Cipro Side Effects: Nausea, Cipro Rash & More

Cipro is the brand name for the antibiotic ciprofloxacin, which is used to treat bacterial infections like prostatitis, urinary infections, and more. The FDA first approved it in 1987.

As with all prescription drugs, Ciprofloxacin can cause side effects like nauseas, diarrhea, “cipro rash” and more, so it should be used with care and under the advice of a doctor.

Cipro Dosage

Cipro is available in liquid, pill, and IV form, and you can get it in dosages of 250 mg or 500 mg. You can also get Cipro in eye and ear drops for eye and ear infections.

Related Read: Cipro: Drug Interactions

How long do you take ciprofloxacin for?

Ciprofloxacin tablets are usually prescribed for a few days or 1 to 3 weeks, depending on your health and the severity of your infection. 

The antibiotic is usually administered at 500 mg every 12 hours. The length of treatment can be 3, 5, or 7 days. In some cases, a higher dose can be administered, of up to 1 gram.

There are rare and common side effects, depending on the proportion of patients reporting them.

The most common side effects of Ciprofloxacin include:


Gastrointestinal symptoms are common when using antibiotics, especially nausea. Drug-induced nausea can be very mild but may sometimes cause vomiting episodes. In some cases, it leads to treatment failure. Patients may also report loss of appetite and other gastrointestinal symptoms.


As with many antibiotics, Cipro can cause alterations to the gut microbiota. After destroying the healthy bacteria in the gut, it can be colonized by pathogens. Thus, talk to your doctor if you develop persistent diarrhea after using Cipro. They might recommend using probiotics to re-establish the gut microbiota. This side effect usually happens when we use a combination of antimicrobial agents or use them for extended periods of time.

Cipro Rash

Ciprofloxacin may trigger an allergic reaction with skin rashes and other skin manifestations after exposure to ultraviolet light. “Cipro Rash” may occur several weeks to months after initiating the medication. If you experience fevers or flu-like symptoms accompanied by a rash, it is essential to promptly reach out to your healthcare team. The rash may initially appear red or purple and could progress to the formation of blisters or skin peeling. Alternatively, you might observe a red rash coupled with swelling of the face, lips, or lymph nodes in your neck or under your arms.

Dizziness and lightheadedness

This is another common side effect. It is caused by an alteration of the inner ear, which regulates the balance of the body. As such, dizziness/vertigo is common as a temporary side effect of many drugs.

Yeast infections

Patients who use Ciprofloxacin repeatedly can experience an overgrowth of candida. They may appear in the oral mucosa (oral thrush) or the vagina. In some cases, the overgrowth may also appear in the gastrointestinal tract.

Neurologic symptoms

In most cases, patients may only experience headaches. In other cases, their neurologic symptoms may also include insomnia and depression. Very rare cases of hallucinations, psychotic reactions, or myasthenia gravis have been described, too.

Other symptoms worth noting include:

  • Tendon problems
  • Muscle weakness
  • Bruising or bleeding symptoms

But very few patients also experience severe side effects. They are uncommon but may sometimes happen, especially with tablets or liquid form.

Nerve damage

For instance, ciprofloxacin may cause a condition called peripheral neuropathy, which is nerve damage in the arms, hands, legs, and feet. Symptoms include pain, tingling, numbness, and weakness.

Cipro side effects may also include tendonitis and Achilles tendon rupture, especially in lung transplant recipients. 

Another population at risk is patients with kidney disease, which will probably be prescribed another drug because ciprofloxacin can be toxic to their kidneys.

Ciprofloxacin HCl, even at the usual dose of 500 mg, can have other side effects in some people. 

It may cause sleeplessness and lightheadedness in some and nervousness in others, depending on their baseline conditions. 

Another uncommon manifestation is musculoskeletal arthropathy. It manifests as swelling and pain in your tendons and joints. 

The most affected areas are the ankle, the calf, and the shoulders, which usually happens on day two of Cipro. In some cases, these side effects can start months after stopping ciprofloxacin.

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Serious and rare side effects of Cipro

Serious side effects are not common. If you experience any of these, you should get medical help as soon as possible:

Severe dizziness and fainting

If you feel severe dizziness and fainting, you should look for medical advice right away. Ciprofloxacin can cause changes in the electrocardiogram in susceptible patients. Some of them are very severe and cause episodes of syncope or fainting. In some cases, patients may even have a cardiac arrest and require defibrillation.

