What To Avoid When Taking Cipro (Ciprofloxacin)

When it comes to bacteria, it’s all about the type. 

Good bacteria in your body help promote healthy digestion, benefit your immune system, and can help fight against bad bacteria.

When harmful bacteria levels become too high in your body, you might need an antibiotic to help fight them off if your body cannot do the job on its own.

There are many different classes of antibiotics, each fighting a specific range of bacteria. 

Cipro is one example of an antibiotic, and there are a few things you should know if you’re prescribed this medication.

Keep reading to learn more about Cipro, including what things to avoid while taking this medication.

What is Cipro (Ciprofloxacin)?

Cipro is the brand name for the antibiotic ciprofloxacin, which is used to treat bacterial infections. Cipro has been around for a while, and the Food and Drug Administration first approved it in 1987.

This antibiotic comes in pill, liquid, and IV form and is typically administered in doses ranging from 250-500 milligrams split among two doses per day.  It is also available in eye drops and ear drops to help fight ear and eye infections.

Cipro is dosed based on body weight, usually 10-15 milligrams per kilogram of body weight. Cipro can be used in children as young as one year old, but with caution.

A course of antibiotics usually lasts 7-14 days to ensure the infection resolves, so if you’re prescribed Cipro, it’s important to take it as prescribed for as long as your healthcare provider recommends.

What is Cipro used for?

Cipro is used to treat bacterial infections. Not all types of bacteria are sensitive to Cipro, meaning it won’t kill certain types of bacteria. 

Cipro is potent at killing bacteria that are considered gram-negative, including bacteria like Escherichia coli, Salmonella, Shigella, and Neisseria meningitidis, a type of bacteria that can cause meningitis (1).

Some of the types of bacterial infections Cipro is used to treat include:

• chest infections, including pneumonia
• skin and bone infections, including osteomyelitis
• sexually transmitted infections (STIs)
• conjunctivitis (pink eye) and other eye infections
• ear infections
• urinary tract and kidney infections
• bacterial meningitis (a rare type of infection that causes inflammation in the fluid and tissues surrounding your brain)

Cipro can also be used to treat and prevent anthrax infections. Anthrax is a serious disease caused by the bacteria Bacillus anthracis. Anthrax can be fatal, so early treatment is crucial for the best outcomes.

If you’ve been exposed to the Anthrax bacteria, you’ll be prescribed Cipro for 60 days to ensure the Anthrax bacteria in your body are killed. You might receive IV antibiotics if you are already experiencing symptoms of an Anthrax infection.

How does Cipro work?

Cipro is in a group of fluoroquinolone (or quinolone) antibiotics. These types of antibiotics kill the bacteria responsible for infections that can make you sick. Cipro doesn’t work for viral infections like viral meningitis, the common cold, or other viruses.

In general, antibiotics can kill bacteria by inhibiting important processes they need for survival and stopping them from multiplying. It can take a while for the bacteria to be killed off completely, which is why dosing for antibiotics like Cipro are over 1-2 weeks.

If you have a serious infection and have been hospitalized, you might receive IV antibiotics like Cipro. IV antibiotics can target the bacteria faster because it doesn’t have to go through digestion.

What are the side effects of Cipro?

Antibiotics kill bad bacteria, but they can also destroy healthy bacteria that reside in your digestive system. These good bacteria are also referred to as probiotics, your microbiome, or gut flora. 

The main side effects of taking antibiotics like Cipro have to do with the disruption of the probiotics in your body. 

Some of the most common side effects of Cipro include:

• nausea
• vomiting
• stomach pain
• heartburn
• diarrhea
• vaginal itching and/or discharge
• pale skin
• unusual tiredness
• sleepiness

If you experience severe or rare side effects while taking Cipro, you should seek medical attention immediately. 

More rare and serious side effects can include:

• severe diarrhea (sometimes bloody) with or without fever and severe stomach pain
• rash
• hives
• itching
• peeling or blistering of your skin
• fever
• swelling of your eyes, face, mouth, lips, tongue, or other body parts
• hoarseness or throat tightness
• difficulty breathing or swallowing
• ongoing or worsening cough
• yellowing of your skin or eyes; pale skin; dark urine; or light-colored stool
• extreme thirst or hunger; pale skin; feeling shaky or trembling; fast or fluttering heartbeat; sweating; frequent urination; trembling; blurred vision; or unusual anxiety
• fainting or loss of consciousness
• decreased urination
• sudden pain in the chest, stomach, or back

How to recover from the side effects of Cipro

It can take several weeks to months to fully recover from the impact Cipro has on your intestinal flora. 

It takes time for your gut to replenish its army of healthy bacteria, and in the meantime, you might experience uncomfortable side effects like stomach upset, constipation, diarrhea, and bloating. 

The best way to recover from the side effects of Cipro is to alter your diet accordingly. For example, eat bland foods if you have nausea/diarrhea or high-fiber foods for constipation) and eat probiotic- and prebiotic-rich foods to help replenish your healthy bacteria levels.

What to avoid when taking Cipro

Medications to avoid

Methotrexate 

Methotrexate is a type of drug used to calm your immune system and keep it from fighting healthy cells. 

While only a few cases have been reported, taking Cipro with methotrexate might interfere with your kidneys’ ability to clear methotrexate from your body., which could lead to toxicity (2). 

