What Is Ciprofloxacin Resistance?
Ciprofloxacin is a synthetic third-generation quinolone antibacterial drug. It has broad-spectrum antibacterial activity and good bactericidal effect. Its antibacterial activity against almost all bacteria is 2 to 4 times stronger than norfloxacin and enoxacin. Enterobacter, Pseudomonas aeruginosa, Haemophilus influenzae, Neisseria gonorrhoeae, Streptococcus, Legionella, Staphylococcus aureus have antibacterial effects.
- Chinese name
- Ciprofloxacin
- English name
- Ciprofloxacin
- nickname
- Ciprofloxacin, Supling
- Chemical formula
- C17H18FN3O3
- Molecular weight
- 331.35
- CAS Registry Number
- 85721-33-1
- Melting point
- 255-257 ° C
- Exterior
- White Granville-like white crystalline powder
- Danger symbol
- Xi
- Category
- Western medicine
- Ciprofloxacin is a synthetic third-generation quinolone antibacterial drug. It has broad-spectrum antibacterial activity and good bactericidal effect. Its antibacterial activity against almost all bacteria is 2 to 4 times stronger than norfloxacin and enoxacin. Enterobacter, Pseudomonas aeruginosa, Haemophilus influenzae, Neisseria gonorrhoeae, Streptococcus, Legionella, Staphylococcus aureus have antibacterial effects.
Ciprofloxacin compounds
Ciprofloxacin Basic Information
- Chinese name: ciprofloxacin
- Chinese alias: 1-cyclopropanyl-6-fluoro-1,4-dihydro-4-oxo-7- (1-piperazinyl) -3-quinolinecarboxylic acid; Ciprole; vanillyl diethyl Amine; Ciprofloxacin, Ciprofloxacin; 1-Cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7 (1-piperazinyl) -3-quinolinecarboxylic acid ;
- English name: ciprofloxacin
- English alias: CPFX; ciloxan; euciprin; CIPROBAY; Ciprofloxacin;
- CAS number: 85721-33-1
- Molecular formula: C 17 H 18 FN 3 O 3
- Molecular weight: 331.34200
- Exact mass: 331.13300
- PSA: 74.57000
- LogP: 1.97710
Physical and Chemical Properties of Ciprofloxacin
- Appearance and properties: white powder
- Density: 1.461 g / cm 3
- Melting point: 255-257 ° C
- Boiling point: 581.8ºC at 760 mmHg
- Flash point: 305.6ºC
- Storage conditions: Store at 0-5ºC
Ciprofloxacin Safety Information
- Customs Code: 3004909090
- WGK Germany: 2
- Danger category code: R36 / 37/38
- Safety instructions: S26; S36
- RTECS number: VB1993800
- Dangerous Goods Sign: Xi
Ciprofloxacin Quality Standard
- USP28, EP5 and BP2002
Ciprofloxacin production method
- Its synthesis starts from 2,4-dichlorotoluene and forms 2,4-dichloro-5fluorobenzoyl chloride through nitration, reduction, fluorination, chlorination, hydrolysis and acid chloride. It then reacts with diethyl propionate, p-toluenesulfonic acid, triethyl orthoformate, and cyclopropylamine before cyclization to form a quinoline ring. After hydrolysis, the piperazinyl group is reintroduced to obtain the product.
Ciprofloxacin uses
- The new broad-spectrum antibacterial drug has strong permeability, high blood concentration, low toxicity, resistance to drug resistance, and can be quickly distributed to other organs. This medicine is easily absorbed orally, and the effect of intramuscular injection is better. The new-type quinolone broad-spectrum antibacterial drugs have a strong effect on Gram-positive and negative bacteria. The third-generation quinolone antibiotics have a broad antibacterial spectrum, strong and rapid bactericidal power. It has bactericidal effect on Gram positive and negative bacteria including Pseudomonas aeruginosa, intestinal bacteria and Staphylococcus aureus. Its hydrochloride is mostly used clinically for the treatment of respiratory infections, urinary tract infections, intestinal infections, biliary tract infections, intra-abdominal infections, gynecological infections, bone and joint infections, and severe systemic infections [1] .
Ciprofloxacin Pharmacopoeia Standard
Ciprofloxacin source (name), content (potency)
- This product is 1-cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7- (1-piperazinyl) -3-quinolinic acid. Calculated based on dry products, C17H18FN3O3 should be 98.5% to 102.0%.
