Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.
HEALTH CANADA ADVISORY
January 23, 2017
Health Canada has issued new restrictions concerning the use of ciprofloxacin. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Antibiotic-associated colitis: This medication, like other antibiotics, may cause a potentially dangerous condition called antibiotic-associated colitis or pseudomembranous colitis. Symptoms include severe, watery diarrhea that may be bloody. If you notice these symptoms, stop taking this medication and contact your doctor as soon as possible.
Behaviour and nervous system: Rarely, ciprofloxacin extended-release may affect behaviour and the nervous system. If you experience confusion, tremors, depression (including thoughts of harming yourself), hallucinations (hearing, seeing, or feeling things that are not actually there), agitation, anxiety, difficulty sleeping, nightmares, or any other behaviour changes while taking this medication, contact your doctor.
Blood glucose: Ciprofloxacin, like other medications in this family may cause changes in blood sugar levels (may cause a loss of blood glucose control) and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.
If you experience symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heartbeat, weakness) or symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour), talk to your doctor.
Drowsiness/reduced alertness: Ciprofloxacin may cause dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how this medication affects you.
Hypersensitivity syndrome: A severe allergic reaction called hypersensitivity syndrome has occurred for some people with the use of ciprofloxacin. This reaction involves a number of organs in the body and may be fatal if not treated quickly. Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.
Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects, since ciprofloxacin is removed from the body primarily by the kidneys. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Ciprofloxacin may reduce liver function and can cause liver failure. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Neuromuscular disorders: Ciprofloxacin may cause increased muscle weakness for people with myasthenia gravis (an autoimmune disorder that causes muscle weakness). If you have myasthenia gravis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Other infections: Use of ciprofloxacin extended-release for a long time may cause other infections, especially by yeast or fungi. If you notice symptoms of an infection (e.g., vaginal yeast infection symptoms such as thick white discharge and itchiness), contact your doctor.
QT prolongation: This medication can lengthen heartbeat as shown on an electrocardiogram test, also known as QT prolongation. Very rare cases of abnormal heart beat have been reported in people while on ciprofloxacin extended-release, but these reports generally involved people who had conditions that predisposed them to abnormal heart beat, or who have been taking other medications that can increase the risk of developing an abnormal heart beat.
If you have heart disease and abnormal heart rhythms, or are taking certain medications (e.g., verapamil, atazanavir), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you develop heart palpitations (fast or irregular heartbeat) or experience fainting spells, stop taking your medication and contact your doctor immediately.
Seizures: Rarely, seizures have been reported with this medication. If you have a history of epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you have a seizure while taking this medication, stop taking it and get immediate medical attention.
Sun sensitivity: Ciprofloxacin extended-release can increase the sensitivity of the skin to sun and increase the chance of sunburn. Avoid the sun, use sunscreen, and avoid sun beds while taking this medication. If you must spend time in the sun, use sunblock with minimum SPF 15. Contact your doctor if severe sun sensitivity occurs (e.g., sunburn).
Tendonitis: Ciprofloxacin extended-release may increase the chance of tendon injury. Injury occurs more commonly for seniors who are also taking, or have recently taken, corticosteroid medications (e.g., prednisone, dexamethasone), however it can happen to anyone who takes ciprofloxacin. If there is any new pain in the tendons, stop taking ciprofloxacin extended-release, avoid physical exercise, and contact your doctor.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking ciprofloxacin extended-release, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of ciprofloxacin extended-release has not been established for children and adolescents less than 18 years of age.