Ciprofloxacin - wikipedia Ciprofloxacin `` Cipro '' redirects here. For the Rome Metro station, see Cipro ( Rome Metro ). Ciprofloxacin Clinical data Trade names Ciloxan, Cipro, Neofloxin, others AHFS / Drugs.com Monograph MedlinePlus a688016 License data US FDA : Ciprofloxacin Pregnancy category AU : B3 US : C ( Risk not ruled out ) Routes of administration By mouth, intravenous, topical ( ear drops, eye drops ) ATC code J01MA02 ( WHO ) S01AE03 ( WHO ) S02AA15 ( WHO ) S03AA07 ( WHO ) Legal status Legal status AU : S4 ( Prescription only ) UK : POM ( Prescription only ) US : ℞ - only Pharmacokinetic data Bioavailability 70 % Protein binding 30 % Metabolism Liver ( incl. CYP1A2 ) Biological half - life 3.5 hours Excretion Kidney Identifiers IUPAC name 1 - cyclopropyl - 6 - fluoro - 4 - oxo - 7 - ( piperazin - 1 - yl ) - quinoline - 3 - carboxylic acid CAS Number 85721 - 33 - 1 PubChem CID 2764 DrugBank DB00537 ChemSpider 2662 UNII 5E8K9I0O4U KEGG D00186 ChEBI CHEBI : 100241 ChEMBL CHEMBL8 NIAID ChemDB 001992 ECHA InfoCard 100.123. 026 Chemical and physical data Formula C H FN O Molar mass 331.346 g / mol 3D model ( JSmol ) Interactive image SMILES c1c2c ( cc ( c1F ) N3CCNCC3 ) n ( cc ( c2 = O ) C ( = O ) O ) C4CC4 InChI InChI = 1S / C17H18FN3O3 / c18 - 13 - 7 - 11 - 14 ( 8 - 15 ( 13 ) 20 - 5 - 3 - 19 - 4 - 6 - 20 ) 21 ( 10 - 1 - 2 - 10 ) 9 - 12 ( 16 ( 11 ) 22 ) 17 ( 23 ) 24 / h7 - 10, 19H, 1 - 6H2, ( H, 23, 24 ) Key : MYSWGUAQZAJSOK - UHFFFAOYSA - N ( verify ) Ciprofloxacin is an antibiotic used to treat a number of bacterial infections. This includes bone and joint infections, intra abdominal infections, certain type of infectious diarrhea, respiratory tract infections, skin infections, typhoid fever, and urinary tract infections, among others. For some infections it is used in addition to other antibiotics. It can be taken by mouth or used intravenously. Common side effects include nausea, vomiting, diarrhea and rash. Ciprofloxacin increases the risk of tendon rupture and worsening muscle weakness in people with the neurological disorder myasthenia gravis. Rates of side effects appear to be higher than some groups of antibiotics such as cephalosporins but lower than others such as clindamycin. Studies in other animals raise concerns regarding use in pregnancy. No problems were identified, however, in the children of a small number of women who took the medication. It appears to be safe during breastfeeding. It is a second - generation fluoroquinolone with a broad spectrum of activity that usually results in the death of the bacteria. Ciprofloxacin was introduced in 1987. It is on the World Health Organization 's List of Essential Medicines, the most effective and safe medicines needed in a health system. It is available as a generic medication and not very expensive. The wholesale cost in the developing world is between 0.03 and 0.13 USD a dose. In the United States it is sold for about 0.40 USD per dose. Contents 1 Medical uses 1.1 Pregnancy 1.2 Breastfeeding 1.3 Children 1.4 Spectrum of activity 1.5 Bacterial resistance 2 Contraindications 3 Side effects 3.1 Tendinitis 3.2 Nervous system 3.3 Cancer 3.4 Other 4 Overdose 5 Interactions 6 Mechanism of action 7 Pharmacokinetics 8 Chemical properties 9 Usage 10 History 11 Society and culture 11.1 Cost 11.2 Generic equivalents 11.3 Available forms 11.4 Litigation 12 References 13 External links Medical uses Ciprofloxacin is used to treat a wide variety of infections, including infections of bones and joints, endocarditis, gastroenteritis, malignant otitis externa, respiratory tract infections, cellulitis, urinary tract infections, prostatitis, anthrax, and chancroid. Ciprofloxacin only treats bacterial infections ; it does not treat viral infections such as the common cold. For certain uses including acute sinusitis, lower respiratory tract infections and uncomplicated gonorrhea, ciprofloxacin is not considered a first - line agent. Ciprofloxacin occupies an important role in treatment guidelines issued by major medical societies for the treatment of serious infections, especially those likely to be caused by Gram - negative bacteria, including Pseudomonas aeruginosa. For example, ciprofloxacin in combination with metronidazole is one of several first - line antibiotic regimens recommended by the Infectious Diseases Society of America for the treatment of community - acquired abdominal infections in adults. It also features prominently in treatment guidelines for acute pyelonephritis, complicated or hospital - acquired urinary tract infection, acute