Heartbeat irregularities

Ciprofloxacin and all fluoroquinolones may cause heartbeat problems. Patients may feel very rapid or irregular heartbeats. In patients with arrhythmia, Ciprofloxacin may trigger one or worsen the heart condition.

When comparing ciprofloxacin vs levofloxacin, Ciprofloxacin is less likely to produce severe arrhythmia than levofloxacin, but it is a side effect to look for in cardiac patients.

Symptoms of aortic dissection

Aortic dissection is the rupture or tear of the aorta. Ciprofloxacin can cause this problem in patients with a dilated aorta. Patients with a high risk for aortic dissection or aneurysm may experience this severe side effect. Symptoms include severe and sudden pain in the chest, back, or stomach, shortness of breath, and cough.

Severe allergic reactions

As it happens with medicines and foods, some people may develop allergic reactions. They are rare but are still reported by some patients. Symptoms to detect severe allergic reactions include skin rash with severe itching, shortness of breath, and swelling of the face, tongue, and throat.

Kidney and liver problems

Cipro is metabolized by the liver and eliminated through the urine. As such, it may cause kidney or liver problems in susceptible patients. Talk to your doctor if you have changes in the amount of urine, pink, or stained urine. You should also report if you get a yellowish tone in the skin and eyes, stomach pain, and persistent vomiting episodes.

Durations of cipro side effects

The side effects of Ciprofloxacin can last for as long as the treatment is held. In most cases, stopping Ciprofloxacin is the best way to end the side effects listed above. After stopping the medication, it may take around one or two days for them to go away.

However, some of them may be long-lasting, and others may not go away. It depends on the side effect and the reason it was triggered in the first place.

Ciprofloxacin is never prescribed for over 3 months to prevent long-lasting side effects. 

Related article: Foods to Eat & Avoid When Taking Cipro

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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 are the warnings and precautions for those taking Ciprofloxacin?

Consider the following precautions if you’re using Ciprofloxacin for a urinary tract infection or any other:

  • Inform your doctor or pharmacist if you’re allergic or have had an adverse side effect after taking Cipro.
  • Inform your doctor about irregular heartbeat problems or any other relevant medical history.
  • Talk to your doctor if you experience a rapid heartbeat. Ciprofloxacin may trigger QT prolongation in the electrocardiogram.
  • Talk to your doctor if you experience muscle weakness. In some cases, Cipro can cause tendon rupture or myasthenia gravis.
  • Inform your doctor if you have episodes of diarrhea or vomiting. They may reduce your levels of magnesium and potassium in the blood and trigger heartbeat problems.
  • If you have diabetes, check your blood sugar regularly.
  • Limit your sun exposure and use sunscreen and protective clothing.

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Alternative antibiotics to Cipro

Some patients may need to take an alternative antibiotic to Cipro if they have a Cipro allergy or the bacteria they’re trying to fight is resistant.

Luckily, Cipro has many alternatives, which can be prescribed for different reasons.

Levofloxacin (Levaquin)

One of the best alternatives to Cipro in the case of bacteria resistance is levofloxacin (Levaquin). It is another quinolone, very similar to Cipro. 

However, keep in mind that levofloxacin is a potent antibiotic. That’s why it is administered in fewer doses than Cipro.

According to studies, levofloxacin can be as effective as Ciprofloxacin for bacterial prostatitis treatment, respiratory infections, and urinary tract infections. And the adverse events are almost the same as Cipro.


This non-quinolone antibiotic is a useful alternative to Cipro in patients with urinary infections. When the urinary tract infection has complicated to pyelonephritis, we can use gentamicin or trimethoprim/sulfamethoxazole.


Another non-quinolone antibiotic, fosfomycin can be useful in cases of uncomplicated urinary tract infection. Especially if there are culture results to make sure the bacteria is sensitive.


Ceftriaxone is another non-quinolone antibiotic. When a urinary infection becomes a major problem, we can use ceftriaxone. It is recommended as an option in patients with sepsis of urinary origin. In uncomplicated urinary tract infections, Cefpodoxime is the second choice after Cipro.

