Floxan

Floxan - Precautions | Dosage | Side Effects

Floxan is a medicine that contains the antibiotic called ciprofloxacin hydrochloride - fluoroquinolone family of medicines. It expresses a very wide range of effects (kills wide range of bacteria) and is used for the treatment of a number of infections, such as:

  • Anthrax
  • Infections caused by bacteria called Neisseria meningitides
  • Intra-abdominal infections
  • Gastrointestinal infections
  • Infections of the bones
  • Infections of the joints
  • Skin infections
  • Soft tissue infections
  • Infections of the respiratory tract
  • Severe ear infections
  • Severe infections of the sinuses
  • Genital infections in both men and women
  • Infection of the testicles
  • Urinary tract infections (especially effective in women)
  • In patients who have a very small number of leukocytes and who also have a bacterial infection

It belongs to one of the most commonly used antibiotics because of its high efficiency.

It is safe for use even in combination with other antibiotics.

When do you need to take special precautions?

Absolute contraindications to this drug include:

  • Allergy to the active substance - ciprofloxacin
  • If you are taking a medication called tizanidine (used for muscle stiffness in multiple sclerosis)

Caution is also required in the following situations:

  • If you have or have had kidney problems
  • If you have or have had neurological disorders (e.g. epilepsy)
  • If you have myasthenia gravis
  • If you have had muscle problems linked to antibiotic use
  • If you have arrhythmias or prolonged QT interval. This medicine may affect the QT interval which can cause heart rhythm disorders

If you notice any of the following side effects, immediately go to your doctor:

  • Sudden allergic reaction which may occur after taking the first tablet, or later during the treatment. If you experience chest tightness, shortness of breath or loss of consciousness, immediately go to the doctor.
  • Pain or swelling of tendons. This side effect is more common in patients on corticosteroid therapy and in elderly patients. If you notice pain or swelling of a joint or muscle, immediately discontinue use and call your doctor.
  • If you suffer from depression, this medicine may worsen the symptoms of depression.
  • This medicine may damage the liver, and you should immediately contact your doctor if you notice any symptoms of liver damage, such as:
    • loss of appetite
    • abdominal pain
    • dark discoloration of urine
    • jaundice
  • If you have a deficiency of the enzyme glucose 6-phosphate dehydrogenase (genetic disease). In such patients, this medication causes anemia.
  • Increased sensitivity to sunlight. Avoid sun exposure while on treatment with this medicine.

Floxan and pregnancy

It is recommended to avoid using this medicine during pregnancy. However, sometimes your doctor may decide that the benefit of the application of this drug outweigh the risks for the child (e.g. in severe infections that can be dangerous to the health of both mother and child).

An increased number of caesarean sections in mothers who took this medicine during pregnancy have been reported, because of the so-called fetal distress, but the root cause remained unknown.1

No malformations or other adverse effects have been reported.

Floxan and lactation

Although some studies have shown that the drug can be used during breastfeeding, because the amount of the drug excreted in breast milk is low and may not cause unwanted effects2, the PIL clearly states that this drug should not be used during breastfeeding because of the possible side effects in infants. It is best to stop breastfeeding while you are on Floxan therapy.

Dosage

Take one tablet during meals or between meals with plenty of fluids. The therapy lasts 5-21 days, or longer if the infection is severe.

Do not take this medicine together with milk or dairy products because they reduce the absorption and therefore reduce the effectiveness of this drug.

Be sure to drink plenty of fluids while you are on treatment with this drug.

Recommended dosage according to the PIL (patient information leaflet) is in the table below:

Indication Recommended dosage regimen
Acute exacerbation of chronic sinusitis 500-750 mg two times a day, during 1or 2 weeks
Chronic suppurative otitis media 500-750 g two times a day, during 1or 2 weeks
Malignant otitis externa 750 mg two times a day, during 4-12 weeks
Uncomplicated cystitis 250-500 mg two times a day, during three days
Complicated cystitis 500 mg two times a day, during one week
Complicated pyelonephritis 500-750 mg two times a day, during 10-21 days
Acute prostatitis 500-750 mg two times a day during 2-4 weeks
Chronic prostatitis 500-750 mg two times a day, during 4-8 weeks
Gonococcal urethritis or cervicitis 500 mg taken only once (a single dose)
Typhoid fever 500 mg two times a day, during one week
Intra-abdominal infections 500-750 mg two times a day, during 5-14 days
Bone and joint infections 500-750 mg, during three months (but not more than three months)
Infections of skin and soft tissue 500-750 mg two times a day, during one or two weeks
Diarrhea caused by microorganisms called Shigella Dysentery 500 mg two times a day, during 1-5 days
In patients who have a very low leukocyte number and who also have a bacterial infection 500-750 mg two times a day until you have a very low leukocyte number

Interactions

Floxan should be used with extreme caution if you are using any the following medicines:

  • Tizanidine - a drug used for the treatment of muscle spasms in multiple sclerosis
  • Phenytoin and other antiepileptic drugs
  • Clozapine - a drug used to treat mental disorders
  • Ropinirole - a drug used for the treatment of Parkinson's disease
  • Glibenclamide - antidiabetic drug
  • Theophylline - a drug used in asthmatics
  • Probenecid - a drug used in patients with gout

Drugs whose concentration in the blood can be increased by Floxan, thus increasing the risk of their side effects include:

  • Duloxetine - antidepressant
  • Sildenafil - used to increase libido
  • Pentoxifylline - a drug that is used in disorders of peripheral circulation

Drugs that may decrease the concentration Floxan in the blood thus reducing its effectiveness include:

  • Omeprazole - a drug that is used for heartburn and ulcers
  • Antacids - drugs that are used in conditions where there is an increased level of stomach acid (such as heartburn)
  • Preparations of calcium and magnesium

Floxan side effects

Possible side effects of this drug include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Abdominal pain
  • Upset stomach
  • Loss of appetite
  • Disturbance of taste
  • Impairment of kidney function
  • Sleep disorders
  • Allergic reactions (rash, hives, tightness in the chest)
  • Fungal infections
  • Ringing in the ears, dizziness and headache
  • Liver damage
  • Muscle damage
  • Prolonged QT interval and arrhythmias
  • Increased levels of the enzyme amylase
  • Vasculitis

These are not all side effects that may be caused by Floxan, and it's necessary to contact your doctor if you notice any effect that you suspect is the result of taking Floxan.

References

  1. NCBI link 1
  2. NCBI link 2