or chronic prostatitis, certain types of endocarditis, certain skin infections, and prosthetic joint infections. In other cases, treatment guidelines are more restrictive, recommending in most cases that older, narrower - spectrum drugs be used as first - line therapy for less severe infections to minimize fluoroquinolone - resistance development. For example, the Infectious Diseases Society of America recommends the use of ciprofloxacin and other fluoroquinolones in urinary tract infections be reserved to cases of proven or expected resistance to narrower - spectrum drugs such as nitrofurantoin or trimethoprim / sulfamethoxazole. The European Association of Urology recommends ciprofloxacin as an alternative regimen for the treatment of uncomplicated urinary tract infections, but cautions that the potential for `` adverse events have to be considered ''. Although approved by regulatory authorities for the treatment of respiratory infections, ciprofloxacin is not recommended for respiratory infections by most treatment guidelines due in part to its modest activity against the common respiratory pathogen Streptococcus pneumoniae. `` Respiratory quinolones '' such as levofloxacin, having greater activity against this pathogen, are recommended as first line agents for the treatment of community - acquired pneumonia in patients with important co-morbidities and in patients requiring hospitalization ( Infectious Diseases Society of America 2007 ). Similarly, ciprofloxacin is not recommended as a first - line treatment for acute sinusitis. Ciprofloxacin is approved for the treatment of gonorrhea in many countries, but this recommendation is widely regarded as obsolete due to resistance development. Pregnancy In the United States ciprofloxacin is pregnancy category C. This category includes drugs for which no adequate and well - controlled studies in human pregnancy exist, and for which animal studies have suggested the potential for harm to the fetus, but potential benefits may warrant use of the drug in pregnant women despite potential risks. An expert review of published data on experiences with ciprofloxacin use during pregnancy by the Teratogen Information System concluded therapeutic doses during pregnancy are unlikely to pose a substantial teratogenic risk ( quantity and quality of data = fair ), but the data are insufficient to state no risk exists. Two small post-marketing epidemiology studies of mostly short - term, first - trimester exposure found that fluoroquinolones did not increase risk of major malformations, spontaneous abortions, premature birth, or low birth weight. The label notes, however, that these studies are insufficient to reliably evaluate the definitive safety or risk of less common defects by ciprofloxacin in pregnant women and their developing fetuses. Breastfeeding Fluoroquinolones have been reported as present in a mother 's milk and thus passed on to the nursing child. The U.S. FDA recommends that because of the risk of serious adverse reactions ( including articular damage ) in infants nursing from mothers taking ciprofloxacin, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother. Children Oral and intravenous ciprofloxacin are approved by the FDA for use in children for only two indications due to the risk of permanent injury to the musculoskeletal system : 1 ) Inhalational anthrax ( postexposure ) 2 ) Complicated urinary tract infections and pyelonephritis due to Escherichia coli, but never as first - line agents. Current recommendations by the American Academy of Pediatrics note the systemic use of ciprofloxacin in children should be restricted to infections caused by multidrug - resistant pathogens or when no safe or effective alternatives are available. Spectrum of activity Its spectrum of activity includes most strains of bacterial pathogens responsible for respiratory, urinary tract, gastrointestinal, and abdominal infections, including Gram - negative ( Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Legionella pneumophila, Moraxella catarrhalis, Proteus mirabilis, and Pseudomonas aeruginosa ), and Gram - positive ( methicillin - sensitive, but not methicillin - resistant Staphylococcus aureus, Streptococcus pneumoniae, Staphylococcus epidermidis, Enterococcus faecalis, and Streptococcus pyogenes ) bacterial pathogens. Bacterial resistance See also : Antibiotic abuse and Antibiotic resistance As a result of its widespread use to treat minor infections readily treatable with older, narrower spectrum antibiotics, many bacteria have developed resistance to