How does Cipro compare to other antibiotics?

  • Cipro vs. Metronidazole: Metronidazole can be used to treat gastrointestinal infections. Sometimes it is used in combination with Cipro. However, Ciprofloxacin is better because it is tolerated with fewer side effects. And some studies show that Cipro is more effective than Metronidazole.
  • Cipro vs. Cefpodoxime: Cefpodoxime is a third-generation cephalosporin. But it has been used too much, and some bacteria have developed resistance. According to a study, Cipro has 4% resistance to urinary tract bacteria, and Cefpodoxime has 8%.
  • Cipro vs. erythromycin: They are both used to treat patients with chancroid, a sexually-transmitted disease. But studies show that Cipro is equally effective with fewer adverse effects. 

So, if you want to know why Cipro is prescribed instead of other antibiotics, it is because it is better tolerated. Side effects are less common in Cipro compared to others. Additionally, more bacteria are still sensitive to Ciprofloxacin.

Why is Cipro considered a strong antibiotic?

Ciprofloxacin is considered a strong antibiotic because it has a low level of resistance. As mentioned above, bacteria are still sensitive to Cipro. In other words, Cipro is still able to clear the infection.

However, this is an ever-changing situation because a potent antibiotic may become weak in the future. That’s because bacteria create resistance when we use an antibiotic too much.

Thus, patients are encouraged not to take Ciprofloxacin without a prescription. If they have a prescription, it should be followed strictly. Otherwise, the bacteria may create resistance against the antibiotic.

Alternatives to Ciprofloxacin

Doctors may try different alternatives to ciprofloxacin in case of hypersensitivity reactions or severe side effects. It depends on the type of infection you need to solve. 

For instance, Cipro is the first choice treatment for acute pyelonephritis, typhoid and paratyphoid fever, prostatitis, low-risk neutropenia, and infectious gastroenteritis or colitis.

  • In acute pyelonephritis, patients may receive ceftriaxone or cefotaxime when Cipro cannot be used. These are third-generation cephalosporins.
  • In typhoid and paratyphoid fever cases, the first choice treatment can be Cipro but ceftriaxone and azithromycin. The latter belongs to the antibiotic group of macrolides.
  • In the case of prostatitis and other inflammatory diseases of the prostate, ceftriaxone and cefotaxime are considered the second option in mild to moderate cases and the first option in severe cases.
  • In infectious gastroenteritis or colitis, Cipro is only used when the pathogen bacteria has not been identified. In such cases, there are many alternatives to ciprofloxacin, including ceftriaxoneazithromycin, and sulfamethoxazole + trimethoprim, which is a bacteriostatic sulfonamide.

Ciprofloxacin can also be considered the first choice for patients with allergies to penicillin and other first-choice drugs. 

Even in such cases, there is a long list of alternatives doctors can consider depending on each case.

There are also natural antibiotics in plants and herbs such as garlic, oregano, onions, clove, and ginger. Their phytonutrients and other components are active against various microbes. 

However, the list of sensitive bacteria is not the same as ciprofloxacin, and the effectiveness is not the same. Thus, they may serve as adjunctive therapy but do not replace antibiotic treatment when a doctor recommends it.


Ciprofloxacin, also known as Cipro, is a very useful antimicrobial agent. It is a quinolone, similar to levofloxacin. 

Cipro works by slowing down the replication of the bacteria and inducing DNA breaks. It is a strong antibiotic with a very wide spectrum and works for different types of infections.

However, Cipro has various side effects that include rare and severe adverse events and more common and mild problems. Common Cipro side effects include nausea, headaches, diarrhea, and other gastrointestinal complaints.

Rare and severe side effects of Cipro include myasthenia gravis and other neuronal problems, arrhythmia, and prolongation of the QT interval in electrocardiograms and others. Some patients may also develop allergies to fluoroquinolones, but this is not very common.

When taking Ciprofloxacin, we should also consider not drinking alcohol, milk, or dairy products. Ciprofloxacin will also interact with drugs that prolong QT interval or make it less effective. Thus, inform your doctor if you’re taking medications or have any chronic conditions.

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what to avoid when taking cipro

What To Avoid When Taking Cipro.


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