Ciprofloxacin
- This product is white to slightly yellow crystalline powder; almost odorless and bitter.
- This product is soluble in acetic acid, very slightly soluble in ethanol and chloroform, and almost insoluble in water.
Ciprofloxacin identification
- (1) In the chromatogram recorded under the content determination item, the retention time of the main peak of the test solution should be consistent with the retention time of the main peak of the reference solution.
- (2) The infrared light absorption spectrum of this product should be the same as that of the control ("Infrared Spectra of Drugs" 979).
Ciprofloxacin inspection
- Crystallinity
- Take a little of this product and check it according to law (Appendix D of Part II of the Pharmacopoeia 2010), and it should meet the requirements.
- Clarity and color of the solution
- Take 0.1g of this product and add 10mol of 0.1mol / L hydrochloric acid to dissolve the solution. The solution should be clear and colorless; if color is developed, compare with yellow or yellow-green standard colorimetric solution No. 4 (Appendix A of Part Two of the 2010 Pharmacopoeia). Deeper.
- relative substance
- Take about 25mg of this product, accurately weigh, add 0.2ml of 7% phosphoric acid solution to dissolve, and then quantitatively dilute with mobile phase A to make a solution containing about 0.5mg per 1ml as the test solution; Mobile phase A was quantitatively diluted to make a solution containing about 1 g per 1 ml as a control solution. Also weigh approximately 15 mg of impurity A reference substance, put it into a 100 ml measuring bottle, add 6 mol / L ammonia solution 0.6 ml and dissolve in an appropriate amount of water, dilute with water to the mark, shake well, take 1 ml precisely and place it in a 100 ml measuring bottle. Mobile phase A was diluted to the mark, shaken, and used as impurity A reference solution. As determined by high performance liquid chromatography (Appendix VD), octadecylsilane bonded silica gel was used as the filler; mobile phase A was 0.025mol / L phosphoric acid solution-acetonitrile (87:13) (pH was adjusted with triethylamine The value is 3.0 ± 0.1), the mobile phase B is acetonitrile, and a linear gradient elution is performed according to the following table. The flow rate is 1.5 ml per minute. Weigh the appropriate amounts of ofloxacin reference, ciprofloxacin reference and impurity reference, add mobile phase A to dissolve and dilute to about 5 g of ofloxacin, 0.5 mg of ciprofloxacin and A mixed solution of 10 g of impurity I was taken into a liquid chromatograph with a detection wavelength of 278 nm and a chromatogram was recorded. The retention time of the ciprofloxacin peak was about 12 minutes. The resolution of ciprofloxacin peak, ofloxacin peak and impurity peak should meet the requirements. Take 20l of the control solution and inject it into the liquid chromatograph, and use 278nm as the detection wavelength to adjust the detection sensitivity so that the peak height of the main component chromatographic peak is about 20% of the full scale. Precisely measure 20 l each of the test solution, the control solution and the impurity A reference solution, and inject them into the liquid chromatograph respectively, with the detection wavelengths of 278 nm and 262 nm, and record the chromatogram. The relative retention time of the ciprofloxacin peak is 1, The relative retention times of the peaks of impurity E, impurity B, impurity C, impurity I, and impurity D are about 0.3, 0.6, 0.7, 1.1, and 1.2, respectively. If there is an impurity peak in the chromatogram of the test solution, the impurity A (262nm detection) is calculated based on the peak area of the external standard method, which must not exceed 0.3%; the impurities B, C, D, and E (278nm detection) are based on the corrected peak area. Calculated (multiplied by the correction factors 0.7, 0.6, 1.4, and 6.7, respectively), should not be larger than the main solution area of the control solution (0.2%); the peak area of other single impurities (detected at 278nm) should not be larger than the main solution area of the control solution (0.2%) (Detection at 278nm) The sum of the peak areas after calibration should not be greater than 2.5 times (0.5%) the main peak area of the control solution. Any peak that is less than 0.1 times the area of the main peak of the control solution in the chromatogram of the test solution can be ignored.
| Time (minutes) | Mobile phase A (%) | Mobile phase B (%) |
| 0 | 100 | 0 |
| 16 | 100 | 0 |
| 53 | 40 | 60 |
| 54 | 100 | 0 |
| 65 | 100 | 0 |
- Loss on drying
- Take this product, use phosphorus pentoxide as a desiccant, and dry it under reduced pressure at 120 ° C for 6 hours. The weight loss should not exceed 1.0% (Appendix L of the second edition of the Pharmacopoeia of the 2010 edition).