this drug in recent years, leaving it significantly less effective than it would have been otherwise. Resistance to ciprofloxacin and other fluoroquinolones may evolve rapidly, even during a course of treatment. Numerous pathogens, including enterococci, Streptococcus pyogenes and Klebsiella pneumoniae ( quinolone - resistant ) now exhibit resistance. Widespread veterinary usage of the fluoroquinolones, particularly in Europe, has been implicated. Meanwhile, some Burkholderia cepacia, Clostridium innocuum and Enterococcus faecium strains have developed resistance to ciprofloxacin to varying degrees. Fluoroquinolones had become the class of antibiotics most commonly prescribed to adults in 2002. Nearly half ( 42 % ) of those prescriptions in the U.S. were for conditions not approved by the FDA, such as acute bronchitis, otitis media, and acute upper respiratory tract infection, according to a study supported in part by the Agency for Healthcare Research and Quality. Additionally, they were commonly prescribed for medical conditions that were not even bacterial to begin with, such as viral infections, or those to which no proven benefit existed. Contraindications Contraindications include : Taking tizanidine at the same time Use by those who are hypersensitive to any member of the quinolone class of antimicrobial agents Ciprofloxacin is also considered to be contraindicated in children ( except for the indications outlined above ), in pregnancy, to nursing mothers, and in people with epilepsy or other seizure disorders. Side effects Rates of side effects appear to be higher than with some groups of antibiotics such as cephalosporins but lower than with others such as clindamycin. Compared to other antibiotics some studies find a higher rate of side effects while others find no difference. In pre-approval clinical trials of ciprofloxacin most of the adverse events reported were described as mild or moderate in severity, abated soon after the drug was discontinued, and required no treatment. Ciprofloxacin was discontinued because of an adverse event in 1 % of people treated with the medication by mouth. The most frequently reported drug - related events, from trials of all formulations, all dosages, all drug - therapy durations, and for all indications, were nausea ( 2.5 % ), diarrhea ( 1.6 % ), abnormal liver function tests ( 1.3 % ), vomiting ( 1 % ), and rash ( 1 % ). Other adverse events occurred at rates of < 1 %. Tendinitis The black box warning on the U.S. FDA - approved ciprofloxacin label warns of an increased risk of tendinitis and tendon rupture, especially in people who are older than 60 years, people who also use corticosteroids, and people with kidney, lung, or heart transplants. Tendon rupture can occur during therapy or even months after discontinuation of the drug. A case control study performed using a UK medical care database found that fluoroquinolone use was associated with a 1.9-fold increase in tendon problems. The relative risk increased to 3.2 in those over 60 years of age and to 6.2 in those over the age of 60 who were also taking corticosteroids. Among the 46,766 quinolone users in the study, 38 ( 0.1 % ) cases of Achilles tendon rupture were identified. A study performed using an Italian healthcare database reached qualitatively similar conclusions. Nervous system The 2013 FDA label warns of nervous system effects. Ciprofloxacin, like other fluoroquinolones, is known to trigger seizures or lower the seizure threshold, and may cause other central nervous system side effects. Headache, dizziness, and insomnia have been reported as occurring fairly commonly in postapproval review articles, along with a much lower incidence of serious CNS side effects such as tremors, psychosis, anxiety, hallucinations, paranoia, and suicide attempts, especially at higher doses. Like other fluoroquinolones, it is also known to cause peripheral neuropathy that may be irreversible, such as weakness, burning pain, tingling or numbness. Cancer Ciprofloxacin is active in six of eight in vitro assays used as rapid screens for the detection of genotoxic effects, but is not active in in vivo assays of genotoxicity. Long - term carcinogenicity studies in rats and mice resulted in no carcinogenic or tumorigenic effects due to ciprofloxacin at daily oral dose levels up to 250 and 750 mg / kg to rats and mice, respectively ( about 1.7 and 2.5 times the highest recommended therapeutic dose based upon mg / m ). Results from photo co-carcinogenicity testing indicate ciprofloxacin does not reduce the time to