia.
Septicemia
Septicemia is a life-threatening complication of an infection. Sepsis occurs when chemicals released in the bloodstream to fight an infection trigger inflammation throughout the body. This can cause a cascade of changes that damage multiple organ systems, leading them to fail, sometimes even resulting in death.
Dosage
As directed by your Physician
Administration
As directed by your Physician
Adverse Reactions/ Side Effects
GI disturbances; headache, tremor, confusion, convulsions; rashes; joint pain; phototoxicity. Transient increases in serum creatinine. Haematological, hepatic and renal disturbances. Vasculitis, pseudomembranous colitis and tachycardia. Phototoxicity.
Potentially Fatal: Anaphylactoid reaction; cardiopulmonary arrest.
Warnings and Precautions
Tendonitis: Ciprofloxacin has been associated with an increased risk of tendonitis and tendon rupture in patients of all ages. The risk is increased in patients older than 60 years of age, in patients taking corticosteroids, and in patients with kidney, heart, or lung transplants.
Monitor: Ensure CBC (including platelets and differential), renal function, and liver enzymes are evaluated before starting therapy and periodically thereafter during prolonged therapy. Monitor patient’s response to therapy. Periodically assess organ system function with prolonged therapy.
Ophthalmic: No overall differences in safety and efficacy have been observed between elderly and younger patients.
Hypersensitivity: Serious and potentially fatal reactions have occurred. Discontinue drug if allergic reaction occurs.
Renal Function: Adjust dose downward accordingly.
Superinfection: Use of antibiotics may result in bacterial or fungal overgrowth.
Photosensitivity: Moderate to severe reactions have occurred with some fluoroquinolones; avoid excessive sunlight and discontinue therapy if phototoxicity occurs.
C. difficile – associated diarrhea: Consider possibility in patients with diarrhea.
CNS disorders: Seizures, increased intracranial pressure, and toxic psychosis have been reported. May also cause nervousness, agitation, insomnia, anxiety, nightmares, paranoia, dizziness, confusion, tremors, hallucinations, depression, and rarely, suicidal thoughts or acts. Discontinue therapy and institute appropriate measures if these reactions occur. Use with caution in patients with known or suspected CNS disorders or other risk factors (e.g, drug therapy, renal function impairment) that may predispose to seizures or lower the seizure threshold.
Crystalline precipitate: An ocular white crystalline precipitate in superficial portion of corneal defect may occur.
Crystalluria: Has been reported rarely. Avoid alkalinity of the urine and keep patient well hydrated.
ER tablets: Ensure that ER tablets are not used to treat infections other than UTIs.
Peripheral neuropathy: Sensory or sensorimotor axonal polyneuropathy resulting in paresthesias, hypoesthesias, dysesthesias, and weakness has been rarely reported. To prevent development of an irreversible condition, discontinue therapy if patient experiences symptoms of neuropathy.
Serious reactions: Clinical manifestations of serious and sometimes fatal reactions that have been reported with ciprofloxacin include acute hepatic necrosis or failure, acute renal insufficiency or failure, agranulocytosis, allergic pneumonitis, anemia (including hemolytic and aplastic), arthralgia, fever, hepatitis, interstitial nephritis, jaundice, leukopenia, myalgia, pancytopenia, rash, serum sickness, Stevens-Johnson syndrome, thrombocytopenia (including thrombotic thrombocytopenic purpura), toxic epidermal necrolysis, and vasculitis.
Syphilis: Not effective in treatment of syphilis. All patients with gonorrhea should have a serologic test for syphilis at time of diagnosis and 3 months after treatment with ciprofloxacin.
Tendon ruptures: Achilles and other tendon ruptures requiring surgical repair and prolonged disability have been reported. Risk increased with concomitant corticosteroid therapy, especially in elderly patients. Discontinue use if patient experiences pain, inflammation, or rupture of tendon.
Contraindications
Contraindicated in pregnancy: Category C Drug. Contraindicated in lactation
Ciprofloxacin and Children: Not drug of first choice in children because of increased incidence of adverse reactions related to joints and surrounding tissue. Do not use ciprofloxacin tablets, oral suspension, or injection in children younger than 18 years of age, except for listed indications. Do not use ophthalmic solution or otic solution in children younger than 1 year of age, ophthalmic ointment in children younger than 2 years of age, or ER tablets in children younger than 18 years of age.
Ciprofloxacin and Geriatric: Because of the risk of reduced renal function, take care in dose selection; renal function monitoring may be useful. Elderly patients may be more susceptible to effects on QT interval or tendons.
Hypersensitivity: Not to be used concurrently with tizanidine. Avoid exposure to strong sunlight or sun lamps during treatment.
Drug Interactions
Decreased absorption with concurrent sucralfate, magnesium-aluminum antacids, calcium, iron, zinc and multivitamins. Increased methotrexate and caffeine levels when taken concurrently with ciprofloxacin. Probenecid reduces renal clearance of ciprofloxacin. Potentiates oral anticoagulants and glibenclamide. Concurrent use with corticosteroids may increase tendon rupture. Concurrent use with ciclosporin may cause transient increases in serum creatinine. CNS excitation may occur with concurrent admin of quinolones and NSAIDs. Serum concentrations of theophylline are markedly elevated when co-administered with ciprofloxacin; monitor serum levels of theophylline.
Potentially Fatal: Concurrent use with tizanidine can cause marked elevation in serum levels of tizanidine; avoid concurrent usage.
Overdosage
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Storage
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Mechanism of Action
Ciprofloxacin promotes breakage of double-stranded DNA in susceptible organisms and inhibits DNA gyrase, which is essential in reproduction of bacterial DNA.
References
https://www.mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/syc-20351214
https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204
https://www.mims.com/india/drug/info/cifran