Ciprofloxacin

What it is

Ciprofloxacin is a fluoroquinolone antibiotic. It blocks the bacterial enzymes that coil and uncoil DNA, so the bacteria cannot copy their genetic material and die. It is used for bacterial infections, particularly of the urinary tract, gut and other sites where the class is active.

Used for

• Bacterial infection

What to know while taking it

It is taken with or without food, but kept apart from dairy, calcium-fortified juice, antacids and mineral supplements, because calcium, iron, magnesium and zinc bind it into a complex the gut cannot absorb, and it lowers those minerals in turn. Strong sun and tanning beds are avoided, as the skin burns more easily on this drug; probiotics are spaced a few hours away, and the course is finished in full. It raises the effect of warfarin, and creatinine and ALT are monitored because the kidneys clear it and the liver can react to it.

When to see a doctor

Pain, swelling or snapping sensation in a tendon, most often the Achilles, means stopping activity and seeing a doctor, as tendon rupture is a rare but real risk. Palpitations or fainting from QT prolongation, new numbness or tingling, blistering sunburn, or severe or bloody diarrhoea also warrant medical review.

Worth knowing

• Rare tendon damage
• Separate from dairy
• Avoid strong sun
• Can prolong the QT interval
• Finish the full course

Markers to watch

• Creatinine
• ALT

Nutrients affected

• calcium — absorption blocked with (Calcium, ionized, Calcium, total, Ferritin)
• iron — absorption blocked with (Ferritin, Hematocrit, Hemoglobin)
• magnesium — absorption blocked with (Glucose, HOMA-IR, Magnesium)
• zinc — absorption blocked with (Free T3, Testosterone, TSH)