appearance of UV - induced skin tumors as compared to vehicle control. Other The other black box warning is that ciprofloxacin should not be used in patients with myasthenia gravis due to possible exacerbation of muscle weakness which may lead to breathing problems resulting in death or ventilator support. Fluoroquinolones are known to block neuromuscular transmission. Clostridium difficile - associated diarrhea is a serious adverse effect of ciprofloxacin and other fluoroquinolones ; it is unclear whether the risk is higher than with other broad - spectrum antibiotics. A wide range of rare but potentially fatal side effects spontaneously reported to the U.S. FDA or the subject of case reports published in medical journals includes, but is not limited to, toxic epidermal necrolysis, Stevens - Johnson syndrome, heart arrhythmias ( torsades de pointes or QT prolongation ), low blood pressure, allergic pneumonitis, bone marrow suppression, hepatitis or liver failure, and sensitivity to light. The drug should be discontinued if a rash, jaundice, or other sign of hypersentitivity occur. Children and the elderly are at a much greater risk of experiencing adverse reactions. Overdose Overdose of ciprofloxacin may result in reversible renal toxicity. Treatment of overdose includes emptying of the stomach by induced vomiting or gastric lavage, as well as administration of antacids containing magnesium, aluminum, or calcium to reduce drug absorption. Renal function and urinary pH should be monitored. Important support includes adequate hydration and urine acidification if necessary to prevent crystalluria. Hemodialysis or peritoneal dialysis can only remove less than 10 % of ciprofloxacin. Ciprofloxacin may be quantified in plasma or serum to monitor for drug accumulation in patients with hepatic dysfunction or to confirm a diagnosis of poisoning in acute overdose victims. Interactions Ciprofloxacin interacts with certain foods and several other drugs leading to undesirable increases or decreases in the serum levels or distribution of one or both drugs. Ciprofloxacin should not be taken with antacids containing magnesium or aluminum, highly buffered drugs ( sevelamer, lanthanum carbonate, sucralfate, didanosine ), or with supplements containing calcium, iron, or zinc. It should be taken two hours before or six hours after these products. Magnesium or aluminum antacids turn ciprofloxacin into insoluble salts that are not readily absorbed by the intestinal tract, reducing peak serum concentrations by 90 % or more, leading to therapeutic failure. Additionally, it should not be taken with dairy products or calcium - fortified juices alone, as peak serum concentration and the area under the serum concentration - time curve can be reduced up to 40 %. However, ciprofloxacin may be taken with dairy products or calcium - fortified juices as part of a meal. Ciprofloxacin inhibits the drug - metabolizing enzyme CYP1A2 and thereby can reduce the clearance of drugs metabolized by that enzyme. CYP1A2 substrates that exhibit increased serum levels in ciprofloxacin - treated patients include tizanidine, theophylline, caffeine, methylxanthines, clozapine, olanzapine, and ropinirole. Co-administration of ciprofloxacin with the CYP1A2 substrate tizanidine ( Zanaflex ) is contraindicated due to a 583 % increase in the peak serum concentrations of tizanidine when administered with ciprofloxacin as compared to administration of tizanidine alone. Use of ciprofloxacin is cautioned in patients on theophylline due to its narrow therapeutic index. The authors of one review recommended that patients being treated with ciprofloxacin reduce their caffeine intake. Evidence for significant interactions with several other CYP1A2 substrates such as cyclosporine is equivocal or conflicting. The Committee on Safety of Medicines and the FDA warn that central nervous system adverse effects, including seizure risk, may be increased when NSAIDs are combined with quinolones. The mechanism for this interaction may involve a synergistic increased antagonism of GABA neurotransmission. Altered serum levels of the antiepileptic drugs phenytoin and carbamazepine ( increased and decreased ) have been reported in patients receiving concomitant ciprofloxacin. Ciprofloxacin is a potent inhibitor of CYP1A2, CYP2D6, and CYP3A4. Mechanism of action Ciprofloxacin is a broad - spectrum antibiotic of the fluoroquinolone class. It is active against both Gram - positive and Gram - negative bacteria. It functions by inhibiting DNA gyrase, and a type II topoisomerase, topoisomerase