Ciprocinal 500 mg film-coated tablets – ciprofloxacin, an antibiotic for bacterial infections

Ciprocinal contains ciprofloxacin, an antibiotic from the fluoroquinolone group. Ciprofloxacin kills the bacteria that cause infections and works only against certain types of bacteria.

In Serbia it is authorised as Ciprocinal 500 mg film-coated tablets in a pack of 10 tablets (manufacturer Zdravlje AD Leskovac, marketing authorisation holder Actavis d.o.o. Beograd) and is a prescription-only medicine.

What is Ciprocinal used for and how should it be taken?

Key facts about the medicine

What is Ciprocinal used for?

In adults, according to the patient leaflet and the Summary of Product Characteristics, Ciprocinal is used for the following bacterial infections:

• respiratory tract infections (lower respiratory tract)
• long-lasting or recurrent ear or sinus infections (acute exacerbation of chronic sinusitis, chronic suppurative otitis media, malignant otitis externa)
• urinary tract infections – uncomplicated acute cystitis (only when other recommended antibiotics cannot be used), acute pyelonephritis, complicated infections, bacterial prostatitis
• genital infections in men and women (gonococcal urethritis and cervicitis, epididymo-orchitis, pelvic inflammatory disease)
• gastrointestinal infections (e.g. travellers’ diarrhoea) and intra-abdominal infections
• skin and soft tissue infections caused by Gram-negative bacteria
• bone and joint infections
• prevention of invasive infections caused by Neisseria meningitidis
• inhalational anthrax (post-exposure prevention and treatment)
• patients with a low white blood cell count (neutropenia) and fever suspected to be caused by a bacterial infection

In children and adolescents, under the supervision of a specialist, the medicine is used for lung and bronchial infections caused by Pseudomonas aeruginosa in cystic fibrosis, complicated urinary tract infections and acute pyelonephritis, inhalational anthrax and, if the doctor considers it necessary, other severe infections.

For severe infections or infections caused by more than one type of bacteria, your doctor may prescribe an additional antibiotic.

How is it taken and dosed?

Your doctor decides the number of tablets, timing and duration of treatment according to the type and severity of infection, the sensitivity of the bacteria and your kidney function. Treatment usually lasts 1 to 21 days, and sometimes longer in severe infections.

Overview of adult doses from the Summary of Product Characteristics (total duration includes any initial infusion therapy):

• Swallow the tablets whole with enough liquid – do not chew them.
• Take them at about the same time every day, with or between meals.
• Do not take them with milk, yoghurt or calcium-fortified fruit juices; calcium in an ordinary meal does not significantly affect absorption.
• Take products containing calcium, magnesium, aluminium or iron, antacids, sucralfate and phosphate binders at least 4 hours before or 2 hours after the medicine.
• Drink plenty of fluids during treatment.

Do not chew the tablets as they have an unpleasant taste. The tablet has a score line and can be divided into equal doses; your doctor decides the number of tablets.

This is the general dosage from the official documentation – your doctor determines your dose.

Special patient groups

• Children and adolescents: only for the listed indications and under specialist supervision; the dose is calculated by body weight (e.g. 10–20 mg/kg twice a day for complicated urinary tract infections, maximum 750 mg per dose). Joint pain and inflammation are common in children.
• Elderly: the dose depends on the severity of infection and kidney function; there is a higher risk of tendon damage (especially with corticosteroids) and heart rhythm disorders.
• Impaired kidney function: the dose is reduced according to creatinine clearance:

• Impaired liver function: no dose adjustment is needed.

Contraindications – when the medicine must not be used

• allergy (hypersensitivity) to ciprofloxacin, other quinolone antibiotics or any of the excipients
• concomitant use of tizanidine (a muscle relaxant) – possible drop in blood pressure and drowsiness

A fluoroquinolone, including this medicine, should not be taken if you have previously had a serious side effect with a quinolone or fluoroquinolone – tell your doctor.

Warnings and precautions

• kidney disease (a dose reduction may be needed)
• epilepsy or other neurological conditions (risk of seizures)
• previous tendon problems during quinolone treatment; age over 60, organ transplantation, kidney disease or concomitant corticosteroid treatment increase the risk of tendon inflammation and rupture
• diabetes – risk of low blood sugar (hypoglycaemia)
• enlargement (aneurysm) or tear (dissection) of the aorta, or a family history of it, or conditions that increase the risk (e.g. Marfan or vascular Ehlers-Danlos syndrome, Takayasu arteritis, giant cell arteritis, Behçet’s disease, hypertension, atherosclerosis); incompetent closure of a heart (mitral) valve with backflow of blood (regurgitation) or a family history of congenital heart valve disease; Turner or Sjögren syndrome
• myasthenia gravis (symptoms may worsen)
• heart disease, congenital QT prolongation (also in the family), low blood potassium or magnesium, slow heart rate, heart failure, previous heart attack, female sex, older age or medicines that prolong the QT interval
• glucose-6-phosphate dehydrogenase deficiency (risk of anaemia)
• worsening of depression or psychosis, signs of nerve damage (pain, burning, tingling, weakness in arms and legs), visual disturbances – contact your doctor immediately
• severe or persistent diarrhoea, especially with blood or mucus, during or weeks after treatment – stop the medicine, do not take medicines that slow the bowel and contact your doctor
• signs of liver damage (loss of appetite, jaundice, dark urine, itching, tender abdomen) or an infection with fever and poor general condition (possible fall in white blood cells) – stop the medicine and contact your doctor
• skin sensitivity to sunlight and UV light – avoid strong sun and sunbeds
• before blood or urine tests, say that you are taking ciprofloxacin

