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C I P R O Information
and Side Effects

A new research article explains how quinolone antibiotics (including "Cipro") cause joint and tendon ruptures...
See also one young man's testimony on the potential for side effects
Reprint of Dr. Shoskes newsgroup comment on antibiotics in prostatitis treatment.
by Jerry Snider R.Ph.
C I P R O Information & Side Effects -
Cipro (Ciprofloxin) is a member of the quinolone group of antibiotics. Peak blood levels are reached 1-2 hours after dosing. If you take an ANTACID containing magnesium or aluminum hydroxide (most have one or both), it will bind up to 90% of the drug, rendering it mostly ineffective. Same is true with zinc, iron, and calcium. It reaches optimum blood levels if taken 2 hours after a meal. If you take THEOPHYLLINE) for asthma, Cipro slows down the breakdown of Theophylline, and it will cause severe nervousness as you would expect with an overdose (could be fatal!). Cipro does the same with CAFFEINE, and will build up higher blood levels of caffeine, causing nervousness and CNS stimulation.
Cipro is effective against gram positive and gram negative bacteria. It works by interfering with an enzyme that bacteria need to replicate their DNA. Cipro enters tissue, including the prostate, and can be isolated from prostatic secretions.
RECOMMENDED DOSE FOR PROSTATITIS: 500mg every 12 hours for 28 days.
*EFFECTIVE AGAINST:

AEROBIC GRAM POSITIVE:
Enterococcus faecalis;
Staph Aureus;
Staph epidermis;
Staph saprophyticus;
Strep pneumoniae; and
Strep pyogenes.