IV, necessary to separate bacterial DNA, thereby inhibiting cell division. Pharmacokinetics Ciprofloxacin for systemic administration is available as immediate - release tablets, extended - release tablets, an oral suspension, and as a solution for intravenous administration. When administered over one hour as an intravenous infusion, ciprofloxacin rapidly distributes into the tissues, with levels in some tissues exceeding those in the serum. Penetration into the central nervous system is relatively modest, with cerebrospinal fluid levels normally less than 10 % of peak serum concentrations. The serum half - life of ciprofloxacin is about 4 -- 6 hours, with 50 - 70 % of an administered dose being excreted in the urine as unmetabolized drug. An additional 10 % is excreted in urine as metabolites. Urinary excretion is virtually complete 24 hours after administration. Dose adjustment is required in the elderly and in those with renal impairment. Ciprofloxacin is weakly bound to serum proteins ( 20 - 40 % ), but is an inhibitor of the drug - metabolizing enzyme cytochrome P450 1A2, which leads to the potential for clinically important drug interactions with drugs metabolized by that enzyme. Ciprofloxacin is about 70 % orally available when administered orally, so a slightly higher dose is needed to achieve the same exposure when switching from IV to oral administration The extended release oral tablets allow once - daily administration by releasing the drug more slowly in the gastrointestinal tract. These tablets contain 35 % of the administered dose in an immediate - release form and 65 % in a slow - release matrix. Maximum serum concentrations are achieved between 1 and 4 hours after administration. Compared to the 250 - and 500 - mg immediate - release tablets, the 500 - mg and 1000 - mg XR tablets provide higher C, but the 24 ‐ hour AUCs are equivalent. Ciprofloxacin immediate - release tablets contain ciprofloxacin as the hydrochloride salt, and the XR tablets contain a mixture of the hydrochloride salt as the free base. Chemical properties Ciprofloxacin is 1 - cyclopropyl - 6 - fluoro - 1, 4 - dihydro - 4 - oxo - 7 - ( 1 - piperazinyl ) - 3 - quinolinecarboxylic acid. Its empirical formula is C H FN O and its molecular weight is 331.4 g / mol. It is a faintly yellowish to light yellow crystalline substance. Ciprofloxacin hydrochloride ( USP ) is the monohydrochloride monohydrate salt of ciprofloxacin. It is a faintly yellowish to light yellow crystalline substance with a molecular weight of 385.8 g / mol. Its empirical formula is C H FN O HCl H O. Usage Ciprofloxacin is the most widely used of the second - generation quinolones. In 2010, over 20 million prescriptions were written, making it the 35th-most commonly prescribed generic drug and the 5th-most commonly prescribed antibacterial in the U.S. History Ciprofloxacin 250 - mg tablets from Ukraine The first members of the quinolone antibacterial class were relatively low - potency drugs such as nalidixic acid, used mainly in the treatment of urinary tract infections owing to their renal excretion and propensity to be concentrated in urine. In 1979, the publication of a patent filed by the pharmaceutical arm of Kyorin Seiyaku Kabushiki Kaisha disclosed the discovery of norfloxacin, and the demonstration that certain structural modifications including the attachment of a fluorine atom to the quinolone ring leads to dramatically enhanced antibacterial potency. In the aftermath of this disclosure, several other pharmaceutical companies initiated research and development programs with the goal of discovering additional antibacterial agents of the fluoroquinolone class. The fluoroquinolone program at Bayer focused on examining the effects of very minor changes to the norfloxacin structure. In 1983, the company published in vitro potency data for ciprofloxacin, a fluoroquinolone antibacterial having a chemical structure differing from that of norfloxacin by the presence of a single carbon atom. This small change led to a two - to 10-fold increase in potency against most strains of Gram - negative bacteria. Importantly, this structural change led to a four-fold improvement in activity against the important Gram - negative pathogen Pseudomonas aeruginosa, making ciprofloxacin one of the most potent known drugs for the treatment of this intrinsically antibiotic - resistant pathogen. The oral tablet form of ciprofloxacin was approved in October 1987, just one year after the approval of norfloxacin. In 1991, the intravenous formulation was