- Residue on ignition
- Take 1.0g of this product, place it in a platinum crucible, and inspect it according to law (Appendix N of Part Two of the Pharmacopoeia 2010 Edition). The residual residue shall not exceed 0.1%.
- Heavy metal
- Take the residue left under the burning residue and check it according to law (Appendix H of Part Two of the 2010 Pharmacopoeia). The content of heavy metals must not exceed 20 parts per million [2] .
Determination of Ciprofloxacin
- It was determined by high performance liquid chromatography (Appendix VD of Part Two of the Pharmacopoeia, 2010 Edition).
- 1 Chromatographic conditions and system suitability tests
- Octadecylsilane-bonded silica gel was used as the filler; 0.025mol / L phosphoric acid solution-acetonitrile (87:13) (the pH was adjusted to 3.0 ± 0.1 with triethylamine) was used as the mobile phase. The detection wavelength was 278 nm; the flow rate was 1.5 ml per minute. Weigh the appropriate amounts of ofloxacin reference, ciprofloxacin reference and impurity reference, add mobile phase to dissolve and dilute to make about 5 g of ofloxacin, 0.1 mg of ciprofloxacin and impurities in 1ml 10 g of the mixed solution, take 20 l into the liquid chromatograph, record the chromatogram, the retention time of ciprofloxacin peak is about 12 minutes. The resolution of ciprofloxacin peak, ofloxacin peak and impurity peak should meet the requirements.
- 2 Assay
- Take about 25mg of this product, accurately weigh, add 0.2ml of 7% phosphoric acid solution to dissolve, and quantitatively dilute with mobile phase to make a solution containing about 0.1mg per 1ml. Precisely take 20l into the liquid chromatograph and record the chromatogram ; Another ciprofloxacin reference was taken and determined in the same way. Calculate the peak area according to the external standard method, and get [3] .
Ciprofloxacin Categories
- Quinolones.
Ciprofloxacin storage
- Shaded and sealed.
Ciprofloxacin
- Ciprofloxacin Lactate Sodium Chloride Injection
Ciprofloxacin
- Impurity A: 1-cyclopropyl-6-fluoro-7-chloro-4-oxo-1,4-dihydroquinoline-3-carboxylic acid (fluoroquinoline acid)
- Impurity B: 1-cyclopropyl-4-oxo-7- (1-piperazinyl) -1,4-dihydroquinoline-3-carboxylic acid
- Impurity C: 1-cyclopropyl-6-fluoro-7-[(2-aminoethyl) amino] -4-oxo-1,4-dihydroquinoline-3-carboxylic acid
- Impurity D: 1-cyclopropyl-7-chloro-4-oxo-6- (1-piperazinyl) -1,4-dihydroquinoline-3-carboxylic acid
- Impurity E: 1-cyclopropyl-6-fluoro-7- (1-piperazinyl) -4- (1H) quinolinone
- Impurities I: 1-cyclopropyl-7-chloro-6-[(2-aminoaminoethyl) amino] -4-oxo-1,4-dihydro-3-quinolinecarboxylic acid
Ciprofloxacin Drug Analysis
- Method name: Ciprofloxacin API-Ciprofloxacin-High Performance Liquid Chromatography
- Scope of application: This method uses high performance liquid chromatography to determine the content of ciprofloxacin in ciprofloxacin bulk drugs.
- This method is suitable for ciprofloxacin APIs.
- Principle of the method: The test product is dissolved in a 7% phosphoric acid solution, diluted with mobile phase, and then subjected to chromatographic separation by high-performance liquid chromatography. The peak area of ciprofloxacin is measured at a wavelength of 277 nm using an ultraviolet absorption detector, and calculated. Its content.
- Reagent: 1. Acetonitrile
- 2. Citric acid solution (0.05mol / L)
- 3. Triethylamine
- 4. 7% phosphoric acid solution
- Equipment: 1. Instrument
- 1.1 HPLC
- 1.2 Column
- Octadecylsilane-bonded silica gel is used as a filler, and the theoretical plate number should not be less than 2000 calculated based on the ciprofloxacin peak.
