Proteus (indole-positive and indole-negative), Providencia, Morganella, Yersinia, Vibrio, Aeromonas,
Plesiomonas, Pasteurella, Haemlobacteris, Campusella , Moraxella, Branhamella,
Acinetobacter, Brucella, Staphylococcus, Sreptococcus agalactiae, Listeria, Corynebacterium, Chlamydia.
Streptococcus pyogenes, Streptococcus pneumonia, Streptococcus viridans, Mycoplasma hominis, Mycobacterium tuberculosis,
Anaerobes are, with some exceptions, moderately sensitive (Peptococcus, Peptostreptococcus) or resistant (Bacteroides).
Significant amounts of the drug are also excreted in bile and feces,
therefore only significant renal dysfunction leads to a slowdown in excretion.
- respiratory tract infections. Ciprofloxacin is recommended for pneumonia caused by Klebsiella spp.,
Enterobacter spp., Proteus spp., Escherichia coli, Pseudomonas aeruginosa, Haemophilus spp., Moraxella catarrhalis,
Legionella spp. and staphylococci;
- infections of the middle ear (otitis media), paranasal sinuses (sinusitis), especially if these infections are caused by gram-negative microorganisms, including Pseudomonas aeruginosa or staphylococci;
- eye infections;
- infections of the kidneys and / or urinary tract;
- genital infections, including adnexitis, gonorrhea, prostatitis;
- infections of the abdominal cavity (bacterial infections of the gastrointestinal tract, biliary tract, peritonitis);
- infections of the skin and soft tissues;
- infections or prevention of infections in immunosuppressed patients (patients taking immunosuppressants or patients with neutropenia);
- Selective bowel decontamination in immunocompromised patients;
- prevention and treatment of pulmonary anthrax (infection with Bacillus anthracis);
- prevention of invasive infections caused by Neisseria meningitidis.
It is necessary to take into account the current official guidelines on the rules for the use of antibacterial drugs.
- treatment of complications caused by Pseudomonas aeruginosa in children with pulmonary cystic fibrosis from 5 to 17 years old;
- prevention and treatment of pulmonary anthrax (infection with Bacillus anthracis).
Application during pregnancy and lactation
Severe liver failure and diseases of the central nervous system (CNS):
increased risk of QT interval prolongation or pirouette arrhythmias
[eg, congenital long QT interval syndrome, heart disease
(heart failure, myocardial infarction, bradycardia), or electrolyte imbalance
(including theophylline, methylxanthine, caffeine, duloxetine, clozapine, ropinirole, olanzapine); myasthenia gravis;
deficiency of glucose-6-phosphate dehydrogenase;
use in elderly patients.
"very often" (> 1/10 appointments), "often" (1/10 - 1/100 appointments),
"infrequently" (1/100 - 1/1000 appointments), "rarely "(1/1000 - 1/10 000 appointments),
Uncommon - eosinophilia;
rarely - leukopenia, anemia, neutropenia, leukocytosis, thrombocytopenia, thrombocythemia;
Rarely - allergic reactions, allergic edema / angioedema;
Uncommon - decreased appetite and food intake;
Uncommon - psychomotor hyperactivity / agitation;
often - confusion and disorientation, anxiety, disturbed dreams (nightmares), depression (increased behavior with the purpose of self-harm, such as suicidal acts / thoughts, as well as attempted suicide or successful suicide), hallucinations;
Uncommon - headache, dizziness, sleep disturbance;
rarely - paresthesia and dysesthesia, hypesthesia, tremor, convulsions (including epileptic seizures), vertigo;
Rarely - tinnitus, hearing loss;
Rarely - vasodilation, lowering of blood pressure, feeling of "rush" of blood to the face;
Often - nausea, diarrhea; infrequently - vomiting, abdominal pain, dyspepsia, flatulence;
Uncommon - increased activity of "hepatic" transaminases, increased concentration of bilirubin;
rarely - liver dysfunction, jaundice, hepatitis (non-infectious);
Uncommon - rash, itching, urticaria; rarely - photosensitivity, blistering;
Uncommon - arthralgia; rarely - myalgia, arthritis, increased muscle tone, muscle cramps;
disorders Uncommon - renal dysfunction;
Often - reactions at the injection site;
infrequently - pain syndrome of non-specific etiology, general malaise, fever;
Uncommon - increased activity of alkaline phosphatase in the blood; rarely - a change in the content of prothrombin, an increase in amylase activity; frequency unknown - increased international normalized ratio (INR) in patients receiving vitamin K antagonists.