introduced. Ciprofloxacin sales reached a peak of about 2 billion euros in 2001, before Bayer 's patent expired in 2004, after which annual sales have averaged around € 200 million. Society and culture Cost It is available as a generic medication and not very expensive. Wholesale it costs between 0.03 and 0.13 USD a dose. In the United States it is sold for about 0.40 USD per dose. Generic equivalents On 24 October 2001, the Prescription Access Litigation ( PAL ) project filed suit to dissolve an agreement between Bayer and three of its competitors which produced generic versions of drugs ( Barr Laboratories, Rugby Laboratories, and Hoechst - Marion - Roussel ) that PAL claimed was blocking access to adequate supplies and cheaper, generic versions of ciprofloxacin. The plaintiffs charged that Bayer Corporation, a unit of Bayer AG, had unlawfully paid the three competing companies a total of $200 million to prevent cheaper, generic versions of ciprofloxacin from being brought to the market, as well as manipulating its price and supply. Numerous other consumer advocacy groups joined the lawsuit. On 15 October 2008, five years after Bayer 's patent had expired, the United States District Court for the Eastern District of New York granted Bayer 's and the other defendants ' motion for summary judgment, holding that any anticompetitive effects caused by the settlement agreements between Bayer and its codefendants were within the exclusionary zone of the patent and thus could not be redressed by federal antitrust law, in effect upholding Bayer 's agreement with its competitors. Available forms Ciprofloxacin for systemic administration is available as immediate - release tablets, as extended - release tablets, as an oral suspension, and as a solution for intravenous infusion. It is also available for local administration as eye drops and ear drops. Litigation A class action was filed against Bayer AG on behalf of employees of the Brentwood Post Office in Washington, D.C., and workers at the U.S. Capitol, along with employees of American Media, Inc. in Florida and postal workers in general who alleged they suffered serious adverse effects from taking ciprofloxacin ( Cipro ) in the aftermath of the anthrax attacks in 2001. The action alleged Bayer failed to warn class members of the potential side effects of the drug, thereby violating the Pennsylvania Unfair Trade Practices and Consumer Protection Laws. The class action was defeated and the litigation abandoned by the plaintiffs. 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Medical portal Ciprofloxacin at Curlie ( based on DMOZ ) U.S. National Library of Medicine : Drug Information Portal - Ciprofloxacin Cipro Package Insert Proquin XR Package Insert Ciloxan Package Insert Ciprofloxacin Ophthalmic Ciprofloxacin - Antimicrobe.org Antibacterials : nucleic acid inhibitors ( J01E, J01M ) Antifolates ( inhibits purine metabolism, thereby inhibiting DNA and RNA synthesis ) DHFR inhibitor 2, 4 - Diaminopyrimidine Trimethoprim Brodimoprim Tetroxoprim Iclaprim Sulfonamides ( DHPS inhibitor ) Short - acting Sulfaisodimidine Sulfamethizole Sulfadimidine Sulfapyridine Sulfafurazole Sulfanilamide Prontosil Sulfathiazole Sulfathiourea Intermediate - acting Sulfamethoxazole Sulfadiazine Sulfamoxole Long - acting Sulfadimethoxine Sulfadoxine Sulfalene Sulfametomidine Sulfametoxydiazine Sulfamethoxypyridazine Sulfaperin Sulfamerazine Sulfaphenazole Sulfamazone Other / ungrouped Sulfacetamide Sulfadicramide Sulfametrole Sulfanitran Combinations Trimethoprim / sulfamethoxazole Ormetoprim / sulfadimethoxine Other DHPS inhibitors Dapsone Topoisomerase inhibitors / quinolones / ( inhibits DNA replication ) 1st g. Cinoxacin Flumequine Nalidixic acid Oxolinic acid Pipemidic acid Piromidic acid Rosoxacin Fluoro - quinolones 2nd g. Ciprofloxacin Ofloxacin Enoxacin Fleroxacin Lomefloxacin Nadifloxacin Norfloxacin Pefloxacin Rufloxacin 3rd g. Levofloxacin Balofloxacin Grepafloxacin Pazufloxacin Sparfloxacin Temafloxacin Tosufloxacin 4th g. Besifloxacin Delafloxacin Gatifloxacin Finafloxacin Gemifloxacin Moxifloxacin Clinafloxacin Garenoxacin Prulifloxacin Sitafloxacin Trovafloxacin / Alatrofloxacin Vet. Danofloxacin Difloxacin Enrofloxacin Ibafloxacin Marbofloxacin Orbifloxacin Pradofloxacin Sarafloxacin Newer non-fluorinated Nemonoxacin Related ( DG ) Aminocoumarins : Novobiocin Anaerobic DNA inhibitors Nitro - imidazole derivatives Metronidazole Tinidazole Ornidazole Nitrofuran derivatives Nitrofurantoin Furazolidone Nifurtoinol RNA synthesis Rifamycins / RNA polymerase