AEROBIC GRAM NEGATIVE:
Campylobacter jejuni
Citrobacter diversus
Citrobacterfreundii
Enterobacter cloacae
E.Coli
Haemophilus influenzae
Haemophilus parainfluenzae
Klebsiella pneumonae
Morganella morganii
Neisseria gonorrheae
Proteum mirabilis
Proteus vulgaris
Providencia rettgeri
Providencia stuartii
Pseudomonas aeruginose
Salmonella typhi
Serratia marcescens
Shigella flexneri
Shigella sonnei.
Effective against 90% of the strains of the following
In Vitro (test-tube) - - - -
AEROBIC GRAM POS:
Staph haemolyticus;
Staph hominis
AEROBIC GRAM NEG:
Acinetobacter Iwoffi
Aeromonas caviae
Aeromonas hydrophilia
Brucella melitensis
Campylobacter coli
Edwardsiella tarda
Haemophilus ducreyi
Klebsiella oxytoca
Legionella pneumophila
Moraxella catarrhalis
Neisseria meningitidis
Pasteurella multocida
Salmonella enteritidis
Vibrio cholerae
Vibrio parahaemolyticus
Vibrio vulnificus
Yersinia enterocolitica
OTHER:
Clamydia trachomatis
Mycobacterium tuberculosis (moderate on both)
RESISTANT BACTERIA NOT HELPED BY CIPRO: Most strains of: Burkholderia cepacia, Stenotrophomonas maltophilia, Bacteroides fragilis, Clostridium difficile- Cipro is slightly less effective in an acid PH.- Resistance develops slowly to Cipro (multi-step mutations)- Synergistic (stronger) effects occur with Cipro if given with Flagyl (metronidazole), Cleocin (Clindamycin), or aminoglucocide or beta-lactam class antibiotics.
CONTRAINDICATIONS: Should not be used by persons with a history of hypersensi-tivity to Cipro, or other quinolones. Not to be used by persons under the age of 18.
WARNINGS: All quinolones cause erosion of cartilage in weight-bearing joints. They may cause convulsions, increases intracranial pressure, toxic psychosis, CNS stimulation (i.e.nervousness, lightheadedness, confusion, hallucinations).Should not be used in anyone with seizure disorders, or cerebral arteriosclerosis. There have been deaths due to anaphylactic shock, and cardiovascular collapse. Also occurring are tingling, itching, facial swelling, and difficult breathing.
DISCONTINUE at the first sign of a rash or any hypersensitivity. Pseudomembranous colitis has been reported from nearly all antibacterial agents (mild to life-threatening), and anyone taking Cipro having diarrhea should immediately check with his prescribing physician. Antibacterial drugs may kill off normal intestinal flora, resulting in an overgrowth of Clostridia. It produces a toxin that is a primary cause of "antibiotic-associated- colitis".
Achilles and other tendon ruptures requiring surgical repair, resulting in prolonged disability can occur from quinolone use. Discontinue Cipro, and consult your physician, if you experience pain, inflammation, or tendon rupture.
Crystaluria (particles out of solution in urine) may occur, particularly if the urine is alkaline. While taking Cipro, maintain hydration (8-8oz glasses of water daily min.)and drink Orange or Cranberry juice, or apple cider vinegar (2 tsp. with 1 tsp.honey in 8 oz water) to maintain acidity of the urine. Photosensitivity (sunburn) occurs easily. Stay out of the sun all you can, or wear sunscreen (spf30) if you can't. Monitor liver, kidney functions, and blood chemistry during prolonged therapy.
DRUG INTERACTIONS:
  • Raises blood levels of THEOPHYLLINE and decreases normal elimination resulting in overdosing, potentially fatal. Also alters DILANTIN blood levels.
  • Given with GLYBURIDE (DIABETA, MICRONASE, GLYNASE), it can cause hypoglycemia. It increases the effects of the blood thinner COUMADIN (WARFARIN), and a patient taking COUMADIN needs to carefully monitor his prothrombin time.
  • BENEMID (PROBENECID) causes decreased breakdown of Cipro requiring less Cipro, or discontinuance of Benemid.
  • CARAFATE (SUCRALFATE), an ulcer drug, causes extremely decreased blood levels of Cipro.
ADVERSE REACTIONS:
  • Nausea (5.2%),
  • Diarrhea (2.3%),
  • vomiting (2%),
  • abdominal pain/discomfort(1.7%),
  • headache(1.2%),
  • restlessness(1.1%), and
  • rash (1.1%).
The following were reported as less than one percent:
  • CARDIOVASCULAR: Palpatation (feeling your heart beat), heart flutter, fainting, angina, heart attack, cardiopulmonary arrest, blood clot to the brain.
  • CENTRAL NERVOUS SYSTEM: Nervousness, dizziness, headache, lightheadedness, insomnia, nightmares, hallucinations, manic attack, tremors, irritability, seizures, lethargy, drowsiness, weakness, no appetite, depression, numbness, depersonalization, ataxia ( lack of muscle coordination), agitation, confusion, delirium, toxic psychosis, muscle twitching, involuntary eye movements.
  • GASTROINTESTINAL: painful oral mucosa, thrush(oral fungal infection),intestinal perforation, G.I. bleeding, jaundice, difficulty swallowing, constipation, intestinal gas, swelling of the pancreas.
  • MUSCULOSKELETAL: joint stiffness, back pain, neck or chest pain, gout flare-up.
  • KIDNEY/URINARY: Kidney failure, urinary retention, urethral bleeding, acidosis, nephritis (inflammation of the kidneys), increased urinary output, kidney stones.
  • RESPIRATORY: difficult breathing, throat or lung swelling (edema), hiccoughs, bronchial spasm, blood clot in the lung, nosebleed.
  • SKIN HYPERSENSITIVITY: itching, rash, sensitivity to sunlight, flushing, chills, swelling of the blood vessels or lymph system, swelling of the face, lips, neck, eyes, or hands. Cuticle candidiasis (yeast) and hyperpigmentation.
  • SPECIAL SENSES: Blurred or disturbed vision, sensitivity to light, seeing double, eye pain, ringing in the ears, hearing loss, bad taste in mouth.
  • MISCELLANEOUS: Elevation of triglycerides and cholesterol. Blood and albumin in the urine, elevated serum potassium, glucose, and albumin. Anemia and agranulo-cytosis (potentially fatal condition where the white blood cell count goes extremely low).

Jerry Snider, R.Ph.


This information is forwarded to you by the Prostatitis Foundation. We do not provide medical advice. We distribute literature and information relevant to prostatitis. While we encourage all research we do not endorse any doctor, medicine or treatment protocol. Consult with your own physician.
© 2002 The Prostatitis Foundation
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