Children - Children have been frequently reported to develop arthropathies.
With the simultaneous use of Ciprolet with didanosine, the absorption of ciprofloxacin is reduced due to the formation of complexes of ciprofloxacin with aluminum and magnesium salts contained in didanosine.
Simultaneous reception of Tsiprolet and theophylline can lead to an increase in the concentration of theophylline in the blood plasma,
due to competitive inhibition in the binding sites of cytochrome P450, which leads to an increase in T1 / 2 of theophylline and an increase in the risk of developing toxic effects associated with theophylline.
Simultaneous administration of antacids, as well as preparations containing aluminum, zinc, iron or magnesium ions, can cause a decrease in the absorption of ciprofloxacin, therefore the interval between the appointment of these drugs should be at least 4 hours.
With the simultaneous use of Tsiprolet and anticoagulants, the bleeding time is lengthened.
With the simultaneous use of Ciprolet and cyclosporine, the nephrotoxic effect of the latter is enhanced.
How to take, course of administration and dosage
The dose of Tsiprolet depends on the severity of the disease, the type of infection, the condition of the body, age, body weight and kidney function.
In uncomplicated diseases of the kidneys and urinary tract, 250 mg is prescribed 2 times / day, and in severe cases, 500 mg 2 times / day.
For diseases of the lower respiratory tract of moderate severity - 250 mg 2 times / day, and in more severe cases - 500 mg 2 times / day.
For the treatment of gonorrhea, a single dose of Ciprolet® is recommended at a dose of 250-500 mg.
For gynecological diseases, enteritis and colitis with severe course and high fever, prostatitis,
osteomyelitis is prescribed at 500 mg 2 times / day (for the treatment of common diarrhea, you can use a dose of 250 mg 2 times / day).
The tablets should be taken on an empty stomach with plenty of fluids.
The duration of treatment depends on the severity of the disease, but treatment should always be continued for at least another 2 days after the symptoms of the disease disappear.
Usually the duration of treatment is 7-10 days.
Treatment: it is necessary to carefully monitor the patient's condition, perform a gastric lavage, carry out the usual emergency measures, and ensure an adequate supply of fluid.
With the help of hemo- or peritoneal dialysis, only a small (less than 10%) amount of the drug can be removed.
The specific antidote is unknown.
The view at the break is a white or almost white mass.
In the treatment of severe infections, staphylococcal infections and infections due to anaerobic bacteria,
For genital infections suspected to be caused by fluoroquinolone-resistant strains of Neisseria gonorrhoeae,
Ciprofloxacin has an effect on prolongation of the QT interval. Given that women have a longer mean QT interval compared to men, they are more sensitive to drugs that cause QT interval prolongation.
see the section "Interaction with other drugs", or in patients at increased risk prolongation of the QT interval / development of arrhythmias of the "pirouette" type (for example, with congenital prolongation of the QT interval, uncorrected electrolyte imbalance,
ciprofloxacin in children , like other drugs of this class, causes arthropathy of large joints in animals.
If severe and prolonged diarrhea occurs during or after treatment, the diagnosis of pseudomembranous colitis should be excluded, which requires immediate discontinuation of the drug and the appointment of appropriate treatment (vancomycin orally at a dose of 250 mg 4 times a day).
With the use of ciprofloxacin, cases of liver necrosis and life-threatening liver failure have been observed.
Patients with severe myasthenia gravis should use ciprofloxacin with caution, as symptoms may worsen.
Ciprofloxacin is a moderate inhibitor of CYP450 1A2 isoenzymes.
In vitro, ciprofloxacin may interfere with bacteriological testing of Mycobacterium tuberculosis,