Rifampicin Rifabutin Rifapentine Rifaximin Rifalazil WHO - EM Withdrawn from market Clinical trials : Phase III Never to phase III Piperazines Simple piperazines ( no additional rings ) 1 - Cyclohexylpiperazine Aminoethylpiperazine Diethylcarbamazine HEPPS Midafotel Piperazine PIPES Phenylpiperazines Acaprazine Antrafenine Aripiprazole Batoprazine Bifeprunox BRL - 15,572 Ciprofloxacin CSP - 2503 Dapiprazole DCPP DMPP Diphenylpiperazine Dropropizine EGIS - 12,233 Elopiprazole Eltoprazine Enpiprazole Ensaculin Etoperidone Flesinoxan Flibanserin Fluprazine Itraconazole Ketoconazole Levodropropizine Lorpiprazole mCPP Mefway MeOPP Mepiprazole Naftopidil Naluzotan Naphthylpiperazine Nefazodone Niaprazine Oxypertine Pardoprunox pCPP pFPP Posaconazole S - 14,506 S - 14,671 S - 15,535 SB - 258,585 SB - 271,046 SB - 357,134 SB - 399,885 Sonepiprazole TFMPP Tolpiprazole Trazodone Urapidil Vesnarinone Vilazodone Vortioxetine WAY - 100,135 WAY - 100,635 Benzylpiperazines 2C - B - BZP Befuraline Bifeprunox Buclizine BZP Chlorbenzoxamine DBZP Fipexide Imatinib MBZP MDBZP Meclozine Methoxypiperamide Piberaline Piribedil Sunifiram Trimetazidine Vesnarinone Diphenylalkylpiperazines ( benzhydrylalkylpiperazines ) Almitrine Amperozide BRL - 15,572 Buclizine BW373U86 Cetirizine Chlorbenzoxamine Chlorcyclizine Cinnarizine Clocinizine Cyclizine DBL - 583 Diphenylmethylpiperazine Dotarizine DPI - 221 DPI - 287 DPI - 3290 GBR - 12,783 GBR - 12,935 GBR - 13,069 GBR - 13,098 GBR - 13,119 Hydroxyzine Lidoflazine Manidipine Meclozine Oxatomide SNC - 80 Vanoxerine Pyrimidinylpiperazines Buspirone Dasatinib Eptapirone Gepirone Ipsapirone Piribedil Prazitone Pyrimidinylpiperazine Revospirone Tandospirone Tirilazad Trimazosin Umespirone Zalospirone Pyridinylpiperazines Atevirdine Azaperone Delavirdine Mirtazapine Pyridinylpiperazine Benzo ( iso ) thiazolyl piperazines Lurasidone Perospirone Revospirone Tiospirone Ziprasidone Tricyclics ( piperazine attached via side chain ) Amoxapine Clopenthixol Clorotepine Clozapine Cyanothepin Doclothepin Docloxythepin Flupentixol Fluphenazine Isofloxythepin Loxapine Meperathiepin Metitepine Octomethothepin Olanzapine Opipramol Oxyclothepin Oxyprothepin Peradithiepin Perathiepin Perazine Perphenazine Pirenzepine Prochlorperazine Thiethylperazine Thiothixene Trifluoperazine Trifluthepin Zuclopenthixol Others / Uncategorized 6 - Nitroquipazine Azimilide Cinepazet Cinepazic acid Cinepazide Cyclohexylpiperazine EGIS - 7625 Hexocyclium Indinavir JNJ - 7777120 Lodenafil Mirodenafil PB - 28 Quipazine Ranolazine SA - 4503 Sildenafil Tadalafil Vardenafil VUF - 6002 Zipeprol Drugs used for diseases of the ear ( S02 ) Infection Acetic acid Aluminium acetotartrate Aluminium triacetate ( Burow 's solution ) Boric acid Chloramphenicol Chlorhexidine Ciprofloxacin Clioquinol Gentamicin Hydrogen peroxide Miconazole Neomycin Nitrofurazone Ofloxacin Polymyxin B Rifamycin Tetracycline Corticosteroids Betamethasone Dexamethasone Fluocinolone acetonide Hydrocortisone Prednisolone Analgesics and anesthetics Lidocaine Cocaine Phenazone GABA receptor modulators Ionotropic GABA Agonists : ( + ) - Catechin Bamaluzole Barbiturates ( e.g., phenobarbital ) BL - 1020 DAVA Dihydromuscimol GABA Gabamide GABOB Gaboxadol ( THIP ) Homotaurine ( tramiprosate, 3 - APS ) Ibotenic acid iso - THAZ iso - THIP Isoguvacine Isomuscimol Isonipecotic acid Kojic amine Lignans ( e.g., honokiol ) Methylglyoxal Monastrol Muscimol Nefiracetam Neuroactive steroids ( e.g., allopregnanolone ) Org 20599 Phenibut Picamilon P4S Progabide Propofol Quisqualamine SL - 75102 TACA TAMP Terpenoids ( e.g., borneol ) Thiomuscimol Tolgabide ZAPA Positive modulators ( abridged ; see here for a full list ) : α - EMTBL Alcohols ( e.g., ethanol ) Anabolic steroids Avermectins ( e.g., ivermectin ) Barbiturates ( e.g., phenobarbital ) Benzodiazepines ( e.g., diazepam ) Bromide compounds ( e.g., potassium bromide ) Carbamates ( e.g., meprobamate ) Carbamazepine Chloralose Chlormezanone Clomethiazole Dihydroergolines ( e.g., ergoloid ( dihydroergotoxine ) ) Etazepine Etifoxine Fenamates ( e.g., mefenamic acid ) Flavonoids ( e.g., apigenin, hispidulin ) Fluoxetine Flupirtine Imidazoles ( e.g., etomidate ) Kava constituents ( e.g., kavain ) Lanthanum Loreclezole Monastrol Neuroactive steroids ( e.g., allopregnanolone, cholesterol ) Niacin Nicotinamide ( niacinamide ) Nonbenzodiazepines ( e.g., β - carbolines ( e.g., abecarnil ), cyclopyrrolones ( e.g., zopiclone ), imidazopyridines ( e.g., zolpidem ), pyrazolopyrimidines ( e.g., zaleplon ) ) Norfluoxetine Petrichloral