Tizanidine 

Cipro shouldn’t be taken with Tizanidine, a type of muscle relaxer. Taking these two medications together could cause low blood pressure, low heart rate, and intense sleepiness.

Certain blood thinners

Taking Cipro with blood thinners like Coumadin (warfarin) might cause altered bleeding, though there aren’t many reported cases of this occurring (3).

Other medications

If you’re taking other prescription medications, it’s always a good idea to ask your healthcare provider or pharmacist if any of them interact with Cipro.

Vitamins to avoid

Iron

Forms of iron like ferrous fumarate and ferrous sulfate shouldn’t be taken at the same time as Cipro (4). Iron can reduce the absorption of Cipro, potentially making it less effective.

Other minerals

Besides iron, other minerals that can bind to Cipro and make it less absorbable include aluminum, calcium, copper, magnesium, manganese, and zinc. You should avoid taking these minerals in supplement form while on Cipro.

Fennel

Supplements containing fennel might interact with Cipro. According to an animal study, fennel significantly impacted the absorption and elimination of Cipro, while also impacting its effectiveness (5). 

Disease interactions

Cipro might not be recommended if you have certain health conditions, such as:

Myasthenia gravis

Cipro may worsen myasthenia gravis, an autoimmune disease that causes nerve and muscular problems. There is a black box warning from the FDA advising patients with myasthenia gravis to avoid taking antibiotics like Cipro.

Tendon problems, including tendinitis

Cipro may cause inflammation and tearing of the tendons (6). You should be cautious when taking Cipro if you’re at risk of tendon problems, including using corticosteroids to treat tendon pain.

Blood sugar problems

If you have diabetes or have a history of non-diabetic hypoglycemia, Cipro might increase the risk of hypoglycemia (low blood sugar) (7).

Kidney problems

Taking high doses of Cipro might worsen kidney problems since Cipro is mainly removed from your body by your kidneys.

Liver problems

While rare, Cipro might cause liver injury, especially if it’s taken at high doses or if you have a history of liver problems.

Seizures

If you’re at risk of having seizures, Cipro might increase the likelihood of having more seizures (8).

Abnormal heart rhythm

If you have heart problems or irregular heartbeat, Cipro might worsen these heart rhythm abnormalities by extending the QT wave, a part of your heart rhythm.

Pregnancy

Cipro is a category C drug related to pregnancy safety, which means that risk cannot be ruled out for the growing baby. If you’re pregnant, your healthcare provider can recommend safer antibiotics for use during pregnancy if needed.

Breastfeeding

Taking Cipro while breastfeeding is “usually considered compatible,” according to a report by the FDA.

Allergic reaction

If you’re allergic to Cipro or its ingredients, you should avoid it.

Foods to avoid

Dairy products

Taking Cipro with dairy products reduces their effectiveness by stopping them from being absorbed from your stomach. 

Avoid consuming dairy products like milk, cheese, yogurt, and other dairy-based foods for at least two hours before and after taking your Cipro dose.

Caffeine

It’s not recommended to consume large amounts of caffeine while taking Cipro as it might exacerbate side effects like nervousness, sleeplessness, heart pounding, and anxiety that caffeine can cause. 

Caffeine is found in some beverages like soda, coffee, energy drinks, and chocolate. While consuming low- to moderate levels of caffeine is likely safe, you should avoid increasing your caffeine intake while finishing a round of Cipro.

Alcohol

Unlike some antibiotics (like Flagyl), Cipro isn’t known to interact with alcohol. Even though there aren’t any known interactions with alcohol, it’s not advisable to consume large amounts of alcohol while taking antibiotics as it might interfere with your body’s efficiency at fighting the infection.

Low- to moderate amounts of alcohol are likely fine to consume while taking Cipro, but you should always contact your healthcare provider for guidance.

Foods to eat when taking Cipro

Pineapple

Pineapples are rich in bromelain, a group of enzymes with anti-bacterial properties. While not specifically studied with Cipro, some studies using other antibiotics found that bromelain increased the absorption of the antibiotics, which can help make them more effective.

Probiotics

Fermented foods are among the best sources of probiotics. Yogurt, kefir, sauerkraut, buttermilk, tempeh, and sourdough bread are all good sources of probiotics.

You can also find probiotic supplements, which some people prefer to take during their course of antibiotics, sometimes for weeks and months afterward.

Fiber-rich foods

As long as you’re not suffering from severe diarrhea, fiber-rich foods act as prebiotics, which help feed the beneficial probiotics in your gut.

Some great sources of fiber include:

• Whole grains
• Nuts
• Seeds
• Legumes
• Fruits
• Vegetables

Bland foods

If you’re experiencing diarrhea from taking Cipro, consider eating a bland, soft diet until your body recovers. Drinking plenty of clear liquids can help prevent dehydration from persistent diarrhea.

A bland diet can include foods like:

• Refined grains (white toast, crackers, white rice, etc.)
• Applesauce and other soft fruits
• Well-cooked vegetables
• Well-cooked lean meats

Conclusion

Cipro is a type of antibiotic drug used to treat a variety of bacterial infections. You should avoid dairy when taking Cipro. You also shouldn’t take certain mineral supplements like iron while taking Cipro, as they can reduce its effectiveness and absorption.

To help reduce potential negative side effects of Cipro, eat foods rich in probiotics to help replenish the depletion of healthy bacteria.

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