Interactions with other medicines, food and drink

• tizanidine – must not be combined
• vitamin K antagonists (warfarin, acenocoumarol, phenprocoumon, fluindione) and other oral anticoagulants; probenecid, methotrexate, theophylline, olanzapine, clozapine, ropinirole, phenytoin, metoclopramide, ciclosporin, zolpidem – tell your doctor
• medicines affecting heart rhythm (antiarrhythmics such as quinidine, disopyramide, amiodarone, sotalol, dofetilide, ibutilide; tricyclic antidepressants; macrolide antibiotics; some antipsychotics)
• ciprofloxacin increases blood levels of pentoxifylline, caffeine, duloxetine, lidocaine, sildenafil and agomelatine
• antacids, omeprazole, mineral supplements, sucralfate, phosphate binders (sevelamer, lanthanum carbonate) and products containing calcium, magnesium, aluminium or iron reduce the effect – take ciprofloxacin 2 hours before or at least 4 hours after them
• dairy products (milk, yoghurt) and calcium-fortified drinks should not be taken at the same time as the medicine

Pregnancy and breast-feeding

As a precaution, the use of ciprofloxacin should be avoided during pregnancy (harm to the cartilage of the unborn child cannot be excluded). The medicine must not be taken while breast-feeding, as ciprofloxacin passes into breast milk and may damage the infant’s joints. If you are planning a pregnancy, tell your doctor.

Driving and using machines

Ciprofloxacin can reduce alertness and cause neurological symptoms, so it may prolong reaction time. Check how you react to the medicine before driving or using machines.

Possible side effects

• Common: nausea, diarrhoea; in children joint pain and inflammation.
• Uncommon: joint pain in adults, secondary fungal infections, reduced appetite, agitation, headache, dizziness, sleep or taste disturbances, vomiting, abdominal pain, heartburn, wind, raised liver enzymes, rash, itching, hives, reduced kidney function, muscle and bone pain, weakness, fever.
• Rare: antibiotic-associated colitis, changes in blood cell counts, allergic swelling (angioedema), raised or lowered blood sugar, confusion, anxiety, depression, hallucinations, tingling, trembling, visual and hearing disturbances, ringing in the ears, fast pulse, drop in blood pressure, difficulty breathing, jaundice or hepatitis, sensitivity to light, crystals or blood in the urine.
• Very rare: severe allergic reaction (anaphylaxis), tendon inflammation and rupture (especially the Achilles tendon), severe blistering skin rashes (Stevens-Johnson syndrome, toxic epidermal necrolysis), serious blood disorders, psychotic reactions, pancreatitis, liver necrosis, worsening of myasthenia gravis.
• Frequency not known: mania, severe heart rhythm disorders (QT prolongation, torsades de pointes), neuropathy, low blood sodium (SIADH), hypoglycaemic coma, DRESS syndrome, AGEP, backflow of blood due to heart valve incompetence.

Very rare long-lasting or permanent side effects of fluoroquinolones (tendons, joints, nerves, depression, fatigue, sleep and memory problems, impaired hearing, vision, taste and smell) and cases of aortic aneurysm or dissection have also been reported. Report suspected side effects to your doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• Overdose: contact your doctor or emergency service immediately and take the pack with you. Symptoms may include dizziness, trembling, headache, tiredness, seizures, hallucinations, confusion, abdominal discomfort and kidney and liver damage.
• Missed dose: if 6 hours or more remain until the next dose, take the missed dose straight away; if less than 6 hours remain, skip it and take the next dose at the usual time. Do not take a double dose.
• Stopping treatment: do not stop treatment early even if you feel better – the infection may return and bacteria may become resistant to the antibiotic.

Related information

For additional support of the intestinal flora during and after antibiotic treatment, see also the Products with probiotics category – products in this category do not replace the medicine you have been prescribed.

Composition, pack and manufacturer

• Active substance: ciprofloxacin – 500 mg per film-coated tablet (as 583 mg ciprofloxacin hydrochloride).
• Excipients – core: colloidal anhydrous silica; magnesium stearate; crospovidone; microcrystalline cellulose PH101; povidone K 30. Coating: hypromellose; macrogol 6000; titanium dioxide (E171).
• Pack: carton with 2 PVC/Alu blisters of 5 film-coated tablets (10 in total).
• Marketing authorisation holder: ACTAVIS D.O.O. BEOGRAD, Đorđa Stanojevića 12, Belgrade. Manufacturer (according to the ALIMS renewal list 2024): ZDRAVLJE AD Leskovac, Vlajkova 199, Leskovac.

Storage

• Store below 25 °C in the original package to protect from light and moisture.
• Keep out of the sight and reach of children.
• Do not use after the expiry date (shelf life: 3 years).

Frequently asked questions

How long is Ciprocinal taken?

It depends on the infection – from a single dose (e.g. gonococcal urethritis) to several weeks (e.g. prostatitis or bone infections). Your doctor always decides the duration.

What should I do if I miss a dose?

If 6 hours or more remain until the next dose, take the missed one straight away; if less than 6 hours remain, skip it. Never take a double dose.

Can I drink coffee during treatment?

According to the leaflet, ciprofloxacin can increase blood levels of caffeine. If you drink a lot of coffee or caffeinated drinks, ask your doctor or pharmacist.

What should I do if I get diarrhoea during treatment?

Diarrhoea is a common side effect. If it is severe, persistent or contains blood or mucus – during or even several weeks after treatment – stop the medicine, do not take medicines that slow the bowel and contact your doctor immediately.

Sources

• ALIMS – Summary of Product Characteristics Ciprocinal®, 500 mg, film-coated tablets (April 2024, Serbian)
• ALIMS – Patient leaflet Ciprocinal®, 500 mg, film-coated tablets (April 2024, Serbian)

Sources checked on: 24 October 2026.