Phenols ( e.g., propofol ) Phenytoin Piperidinediones ( e.g., glutethimide ) Propanidid Pyrazolopyridines ( e.g., etazolate ) Quinazolinones ( e.g., methaqualone ) Retigabine ( ezogabine ) ROD - 188 Skullcap constituents ( e.g., baicalin ) Stiripentol Sulfonylalkanes ( e.g., sulfonmethane ( sulfonal ) ) Topiramate Valerian constituents ( e.g., valerenic acid ) Volatiles / gases ( e.g., chloral hydrate, chloroform, diethyl ether, paraldehyde, sevoflurane ) Antagonists : Bicuculline Coriamyrtin Dihydrosecurinine Gabazine ( SR - 95531 ) Hydrastine Hyenachin ( mellitoxin ) PHP - 501 Pitrazepin Securinine Sinomenine SR - 42641 SR - 95103 Thiocolchicoside Tutin Negative modulators : 1, 3M1B 3M2B 11 - Ketoprogesterone 17 - Phenylandrostenol α5IA ( LS - 193,268 ) β - CCB β - CCE β - CCM β - CCP β - EMGBL Anabolic steroids Amiloride Anisatin β - Lactams ( e.g., penicillins, cephalosporins, carbapenems ) Basmisanil Bemegride Bilobalide CHEB Cicutoxin Cloflubicyne Cyclothiazide DHEA DHEA - S Dieldrin ( + ) - DMBB DMCM DMPC EBOB Etbicyphat FG - 7142 ( ZK - 31906 ) Fiproles ( e.g., fipronil ) Flavonoids ( e.g., amentoflavone, oroxylin A ) Flumazenil Fluoroquinolones ( e.g., ciprofloxacin ) Flurothyl Furosemide Iomazenil ( I ) Isoallopregnanolone Isopregnanolone ( sepranolone ) L - 655,708 Laudanosine Leptazol Lindane MaxiPost Morphine Morphine - 3 - glucuronide MRK - 016 Naloxone Naltrexone Nicardipine Nonsteroidal antiandrogens ( e.g., apalutamide, bicalutamide, enzalutamide, flutamide, nilutamide ) Oenanthotoxin Pentylenetetrazol ( pentetrazol ) Phenylsilatrane Picrotoxin ( i.e., picrotin and picrotoxinin ) Pregnenolone sulfate Propybicyphat PWZ - 029 Radequinil Ro 15 - 4513 Ro 19 - 4603 RO4882224 RO4938581 Sarmazenil SCS Suritozole TB - 21007 TBOB TBPS TCS - 1105 Terbequinil TETS Thujone U-93631 Zinc ZK - 93426 GABA - ρ Agonists : BL - 1020 CACA CAMP Homohypotaurine GABA GABOB Ibotenic acid Isoguvacine Muscimol N - Chloroacetylcytosine arabinoside Picamilon Progabide TACA TAMP Thiomuscimol Tolgabide Positive modulators : Allopregnanolone Alphaxolone ATHDOC Lanthanides Antagonists : ( S ) - 2 - MeGABA ( S ) - 4 - ACPBPA ( S ) - 4 - ACPCA 2 - MeTACA 3 - APMPA 4 - ACPAM 4 - GBA cis - 3 - ACPBPA CGP - 36742 ( SGS - 742 ) DAVA Gabazine ( SR - 95531 ) Gaboxadol ( THIP ) I4AA Isonipecotic acid Loreclezole P4MPA P4S SKF - 97541 SR - 95318 SR - 95813 TPMPA trans - 3 - ACPBPA ZAPA Negative modulators : 5α - Dihydroprogesterone Bilobalide Loreclezole Picrotoxin ( picrotin, picrotoxinin ) Pregnanolone ROD - 188 THDOC Zinc Metabotropic GABA Agonists : 1, 4 - Butanediol 4 - Fluorophenibut Aceburic acid Arbaclofen Arbaclofen placarbil Baclofen BL - 1020 GABA Gabamide GABOB GBL GHB GHBAL GHV GVL Isovaline Lesogaberan Phenibut Picamilon Progabide Sodium oxybate SKF - 97,541 SL 75102 Tolgabide Tolibut Positive modulators : ADX - 71441 BHF - 177 BHFF BSPP CGP - 7930 CGP - 13501 GS - 39783 rac - BHFF KK - 92A Antagonists : 2 - Hydroxysaclofen CGP - 35348 CGP - 46381 CGP - 52432 CGP - 54626 CGP - 55845 CGP - 64213 DAVA Homotaurine ( tramiprosate, 3 - APS ) Phaclofen Saclofen SCH - 50911 SKF - 97541 Negative modulators : Compound 14 See also Receptor / signaling modulators GABA receptor positive modulators GABA metabolism / transport modulators Retrieved from `` https://en.wikipedia.org/w/index.php?title=Ciprofloxacin&oldid=817544436 '' Categories : Cyclopropanes Fluoroquinolone antibiotics Otologicals Ophthalmology drugs Piperazines GABAA receptor negative allosteric modulators Bayer AG World Health Organization essential medicines Hidden categories : CS1 maint : Multiple names : authors list CS1 French - language sources ( fr ) Webarchive template wayback links Use dmy dates from August 2012 Template : drugs.com link with non-standard subpage ECHA InfoCard ID from Wikidata Drugboxes which contain changes to watched fields All articles with unsourced statements Articles with unsourced statements from December 2016 Articles with unsourced statements from August 2015 Articles with unsourced statements from September 2015 Articles with DMOZ links RTT Talk Contents About Wikipedia Afrikaans تۆرکجه বাংলা Boarisch Dansk Deutsch Español فارسی Français Bahasa Indonesia Italiano עברית Қазақша Magyar Nederlands 日本 語 Norsk ଓଡ଼ିଆ Polski Português Русский Српски / srpski Srpskohrvatski / српскохрватски Suomi Svenska ไทย Українська Tiếng Việt 中文 Edit links This page was last edited on 29 December 2017, at 02 : 22. 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Question: is cipro good for an upper respiratory infection
Answer: Ciprofloxacin