- 1.3 UV absorption detector
- Chromatographic conditions
- 2.1 Mobile phase: 0.05mol / L citric acid solution acetonitrile = 82 18, triethylamine adjusts the pH to 3.5
- 2.2 Detection wavelength: 277nm
- 2.3 Column temperature: 30 ° C
- 2.4 Flow rate: 1mL / min
- Sample preparation: 1. Preparation of reference solution
- Precisely weigh about 25mg of ciprofloxacin reference substance, place it in a 50mL volumetric flask, dissolve it with 0.2mL of 7% phosphoric acid solution, add mobile phase to dilute to the mark, and shake to obtain the reference solution.
- 2. Preparation of test solution
- About 25mg of the test sample is accurately weighed, placed in a 50mL volumetric flask, dissolved in 0.2mL of a 7% phosphoric acid solution, diluted with mobile phase to the mark, and shaken to obtain the test solution.
- Note: "Precision weighing" means that the weighed weight should be accurate to one thousandth of the weighed weight. "Precision measurement" means that the accuracy of measuring the volume should meet the accuracy requirements of the volume pipette in national standards.
- Operation steps: Precisely pipette 10 mL of each of the reference solution and the test solution, and inject them into a high-performance liquid chromatograph. Measure the peak area of ciprofloxacin (C17H18FN3O3) at a wavelength of 277 nm with an ultraviolet absorption detector and calculate its content 4] .
Ciprofloxacin Drug Description
Ciprofloxacin Pharmacology and Toxicology
- It belongs to fluoroquinolones and has the same antibacterial spectrum as norfloxacin. Its antibacterial activity is currently the strongest among the widely used fluoroquinolones. In addition to its high antibacterial activity against Gram-negative bacilli, it also has a good antibacterial effect on Staphylococcus, and its effect on Pneumococcus and Streptococcus is slightly worse than Staphylococcus. This product also has inhibitory effects on some mycobacteria, chlamydia trachomatis, ureaplasma urealyticum, and mycoplasma hominis. For the mechanism of action and bacterial resistance of this drug, see Norfloxacin. As bactericides, quinolones are currently considered to act on the A subunit of bacterial cell DNA helicases, inhibit DNA synthesis and replication and cause bacterial death [5] .
Ciprofloxacin pharmacokinetics
- Orally
- After 250 mg and 500 mg, the peak plasma concentrations were 1.45 mg / L and 2.56 mg / L, respectively, and the bioavailability was 49% to 70%. After intravenous infusion of 100mg of the product, the peak blood concentration was 2.53 ± 1.03mg / L. The drug is widely distributed in the body after absorption, and can reach effective drug levels in vesicular fluid, prostate, lung and urogenital tract tissues, and sputum. The elimination half-life of this product is 3.3 to 4.9 hours, and 29% to 44% (oral) and 45% to 60% (intravenous) of the drug dosage are excreted from the urine in the form of the drug. Expelling. The drug concentration in the bile is much higher than the blood drug concentration, and about 15% to 25% of the dose is excreted from the feces.
- Ciprofloxacin Hydrochloride Products
- Pharmacological effects: Ciprofloxacin is a quinolone broad-spectrum antibiotic for oral or intravenous administration.
- Microbiology: Ciprofloxacin has a broad antibacterial spectrum and strong antibacterial ability. This product inhibits bacterial DNA helicase and prevents bacterial replication, so it quickly reduces bacterial reproduction. It is a bactericidal antibacterial drug. Ciprofloxacin works in a special way and is different from any other antibiotic except quinolone. Therefore, ciprofloxacin has a higher antibacterial capacity against penicillin, cephalosporins, aminoglycosides and tetracycline-resistant beads. In vitro experiments have proven that the combined application of ciprofloxacin with -lactams and aminoglycoside antibiotics can produce additive effects or no effects. Synergistic effects of animal experiments and drugs often occur, especially in leukopenia animals.
- Drugs that can be used in combination with ciprofloxacin include: Pseudomonas aloxicillin, ceftazidime. Streptococcus is meloxicillin, aloxicillin, and other highly effective -lactam antibiotics. Staphylococci are -lactam antibiotics, especially isoxazole penicillin and vancomycin. Anaerobic bacteria are metronidazole and clindamycin.
- Absorption, distribution and elimination: Ciprofloxacin hydrochloride is administered to healthy people by 0.25g or 0.5g orally. After 1 to 2 hours, the Cmax is 1.5 g / ml and 2.5 g / ml, respectively. The half-life is about 4 hours. The product is mainly distributed in bile. , Mucus, saliva, bone, and prostate, but lower concentrations in the brain and spinal cord, the product can be metabolized in the liver and excreted in the urine by the kidney. Can maintain high drug concentration in urine. [5]
Ciprofloxacin indications
- Ciprofloxacin has a wider clinical use than norfloxacin. In addition to urinary tract infections, intestinal infections, gonorrhea, etc., it can also be used to treat influenza bacteria, E. coli, pneumoniae, Proteus mirabilis, Proteus common, Bone and joint infections, skin and soft tissue infections and pneumonia, sepsis, etc. caused by Profidens, M. bacillus, Pseudomonas aeruginosa, Enterobacter cloacae, C. fraudis, Staphylococcus (including methicillin-resistant strains), etc. . The oral preparation of this product is compatible with norfloxacin; intravenous administration can be used for the treatment of severe infections, such as enterobacteriaceae bacterial sepsis, pulmonary infection, abdominal cavity, biliary tract infection and so on.
- Ciprofloxacin Hydrochloride
- Severe infections can be combined with other synergistic antibacterial drugs. For all non-complicated and comorbid infections caused by ciprofloxacin-sensitive fungi. include:
- Respiratory infections: Ciprofloxacin can be used in pneumonia caused by Klebsiella, Enterobacter, Proteus, Pseudomonas, Haemophilus, Branhamella, Legionella and Staphylococcus . Ciprofloxacin is generally not the drug of choice for the treatment of encephalococcal encephalitis in non-inpatients.
- Middle ear infections (otitis media), sinus infections (sinusitis), especially infections caused by Gram-negative bacteria or staphylococci including Pseudomonas.
- Eye infection.
- Renal and / or urinary tract infections.
- Gonadal organ infections: Including uterine appendicitis, gonorrhea, and prostatitis.
- Celiac infection (intestinal infection, biliary infection, peritonitis).
- Skin and soft tissue infections.
- Bone and joint infections.
- Septicemia, bacteremia.
- Prevention of infection or infection in patients with a weakened immune system (immunosuppressive or leukopenia). Immunosuppressed patients undergo selective intestinal purification.
- In vitro studies have shown that ciprofloxacin is sensitive to the following pathogens: Escherichia coli, Shigella, Salmonella, citric acid halide, Klebsiella, Enterobacter, Serratia, Hivenia hive, Dumb Edwardsiella, Proteus (indole-positive and indole-negative), R. przewoldi, Morgenella, Yersinia, Vibrio, Aeromonas, Pseudomonas pseudomonas , Pasteurella haemorrhagic, Haemophilus, Campylobacter jejuni, Pseudomonas aeruginosa, Legionella, Neisseria, Moraxella, Brucella, Staphylococcus, Listeria, Corynebacterium , Chlamydia.
- The following bacteria have a large variation in sensitivity: Acinetobacter, Gardnerella, Flavobacterium, Alcaligenes, Streptococcus agalactiae, Streptococcus faecium, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus grass green, Mycoplasma , Mycobacterium tuberculosis, and occasional technical bacteria. Ciprofloxacin has less antibacterial effect on Streptococcus than penicillin antibiotics.
- The following bacteria are resistant: Ureaplasma urealyticum, Streptococcus faecium, and Nuka sclerotiorum. With a few exceptions, the sensitivity of anaerobic bacteria ranges from moderately sensitive (such as pneumococcus and pneumococcus) to resistant (bacteroides). Ciprofloxacin is not effective against Treponema pallidum [5] .
Ciprofloxacin dosage
- 1. The daily dosage for adults (calculated based on ciprofloxacin, hereinafter the same) is 0.5 to 1.5 g, and it is taken orally twice a day. Intravenous infusion is 0.2 to 0.6 g per day, but the speed should not be too fast; the infusion is divided into 2 times, each time is about 1 hour.
- 2. Bone and joint infection, 1.0-1.5g a day, divided into 2 or 3 times, the course of treatment is 4-6 weeks or longer. [5]
- 3 Pneumonia and skin and soft tissue infections are 1 to 1.5 g daily, divided into 2 times, and the course of treatment is 7 to 14 days.
- Ciprofloxacin Lactate for Injection
- 4 Intestinal infection is 1 g daily, divided into 2 times, and the course of treatment is 5 to 7 days. Typhoid fever is 1.5 g daily, divided into 2 doses, the course of treatment is 10 to 14 days. 5. Urinary tract infection is 0.5 to 1 g per day, divided into 2 doses, the course of treatment is 7 to 14 days; the course of treatment of severe or complicated cases needs to be appropriately extended.
- 6. Gonorrhea is administered orally in a single dose of 0.25 to 0.5 g.
- 7. Severe cases can be administered intravenously, 0.4 to 0.6 g daily, divided into two intravenous infusions.
- (1) This product should be taken on an empty stomach. Although food can delay its absorption, the total absorption (bioavailability) has not decreased, so it can also be taken after a meal to reduce gastrointestinal reactions; 250ml of water should be taken at the same time.
- Ciprofloxacin Hydrochloride Products
- Caution: Ciprofloxacin cannot be used after its expiry date. Keep out of the reach of children. [5]
Ciprofloxacin adverse reactions
- Mainly gastrointestinal reactions (3-4%), central nervous system symptoms (2%), allergic reactions (0.5-1.0%), and laboratory testing abnormalities (3-4%), which may cause epilepsy and even convulsions ( Overdose is prone to occur). Most of the adverse reactions are mild, so they rarely affect the continuation of treatment. Crystallized urine, joint pain or stiffness, light sensitivity, and visual impairment seen in norfloxacin can also occur in the course of this product. Can cause mild gastrointestinal irritation or discomfort, nausea, heartburn, and loss of appetite. Mild nervous system reactions, dizziness, drowsiness, headache, restlessness, symptoms disappear (return to normal) after withdrawal. Allergic reactions,
- Ciprofloxacin Hydrochloride Products
- Rash, itching, flushing of the face or skin, congestion of the conjunctiva. It can also cause transient elevation of aminotransferase, fluid retention, and so on. Individual cases can cause liver damage. Symptoms disappear (return to normal) after discontinuation. Can cause kidney damage, elevated urea nitrogen, renal dysfunction with caution. There are also leukopenia and thrombocytopenia, increased eosinophils, and oral ulcers. Hypersensitivity to the upper respiratory tract mucosa, edema of the throat, suffocation, vasculitis of the skin, joint and muscle pain, severe cases can be life-threatening. Gastrointestinal tract: nausea, diarrhea, vomiting, indigestion, abdominal pain, bloating, anorexia. If severe long-term diarrhea is found during or after treatment, you must consult your doctor, as this may cause serious intestinal diseases (pseudomembrane enteritis) and require timely treatment. Once this happens, the use of ciprofloxacin must be stopped, and appropriate treatment (vancomycin 4 x 250 mg / day) should be given, and intestinal peristaltic drugs should be disabled [5] .
- Nervous system: dizziness, headache, fatigue, agitation, tremor;
- Ciprofloxacin Hydrochloride
- Sensory organs: Sensory organs are rare in side effects, sometimes impaired taste, visual disturbances (dual vision, color vision), and temporary impairment of tinnitus hearing, especially in high frequency environments.
- High allergic reaction: In some cases, an allergic reaction may occur on the first application of the drug. In this case, stop using the drug and immediately notify the doctor.
- Skin reactions: such as rash, itching, and drug fever.
- Rare adverse reactions: skin bleeds (stasis), blister formation, accompanied by bleeding (bleeds) and small nodules (papules) with crusts, which indicate vasculitis.
- StevensJohnson and Lyell syndrome: interstitial nephritis, hepatitis, liver necrosis, and rarely cause life-threatening liver failure. In some patients, allergic reactions can occur on initial administration (eg, facial, vascular, and laryngeal edema; dyspnea) , Leading to life-threatening physical grams); once these conditions occur, the drug should be discontinued immediately and treated (shock treatment).
- Cardiovascular System:
- Tachycardia: Rarely flushing, migraine, syncope.
- Other side effects:
- Arthralgia: Rarely are weakness, muscle pain, tenosynovitis, light sensitivity, transient renal impairment, including transient renal failure. Achilles tendinitis is occasionally seen during the use of ciprofloxacin, so if symptoms of the Achilles tendon (pain and swelling) appear, discontinue the medication and notify your doctor. Long-term use of ciprofloxacin can cause dual infections caused by resistant bacteria or yeast-like fungi.
- Ciprofloxacin Lactate for Injection
- Impact on laboratory parameters and urinary sedimentation: Transaminase, alkaline phosphatase may be temporarily increased, bile stasis jaundice, especially those patients with liver damage in the past are more prone to these adverse reactions. Urea nitrogen, creatinine, or bilirubin are temporarily elevated in the serum, and some patients have hyperglycemia, crystalline urine, or hematuria.
- Local reactions: Phlebitis or thrombophlebitis.
- Others: Ciprofloxacin can affect patients' ability to drive or operate machines, even if they take medicine strictly according to the doctor's requirements, especially those who drink alcohol at the same time [5] .
Ciprofloxacin Contraindications
- (1) This product is not suitable for those who are allergic to quinolone.
- (2) This product is not suitable for children, pregnant women and nursing women.
- Ciprofloxacin Hydrochloride Products
- (4) Patients with previous history of epilepsy or central nervous system disease should be used with caution. Patients with renal impairment should be dosed according to the degree of renal impairment when applying this product. The mechanism of action of fluoroquinolones such as norfloxacin is to inhibit DNA synthesis. The damage to cartilage was found in young rats. Therefore, this kind of drug should not be used in children and pregnant women. Breastfeeding should be suspended during application. The drug can be secreted into milk. Patients with central nervous disease such as epilepsy should avoid using fluoroquinolones such as this product, because they are prone to severe central nervous system reactions. Severe renal dysfunction should also be avoided, as adverse reactions such as convulsions can occur. Use with caution in patients with severe arteriosclerosis and epilepsy. Patients known to be allergic to ciprofloxacin or other quinolones are contraindicated. It is contraindicated in children, adolescents, pregnant women, or lactating women because there is no experience with drugs in these people. Animal experiments have shown that ciprofloxacin may damage the articular cartilage during development, but no teratogenicity has been reported. Patients with epilepsy and patients with central nervous system disease should be particularly careful with ciprofloxacin. Drugs should only be considered when the advantages outweigh the disadvantages, because they may cause adverse reactions in the central system of the patient. [5]
Ciprofloxacin Drug Interactions
- (1) Urine alkalizing agent can reduce the solubility of the product in the urine, leading to crystalline urine and renal toxicity
- (2) antacids containing aluminum or magnesium can reduce the oral absorption of the product.
- epilepsy
- (4) probenecid can reduce the secretion of the product from the renal tubules by about 50%, and when used together, it can cause toxicity due to the increased blood concentration of the product.
- (5) The combination of the product and theophylline can reduce the latter's liver clearance by about 30%, increase the blood concentration of theophylline and prolong the half-life and cause poisoning, and nausea, vomiting, tremor, restlessness, agitation, convulsions, palpitations Etc. Therefore, the theophylline blood concentration and dose adjustment should be measured when used together. Norfloxacin and other quinolones can inhibit the metabolism of theophylline, caffeine, and oral anticoagulants (warfarin) in the liver, which can increase the blood concentration of the above drugs due to reduced metabolism, leading to adverse reactions. Avoid co-use. When it must be combined, the theophylline blood concentration or prothrombin time should be monitored and the dose adjusted accordingly. Antacids can reduce the intestinal absorption of quinolone oral preparations such as this product, and should not be used together.
- Ciprofloxacin Hydrochloride Tablets
Ciprofloxacin Veterinary Drug Application
Ciprofloxacin action and application
- This product is a broad-spectrum fungicide. The antibacterial activity against Gram-negative bacteria is currently the strongest one of fluoroquinolones used in veterinary clinics; it also has a strong effect on Gram-positive bacteria. In addition, it also has a strong antibacterial effect on Mycoplasma anaerobic bacteria and Pseudomonas aeruginosa. It is used for the interference of various systems throughout the body, and has good effects on the digestive tract, respiratory tract, urogenital tract, skin and soft tissue infections, and mycoplasma infections [5] .
Ciprofloxacin usage and dosage
- Taken orally, once per dose, 5 to 15 mg per 1 kg of body weight for pigs and dogs. 2 times / d.
- Mixed drink, 25 ~ 50mg for each 1L of drinking water.
- Intramuscular injection, once dose, 2.5 mg for livestock and 5 mg for poultry per 1 kg of body weight. 2 times / d. [5]